Fatigue from rheumatoid arthritis (RA) can feel like a heavy fog that won’t lift, no matter how much rest you get. It’s more than just being tired — it can affect your focus, mood, and ability to get through the day. Fatigue is one of the most common and frustrating symptoms of RA. If you’re looking for ways to feel more like yourself and get some energy back, you’re not alone.

Studies show that people with RA experience fatigue levels four to eight times higher than those without the condition. In fact, 93 percent of members on myRAteam reported fatigue, which can have a significant impact on quality of life. Most of these members (70 percent) also said fatigue is a trigger that makes their RA worse.

“I’ve been very tired and fatigued (which makes it all worse). How do you all deal with fatigue? Any tips?” one myRAteam member asked.

“Sometimes I think the fatigue is worse than the pain,” another member wrote.

Chronic fatigue from RA goes beyond ordinary tiredness. It can drain you physically and emotionally, making daily life feel overwhelming.

People with RA may feel uncomfortable bringing up fatigue with their rheumatologists. And sometimes even if they do, they end up feeling dismissed or ignored. Fortunately, research and awareness about RA fatigue are growing. Meanwhile, you can take proactive steps to get some of your energy back.

What Causes Fatigue in Rheumatoid Arthritis?

People with RA may have fatigue from the condition itself or another related condition. RA is a type of inflammatory arthritis. Its high inflammation levels can cause feelings of sickness and low energy.

RA can also contribute to fatigue because of:

• Joint pain
• Depression
• Disability from RA
• Sleep disturbance, such as sleep apnea

Many related health conditions, called comorbidities, that can occur with RA may increase fatigue as well, such as:

• Asthma — Causes the airways to swell and makes breathing difficult
• Cardiovascular disease — A group of conditions that affect the heart and blood vessels
• Chronic obstructive pulmonary disease (COPD) — Lung disease that makes it hard to breathe and gets worse over time
• Diabetes — Affects how the body controls blood sugar
• Anemia — A possible side effect of the RA medication methotrexate, but it can also appear due to ongoing inflammation in the body
• Fibromyalgia — A long-term condition that causes body pain, tiredness, and sensitivity to touch

If your fatigue interferes with your daily life, talk to your healthcare provider. In the meantime, here are five ways to manage RA fatigue.

1. Find Exercises That Work for You

Exercise can improve RA symptoms and boost energy. Stretching, short walks, water exercises, and yoga are all recommended for people with RA.

“Look for chair exercises on YouTube. I especially like chair tai chi and chair yoga,” one myRAteam member suggested.

Another member wrote, “I have exercised with my RA for many years, and with that and medication, I don’t get many flare-ups. I am 75, and I continue to walk and exercise.”

Appropriate routines that incorporate exercises for range of motion, flexibility, aerobics, and strengthening can improve physical and mental health for people with RA.

Regular physical activity can:

• Help you maintain a healthy weight and stronger muscles and bones
• Reduce the risk of conditions such as cardiovascular disease, type 2 diabetes, and cancer
• Trigger the release of endorphins, which can boost your mood

Getting Started

Start slowly and build up your stamina over time. Talk to your healthcare team about exercise. You can ask for a referral to a physical therapist who can develop an exercise program that’s right for you. They can teach you exercises to do at the gym or at home.

“Have you discussed having hand therapy, occupational therapy, and physical therapy with your rheumatologist?” a myRAteam member asked. “They really helped me to be able to do everyday things.”

2. Choose Foods for Steady Energy

A healthy diet helps regulate energy highs and lows. Cutting back on sugar and pacing smaller meals throughout the day can help you avoid reactive hypoglycemia — a sugar crash that contributes to low energy levels.

Other healthy eating habits to reduce fatigue include:

• Skipping sugary cereals and high-fat meats at breakfast
• Drinking plenty of water to prevent dehydration, which causes headaches and fatigue
• Avoiding foods that upset your stomach or cause heartburn, which can lead to poor sleep

Your doctor can provide a referral to a nutritionist who can help design a healthy diet for you.

A member said, “A healthy snack can give a boost — my favorites for that are unsalted nuts, dried apricots, or one or two dark chocolate candies.”

3. Take Breaks When Needed

Self-care is essential to managing RA fatigue. Knowing your limits and sticking to them is a good place to start. Sometimes, you may simply need to stop what you’re doing and sit down or take a rest.

“Try to rest more and don’t feel guilty,” said a myRAteam member.

Another member advised, “Pick one day a week just for you. Relax, sleep in, or take a nap. Even if you do work, take one day on the weekend for yourself.”

Keep a schedule that puts your well-being first and leaves enough time for a good night’s sleep. Arrange your to-do list based on when you know you’ll have the most energy. One member wrote, “I do what I can in the morning because, if I don’t get my chores done early, I’m too tired in the afternoon. I try to rest more in the afternoon.”

4. Seek Mental Health and Social Support

Often, the anxiety of having an illness like RA can be exhausting. Others may not understand what you’re going through. Letting loved ones and friends know about your fatigue can help you better manage daily activities and social interactions. Family members and friends may need guidance when it comes to offering help.

If your workday is difficult to manage, reach out to your supervisor or human resources manager. Discuss your work schedule, working from home, or other changes to help get your job done without it being too tiring.

You may also want to ask your healthcare provider for a referral to counseling. Counseling or therapy can help relieve anxiety. A trained therapist can give you tools and techniques to manage stress and mood swings and to communicate better with others.

There’s even research that psychological therapy can relieve fatigue. People with RA who participate in a form of therapy called cognitive behavioral therapy (CBT) may feel less tired, get more sleep, and manage pain better. CBT is a type of talk therapy that helps people notice unhelpful thoughts and behaviors and learn how to change them.

5. Discuss Fatigue During Doctor’s Visits

Maintaining your RA treatment plan is crucial for good energy levels. Fortunately, almost all types of commonly used RA medications can help lower fatigue. They work by reducing inflammation, chronic pain, and disease activity.

For example, a review of 32 studies found that treating RA with biologic drugs can help reduce fatigue. Biologics are medications made from living cells that target specific parts of the immune system. Janus kinase (JAK) inhibitors are another type of RA treatment. These drugs block certain enzymes that affect how the immune system works. Studies suggest that JAK inhibitors may also help relieve RA-related fatigue.

Be sure you’re getting the support you need from your healthcare team. If you’re not sure how to explain RA fatigue, start by explaining its effect on your daily life. Talk to your doctor about other conditions you may have. For instance, anemia (low levels of red blood cells) could contribute to fatigue. You may need more testing to find out if there’s another problem that requires treatment.

Your doctor can also review and adjust medications if needed. They can see if you might benefit from supplements, vitamins, a sleep aid, or an antidepressant to help improve your energy levels. Always get medical advice before taking any new supplements. Some may interact with your other treatments.

Talk With Others Who Understand

On myRAteam, the social network for people with rheumatoid arthritis and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with RA.

Is severe fatigue one of your usual RA symptoms? Have you found any lifestyle changes or tips that help fight fatigue? Share your experiences in the comments below, or start a conversation by posting on your Activities page.