Psoriatic Arthritis Fatigue: How to Have More Energy
Rheumatic ConditionsPsoriatic Arthritis

9 Ways to Manage Psoriatic Arthritis Fatigue

Following a healthy lifestyle and balancing your activity with rest can help boost your energy levels.
9 Ways to Manage Psoriatic Arthritis Fatigue
Sergey Narevskih/Stocksy
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Updated on April 3, 2024
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The hallmark symptom of psoriatic arthritis is pain that affects the joints. But for some people, life with psoriatic arthritis includes ongoing fatigue and possibly more widespread pain.

In fact, one study of 64 people with psoriatic arthritis found that more than 25 percent of participants experienced widespread pain, and these people were more likely to have increased fatigue.

 Another study found that fatigue in psoriatic arthritis was linked to greater disease activity, with 22 percent of the 231 participants with psoriatic arthritis experiencing severe fatigue.

“There is a high incidence of fatigue in patients who have psoriasis and psoriatic arthritis,” says rheumatologist Soumya Reddy, MD, an assistant professor of medicine and dermatology at the NYU Grossman School of Medicine and co-director of the Psoriatic Arthritis Center at NYU Langone Health in New York City.

“Systemic inflammation from psoriatic disease itself, psychosocial factors, the presence of comorbidities such as depression and fibromyalgia, and certain medications may all contribute to fatigue,” Dr. Reddy says.

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Fatigue: A Common Symptom in Psoriatic Arthritis

The link between psoriatic arthritis and fatigue is not news for blogger Amanda Steyer, who has psoriatic arthritis. “Fatigue is a huge part” of living with the condition, she says. “There are days when I don’t want to get out of bed, and I spend the entire day wishing I could get back into bed.” But with five children, Steyer has a lot of motivation to get going.

Steyer was formally diagnosed with psoriatic arthritis at age 41 but has had symptoms on and off throughout her life. She takes medication to manage her symptoms, although some of her fatigue also appears to be due to her psoriatic arthritis treatment regimen.

“My energy levels are better — not fantastic but much more manageable — than when my psoriatic arthritis is untreated,” she says. She can move more freely and even hike with her family, a pastime she’s always enjoyed.

In an analysis of 831 people with psoriatic arthritis, researchers found that 78 percent of participants reported fatigue as a symptom. Greater severity of fatigue was linked to having more severe psoriatic arthritis, having psoriatic arthritis for a longer period of time, having more swollen and tender joints, and having a larger area affected by psoriasis. Even after adjusting for other factors, greater fatigue was linked to worse quality of life and lower work productivity as reported by participants.

Another study involving 137 people with psoriatic arthritis found that 45 percent of participants experienced fatigue, while 38 percent experienced sleep disturbances and 38 percent experienced anxiety or depression. Pain, sleep disturbances, and anxiety or depression were all linked to experiencing fatigue.

Doctors are just beginning to understand the link between psoriatic arthritis and fatigue.

“Psoriatic arthritis is a chronic health condition that involves inflammation, and inflammatory conditions can bring about some fatigue as a symptom,” explains Christine Alexander, MD, the chair of the department of family medicine at MetroHealth in Cleveland.

But many doctors evidently aren’t aware of fatigue as a symptom among their patients — for the 78 percent of participants with psoriatic arthritis who reported fatigue, their own doctors didn’t record fatigue as a symptom more than two-thirds of the time.

Strategies for Surviving Psoriatic Arthritis Fatigue

Whether your fatigue is due to your psoriatic arthritis, a treatment you’re taking for it, or a related health condition, try these strategies to help regain some of your energy.

1. Lead a Healthy Lifestyle

You’ll be better able to fight fatigue if you’re eating a varied, healthy diet and avoiding tobacco and alcohol, says Dr. Alexander.

2. Ask for Help

Steyer often asks for rides to events, knowing she will be too tired afterward to drive home safely. Know yourself and ask for help when (or before) you need it.

3. Set Priorities and Honor Your Limits

“I’ve learned to prioritize those things that are most important,” says Steyer, who plans her week with days off between major activities to allow time for recovery. Pay attention to how different activities affect your body and don’t hesitate to set limits for yourself.

4. Stay Physically Active

It may seem counterintuitive, but exercise can actually boost your energy levels and fight fatigue. “If done regularly, exercise increases our body’s natural opiates and provides both energy and improved sleep,” Alexander explains.

The National Psoriasis Foundation notes that according to current guidelines, people with psoriatic arthritis should do some combination of exercise and physical or occupational therapy to help reduce inflammation and improve overall physical function.

5. Balance Activity and Rest

Instead of powering through her to-do list, Steyer breaks up active tasks, such as cleaning, into 10- or 20-minute segments and rests or does easier things in between. This downtime can include activities like browsing the internet, researching treatments and therapies, reading, or doing puzzles with the kids, she says.

6. Educate Yourself About Treatment Options

Getting effective treatment for your psoriatic arthritis that reduces inflammation can be the key to less pain and fatigue, the National Psoriasis Foundation notes. It’s especially important to start treatment as early in the course of your disease as possible, and many people will need to change medications over time to keep symptoms to a minimum.

7. Talk to Your Doctor About Vitamin D

Some studies have shown a correlation between vitamin D deficiency and psoriatic arthritis. People who have a vitamin D deficiency can also experience fatigue as a result of that condition alone.

 Talk to your doctor about your risk for vitamin D deficiency, whether you should have your vitamin D level checked, and whether vitamin D supplements might be helpful for you.

8. Explore Alternative Therapies

Many people with psoriatic arthritis benefit from stress reduction techniques like guided relaxation, massage therapy, or acupuncture, which are supported by current treatment guidelines.

9. Talk to Your Doctor About a Healthy Weight for You

For people with psoriatic arthritis who have excess body weight, losing weight can reduce fatigue and other psoriatic arthritis symptoms.

 Talk to your doctor about a healthy weight for you and sustainable ways to achieve that weight.

Despite the reality that psoriatic arthritis and fatigue often go hand in hand, you can take steps to put more energy back in your life.

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Alexa Meara, MD

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Alexa Meara, MD, is an assistant professor of immunology and rheumatology at The Ohio State University. She maintains a multidisciplinary vasculitis clinic and supervises a longitu...

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Madeline R. Vann, MPH, LPC

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Madeline Vann, MPH, LPC, is a freelance health and medical writer located in Williamsburg, Virginia. She has been writing for over 15 years and can present complicated health topic...

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Resources
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  2. Lai TL et al. Fatigue in Psoriatic Arthritis: Is It Related to Disease Activity? International Journal of Rheumatic Diseases. March 2021.
  3. Gossec L et al. Effect of Fatigue on Health-Related Quality of Life and Work Productivity in Psoriatic Arthritis: Findings From a Real-World Survey. The Journal of Rheumatology. November 2022.
  4. Haugeberg G et al. Psoriatic Arthritis: Exploring the Occurrence of Sleep Disturbances, Fatigue, and Depression and Their Correlates. Arthritis Research & Therapy. August 2020.
  5. Managing Chronic Pain and Fatigue. National Psoriasis Foundation. April 28, 2021.
  6. Al-Dhubaibi MS. Association Between Vitamin D Deficiency and Psoriasis: An Exploratory Study. International Journal of Health Sciences. January-February 2018.
  7. How Fat Affects PsA. Arthritis Foundation.