Many people use the words fatigue and tired interchangeably — but for people living with a chronic illness like inflammatory arthritis, there is a huge difference.
Fatigue is a medical symptom. And, unlike being tired, a steady stream of caffeine or night of quality sleep isn’t enough to jolt you back to life. And you can’t always pinpoint why you have fatigue, as there are often many causes including anxiety and depression, inflammation, pain, medication, sleep issues, and/or other chronic health conditions.
It’s “very hard to restore energy when you have a chronic illness,” says Jessica R. Berman, MD, a rheumatologist at Hospital for Special Surgery in New York City. “I often encourage my patients to think about their energy as gas in a car. They don’t have a full tank; they’re starting with half a tank.”
This serves as a reminder that they need to plan how to use their energy. Here are a few tips, from Dr. Berman and members of the CreakyJoints and Global Healthy Living Foundation community, for increasing — and saving — your energy during the day.
How to Increase Your Energy with a Chronic Illness
Working with your health care provider is the best way to determine what’s causing your fatigue — and to come up with a plan for restoring some of your energy. In the meantime, these strategies can also help.
When we asked CreakyJoints community members on Facebook, Twitter, and Instagram how they keep their energy up when battling a chronic illness, the overwhelming majority said moving their body gives them a much-needed boost.
Daryland B. aims for 30 minutes per day — 15 minutes on the elliptical and 15 minutes on treadmill — while Cristina swears by a short walk outside. Colleen dances in her recliner.
“I can’t emphasize enough how much exercise helps with energy,” says Dr. Berman, who recommends starting very slowly. “I have my patients work with a physical therapist to set up a program that slowly increases their movement,” she says.
For example, someone may start by riding on a bike for two minutes, twice a week, increasing their time and frequency gradually each week.
“It’s important to just do something, even if it’s not a lot,” Dr. Berman says. “Over time that will help your muscles become more efficient when you use them, which leads to you having more energy.”
Take a rest
Another popular energy-boosting method among community members: a power nap. “I love a nap when I can take one,” says Laurie O.
Although Dr. Berman says a nap won’t completely revitalize you, it can help you get some “appropriate rest,” so the fatigue doesn’t hit you even harder. “Don’t feel ashamed to nap if you can,” she says.
The National Sleep Foundation says the ideal nap time is between 10 and 20 minutes, so make sure you set your alarm. Anything less can prevent you from moving deep enough through sleep stages, and anything more (over 30 minutes, for example) can lead to sleep inertia, or a prolonged period of drowsiness following a nap, say researchers.
Read more here about tips for napping when you have arthritis.
Sip some coffee
Caffeine is a go-to energy booster for everyone, chronic illness or not. And not surprisingly, many CreakyJoint members swear by their morning cuppa Joe to get going — “I need my large Timmy’s coffee to fuel my day,” says Sammy J.
While a cup of coffee in the A.M. is okay, Dr. Berman warns against overdoing it. “Too much caffeine can be detrimental,” she says. Excessive caffeine consumption is known to increase anxiety and disrupt the sleep-wake cycle, which can worsen fatigue.
How to Preserve Your Energy with a Chronic Illness
When your energy tank is low, you need to plan out your day, says Dr. Berman. Here are some of her top suggestions for using your energy smartly and preserving some of it for more daunting tasks throughout the day. Many of these tips fit into what’s known as energy pacing, or techniques to conserve energy when you live with conditions that cause chronic fatigue.
Shrink your To-Do list
Just because something is on your To-Do list doesn’t mean it needs to be done in the next 24 hours — or even the next few days, if we’re being honest.
If you’re making a list of things that need to get done each day, make sure you write them in order of priority from top to bottom. For example, going grocery shopping when your fridge is near empty is a must-do, but cleaning the house for company that’s coming in a few days can probably wait.
Once you have organized your list, cross off the bottom three items, says Dr. Berman. You’ll immediately feel lighter knowing there’s less to do and won’t push yourself past the limits to get it all done.
Reduce repetitive motion
Bend. Lift. Repeat. While that combination may be fine for a fitness class, it’s not a good idea if you’re trying to save some energy.
“Repetitive bending, pushing, twisting — all those things can use up energy,” says Dr. Berman. She advises minimizing any activities that require repetitive motion. Consider doing chores and errands like laundry, unloading the dishwasher, putting away groceries, or meal planning in small chunks throughout the day.
Do you get exhausted standing by the sink and doing dishes? Does the mere thought of showering and getting dressed each morning make you want to take a nap? For people with chronic illnesses, these little daily tasks can add up and drain your energy. Fortunately, there are several tools that you can purchase (or craft yourself) to make it easier.
Some arthritis-friendly aids to consider:
- Duster with extendable handle to clean blinds, baseboards, and fans
- Button hooks to wrap around buttons so you can thread them without using a pincer grasp with your pointer finger and thumb
- Long-handed dustpans and brooms so you can sweep without having to bend over
- Long-handled scrub brush to clean the shower/tub and windows
- Nylon or terrycloth bath mitt to allow you to use your entire arm to clean instead of small hand joints
- Rolling laundry basket to transport laundry
- Self-propelled or robot vacuum
- Shoehorns to put shoes on and take them off
- Shower chair so you can sit while you bathe
- Small stepstool to sit on when cleaning surfaces close to the ground
- Sock aids that help you put your foot into it and pull your sock up on your leg without having to bend down and use finger dexterity and hand strength
- Steam mop to loosen the dirt so it’s easier to sweep
- Thick kneeling pad to provide comfort when you have to kneel to complete chores
- Zipper pulls to “hook” your fingers through the opening and pull down using large arm muscles rather than tiny finger muscles
Ask for help
“I think some people [with chronic illnesses] are hesitant to ask [for help] because they want to maintain their independence,” says Dr. Berman. But leaning on loved ones doesn’t mean you’re solely depending on them. In many cases, your loved ones may be grateful that you asked.
“Oftentimes, friends and family members understand the struggles and want to help, but just don’t know how,” says Dr. Berman. Be specific about the things they can do for you.
If you have the financial means, you can also consider hiring services like grocery delivery, wash and fold, or house cleaning.
How to Talk to Your Doctor About Fatigue
If you find that your energy is limited and you’re struggling to get through your usual daily routine, it is important to speak to your health care provider. Together, you can determine if your fatigue is a sign that your disease is progressing or needs to be treated more aggressively. Or you might have other medical conditions that are causing or exacerbating your fatigue. In chronic illness, it’s common for fatigue to result from multiple causes, which can require multiple treatment approaches.
When talking with your health care provider about fatigue, Dr. Berman says you should bring it up at the start of your appointment. “Often, we’re very busy making sure the medications and labs are ordered or addressing parts of people’s disease that we get more concerned about,” she says. “For example, we may be focused on pain because that’s something we can fix.” Mentioning fatigue early in the visit and emphasizing how big of an issue it is for you, helps ensure that you and your provider will address it.
Dr. Berman suggests describing how fatigue is affecting your quality of life. What is it preventing you from doing? This will allow you and your doctor to start a dialogue about fatigue and what may be causing it. After all, several things may contribute to your lack of energy that aren’t necessarily directly related to your chronic illness, including infections, sleep apnea, and medication side effects, says Dr. Berman.
Remember, your health care team cannot help if don’t speak up. By voicing your concerns, you have a better chance of finding a solution that manages your disease without draining you of energy.
Fry A. Napping. The National Sleep Foundation. https://www.sleepfoundation.org/sleep-hygiene/napping.
Hilditch CJ, et al. A 30-minute, but not a 10-minute nighttime nap is associated with sleep inertia. Sleep. March 2016. doi: https://doi.org/10.5665/sleep.5550.
Interview with Jessica R. Berman, MD, Rheumatologist at Hospital for Special Surgery in New York City.