Why Psoriatic Arthritis (PsA) Causes Fatigue And How To Manage It

Many people associate psoriatic arthritis (PsA) with itchy, scaly skin and joint pain, but excess fatigue is also a symptom for at least 50% of people with PsA.

Fatigue from PsA might be mild, moderate, or severe. It can happen without warning, even if you haven’t done anything strenuous.

Sometimes healthcare providers underestimate how many people with PsA have fatigue and how severely the fatigue impacts people’s quality of life.

Fatigue is a common symptom for PsA and many other autoimmune and inflammatory conditions. PsA causes your immune system to mistakenly attack itself, which can cause fatigue.

Someone with PsA may also experience fatigue because they’re likely not getting enough good-quality sleep.

PsA symptoms that can cause sleep challenges and trigger fatigue include:

Untreated joint pain or skin symptoms
Anxiety and depression
Social stressors and psychological (mental) stress

When fatigue is severe, simple activities like taking a shower might feel challenging. Even if your fatigue is mild to moderate, you might need to cut out some of your regular activities and get more rest.

The amount of fatigue you experience can vary day to day, which can sometimes make it hard to have a set schedule. Fatigue can cause stress, disappointment, and frustration because it can affect how you function in your daily life.

Fatigue can also impact your thinking and problem-solving skills while working, keeping you from doing your best at your job and decreasing your productivity.

Managing fatigue requires a balance. When fatigued, you’ll need more rest than usual to get your energy back, and you won’t be able to take on as many tasks. Pushing too hard can make things worse.

However, small changes can help you improve your overall quality of life. Psychologists, occupational therapists, and related professionals often recommend pacing yourself to help you make the most of your energy without setting yourself back. Pacing is adjusting your daily activities by adding breaks or slowing down when needed.

Consider trying the following tips to help manage your fatigue:

Be realistic about how you feel, and prioritize your most important tasks since you may only have a certain amount of energy to spend in a particular day.
Exercise when you can. Low-impact exercises like walking or swimming may be better than high-impact exercises. When you’re very tired, it’s okay to rest or scale back your exercise, such as walking for 10 minutes instead of half an hour.
Find time for hobbies and activities that decrease your stress and bring you joy. These can increase your natural energy.
Experiment with your diet. Foods and drinks high in sugar may give you a quick boost but cause energy crashes. Getting enough fruits and vegetables, protein, and healthy fats like olive oil can help keep your energy up.
Avoid smoking and drinking since they can make symptoms worse.
Avoid caffeine—at least in the afternoons or evenings—and have a set bedtime every night. Make your bedroom a quiet and restful space, and avoid using screens close to bedtime. Budget enough time for a full night’s sleep, and take short naps early in the day if needed.

Adjust your medications for PsA if needed, such as switching to a different treatment or increasing your dose. Biologics—drugs made from living substances—may help with fatigue. Options include tumor necrosis factor (TNF) inhibitors like Enbrel (etanercept).

If you have chronic fatigue from PsA, your healthcare provider may suggest specific local resources, such as community support groups or recommendations on mental health providers. Other management options include counseling, therapy, meditation, prayer, listening to music, or walking in nature.

Communicating your needs with your family, friends, and colleagues is also important. Because fatigue is an invisible PsA symptom, it may be difficult for others to understand what you’re experiencing. Sharing your experience can make it easier to make accommodations.

Although not a part of standard medical recommendations, some people with chronic fatigue from illnesses like PsA report benefits from programs marketed for brain retraining or nervous system integration. These may help decrease your stress while building self-acceptance and a positive attitude, which may help gradually reduce your fatigue.

If you have PsA, consider having regular checkups with healthcare providers like a rheumatologist (a doctor who specializes in immune system and musculoskeletal health). A rheumatologist can help you find ways to decrease your fatigue, including prescribing medications and treating other possible causes of fatigue.

Seek immediate medical attention if you have: