OA and Fatigue

OA and Fatigue

Coping With Fatigue and Chronic Pain

Fatigue is defined as the lack of energy, or lethargy of body and mind, possibly caused by sleep deficit, hormone deficiency, or other diseases. It has been proven to be associated with cognitive problems, reduced job performance, reduced motivation, increased safety risks, and numerous negative physiological changes. Fatigue-related problems are also believed to cost the United States an estimated $18 billion dollars per year in lost productivity and accidents. More than 1,500 fatalities, 100,000 crashes, and 76,000 injuries annually are attributed to fatigue-related drowsiness on the roads.

For people suffering pain from osteoarthritis, fatigue can be a natural result of their condition. It is simply exhausting to deal with an unpleasant feeling, like pain, for days on end. Doctor’s appointments, medication, and anticipating the pain, all take an emotional and physical toll on one’s energy. Some people with non-apparent disabilities, such as osteoarthritis, can become tired by the constant effort required to pass as non-disabled. Sometimes the pain does not go away when resting or laying down. The pain can make it difficult to get a good night’s sleep or concentrate on relaxing when one uncomfortable.

Sleep is Important

Simply put, sleep is very important. The National Sleep Foundation details how crucial sleep is to our well-being and energy levels. Sleep has been proposed to be a physiological adaptation to conserve energy and heal; it restores energy to our bodies, helps clear waste from the brain, and can even clear out negative emotions from our thought process. If someone with osteoarthritis manages to fall asleep, the pain can cause that person to wake up multiple times per night, resulting in low-quality sleep and a general feeling of fatigue.

The Spoon Theory

The fatigue a pain sufferer endures can perpetuate the pain cycle and make one perceive the pain as even worse. This can make completing everyday tasks such as putting on clothes or getting out of bed very difficult. It can also lead to social alienation because you are simply not up for something that requires energy, such as going out or seeing friends. The spoon theory, by Christine Donato, explain why people with a chronic illness have reduced amount of energy available for productive tasks. “Spoons” are used as an intangible unit of measurement to track how much energy a person has every day. Each activity costs a certain amount of spoons and can’t be replaced until the next day. Someone who runs out of spoons loses the ability to do anything other than rest. Pain sufferers must plan their activities to ensure that every day is manageable because their disability uses up a lot of their spoons. On the other hand, healthy people have a never-ending supply of spoons and thus almost never need to worry about running out of them.

One’s energy levels can be improved not only through sleep, but also through exercise and nutrition, maintaining a regular sleep schedule, and supplements or medication.

Exercise and Nutrition

Proper nutrition and a regular osteoarthritis exercise program can help to increase one’s energy when dealing with OA and fatigue. Certain foods, such as raw fruits, vegetables, yogurt, complex carbohydrates, nuts, and lean meats are known to give a boost to one’s energy. Sugar, simple carbohydrates, and fried food are prone to making one feel lethargic and lacking energy. Changing the frequency of your meals can also help to increase energy levels and it varies person to person. Some people achieve a boost with multiple small meals throughout the day, while others prefer the concept of three solid meals every day.

Next page: maintaining a regular sleep schedule and visiting your doctor.

Exercise and Nutrition

Some people turn to caffeine for an energy boost when fatigued and while there are some benefits of coffee, its effects wear off after a couple of hours, cause a “crash”, and can interfere with the natural sleep cycle.

Exercise is also a great way to improve one’s energy levels. In a study published in the Psychotherapy and Psychosomatics journal in 2008, it found that inactive people who normally complained of fatigue could increase energy up to 20% while decreasing fatigue by as much as 65% by participating in a regular, low-intensity exercise program. One might think that exercising would tire a person out even more but it is quite the opposite long-term. Aerobic exercise has been show to spark the mitochondria in our body’s cells to produce more energy to meet the increased energy requirements created by exercise. Although it is probably difficult to exercise with painful osteoarthritis, one can still try a stationary bike, short walks outside, stretches, light weights, and water aerobic exercises.

Maintaining a Sleep diary and Regular schedule

Having a regular time to wake up each morning and go to bed each night can help tremendously with sleep and overall energy levels. Keeping up with a regular sleep schedule can include not lying in bed until its bedtime, wake up around the same time every day, being careful with the length and frequency of naps, adjusting temperatures in one’s bedroom. A regular sleep schedule can also help strengthen circadian rhythms and leads to regular times of sleep onset. Keeping a journal and writing down how you slept each night and factors that could have interrupted with your sleep can help analyze what leads to sleep problems.

Medicine and Visiting Your Doctor

If none of the previous alternative methods mentioned are helping, then it could be time to have a discussion with your doctor about taking supplements or medication for sleep. There are energy providing supplements, such as Vitamin B6, B12, and ginseng that are known to provide a natural energy boost with minimal side effects. There are also several natural sleep aids, such as tryptophan, melatonin, and various herbs that are available at most retail locations. Newer medications in the market are also available that don’t have as many side effects as previous sleeping pills. Open communication with your doctor about osteoarthritis, fatigue, and pain can lead to a proper remedy for these problems.


Fatigue, osteoarthritis, and pain are often linked because of many possible reasons. The pain can be exhausting to deal with every day, interfere with one’s sleep, and cause one to run out of daily spoons, as Donato’s spoon theory suggests. The lack of energy can have many possible consequences; it can perpetuate the pain cycle and make the pain worse, cause irritability, decreased motivation, and a higher risk for work-place or automobile accidents. Fortunately there are a couple of ways to combat the fatigue that may be associated with chronic pain. A nutrition and low-intensity exercise program can help regulate schedules. Maintaining and documenting a regular sleep schedule can naturally increase energy levels and decrease fatigue. Finally, natural and pharmacologic sleep aids are also options after consulting with a doctor. Fatigue may be hard enough to deal with, but the methods described above are just a few ways to help combat the lack of energy associated with osteoarthritis.


ProHealth (Deep Relaxation Techniques for Fibromyalgia Patients)

NCBI (The Effects of Fatigue and Sleepiness on Nurse Performance and Patient Safety)

WebMD (Foods to Fight Fatigue)

WebMD (Exercise for Energy: Workouts that Work)

Help Guide (Sleeping Pills and Natural Sleep Aids)

Help Guide (How to Sleep Better)

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