Autumn is slowly turning into winter and with the darker nights I get an urge to hibernate.Some of this is just my response to cold, wet evenings and some of it is the effects of feeling exhausted by arthritis. Before we get into the ins and outs of what to do when you feel exhausted, I want to explain what I mean by 'fatigue' or 'tiredness' when you suffer from the pain of arthritis. Sometimes, those of us with arthritis feel ordinarily tired: exhausted, cranky and like we could do with an extra 6 hours in bed. However, when your arthritis is flaring the fatigue is nothing like that 'ordinary tired' feeling. It feels like someone has simply taken your battery out (a friend once said it was like being the opposite of the Duracell bunny!). Sleep doesn't particularly help and you tend to feel like you are wandering around with lead for limbs and borscht for brains.
Why does this happen? Well, arthritis pain is both physically demanding and mentally exhausting. The inflammation that causes pain taxes your body - systemic inflammation over time can lead to anaemia and cachexia (loss of lean body mass), both of which increase feelings of fatigue. Medications that help tackle inflammation, like anti-inflammatories or disease modifying drugs, can also cause side effects which increase fatigue. Anyone who has had a 'methotrexate hangover' will recognise well the feeling of being utterly wiped out by a medication. Diet can help to some extent with this kind of arthritis fatigue. Eating plenty of omega 3 rich foods can help reduce inflammation and you can also support your body by making sure you are getting enough B vitamins and iron through eating plenty of wholegrains, leafy greens and even lean red meat.
Pain can make it difficult to sleep which leads to even more fatigue. Arthritis can stop you getting comfortable at night or wake you in the early hours of the morning. Some people with arthritis call this , fittingly, 'painsomnia'. Luckily you can help tackle some of the causes of insomnia through diet. Try not to eat anything heavy, spicy or tough on the digestive system in the 3 hours before bedtime. Instead try a light snack to help balance your blood sugar that is rich in calcium, magnesium and the amino acid, tryptophan. A bowl of milky porridge (oatmeal) or a chicken sandwich on wholemeal bread both provide the right mix of sleep-encouraging nutrients.
Finally, being tired and in pain makes shopping,cooking and eating healthily a challenge. It can be very tempting to reach for something instant or ready made when you are totally exhausted. However, people with all kinds of arthritis have been shown to be more likely to be deficient in vitamins C, E, folic acid and calcium than people without the condition, probably due to the difficulties preparing food you are shattered. Shortages of these nutrients can exacerbate fatigue and make it harder to bounce back from pain. A well-balanced healthy diet can help you cope - try stocking the freezer up with pre-prepared home made meals, frozen veg and fish and even healthier ready meals (see here for tips) so you have a stash of easy, healthy options when you feel a flare coming on.
And, if all this sounds too much like hard work and you just want to get into bed or slump on the sofa - go for it. Sometimes you need to listen to what your tiredness is telling you.