Management for fatigue associated with rheumatoid arthritis

Fatigue is a common complaint in patients with rheumatoid arthritis (RA). Consider and manage potential contributors to fatigue, such as:

  • anaemia—anaemia of chronic disease, cytopenia, iron deficiency, vitamin B12 or folate deficiencies
  • hypothyroidism
  • drug adverse effects
  • depression and sleep disturbance—often associated with chronic pain
  • weakness due to loss of muscle mass.

See Conditions commonly associated with fatigue for more information on the assessment of patients with fatigue.

Note: Encourage patients with RA to engage in low-impact physical activity and social interactions to counteract fatigue.

There are no pharmacological treatments for fatigue in rheumatoid arthritis (RA). There is some evidence that physical activity (eg pool-based therapy, yoga, dynamic strength training, stationary cycling, low-impact aerobics, Tai Chi) and psychosocial interventions (eg cognitive behavioural therapy, mindfulness) have a small benefit, but the optimal treatment strategy is not yet established.