Everyone gets tired. That is how the body signals it needs to rest and recharge. Overwork yourself physically and you feel it in your muscles or joints. Overwork yourself mentally and you need a break. But when your need for rest seems excessive or becomes disruptive – thwarting your productivity, making everyday tasks seem daunting, robbing you of enjoyment and interaction with others – what once may have been tiredness has become fatigue. But rest assured: There are viable fatigue treatments and means to beat fatigue.

Fatigue often means something sinister is lurking. The symptom accounts for 10 million doctor office visits each year, many of who are by people with arthritis-related conditions. Up to 98 percent of people with rheumatoid arthritis (RA) report fatigue, as do 50 percent or more of those with lupus or Sjögren’s syndrome. The percentage grows higher when obesity, depression, fibromyalgia, congestive heart failure, lung problems or chronic headaches are present, too.

Because so many people with so many different medical problems experience fatigue, doctors have a tough time sorting out causes. Here we take a look at what could be behind your zapped energy and help you learn how to beat fatigue.

The Challenge of Fatigue

Fatigue is hard to describe and harder to diagnose. If you find yourself with no energy even after a full night’s rest, it may be fatigue. But understanding fatigue requires more than understanding the body’s normal need for rest.

Martha Grant, 53, of Berkeley, California, knows fatigue all too well. Except for a brief respite in her early 20s, she’s struggled with it since her diagnosis with juvenile rheumatoid arthritis (JRA) at age 11. “Most people feel well as the norm and then get the flu for a few days. For me, living with fatigue is like having the flu every single day,” she says.

In a study of how people with RA perceive fatigue, Sarah Hewlett, PhD, senior lecturer in Rheumatology Health Professions at the University of Bristol in England, found patients described fatigue as “severe weariness and dramatic and overwhelming exhaustion attributed to inflammation, working the joints harder and getting unrefreshing sleep.” 

Patients with various chronic diseases experience fatigue as an occasional come-and-go symptom, but many RA patients experience long-lasting fatigue, says Ken Pischel, MD, head of the rheumatology division at Scripps Clinic in La Jolla, California. Their bouts of fatigue sometimes seem unwarranted because they usually aren’t preceded by excess activity and may even occur when their joints are feeling good.

As such, patients have a hard time telling their doctors what may have led to the fatigue. In Hewlett’s study, the few RA patients who felt comfortable discussing fatigue with their doctors still reported inadequate care for it, perhaps because of the emphasis on more measurable physical problems, or perhaps because pain is usually eased with medication, whereas a fatigue treatment isn’t that straightforward. In often-rushed appointments, doctors may only be able to confirm fatigue’s existence, but Hewlett says this offers little help to patients.