Fatigue and axSpA


What is fatigue?

Fatigue is a feeling of both physical and mental tiredness. It is often described as exhaustion or a lack of energy and can make everyday tasks seem impossible. Many people with axial spondyloarthritis (axSpA) experience fatigue, no matter what they have been doing or how much sleep they get. There are many possible causes of fatigue, including the disease activity, pain (which can also affect sleep), certain medicines, muscle weakness and wasting (deconditioning), or depression.

How can I manage fatigue?

The good news is that there are ways you can deal with fatigue:

  • Talk to your doctor. Make sure you let your doctor know if your fatigue does not improve or is made worse by your arthritis medicines. Sometimes small changes in treatment can make major differences in how you feel.
  • Exercise. Exercise is one of the best things you can do to combat fatigue. Exercise can help strengthen muscles and increase your fitness. Within a few months, you should feel an increase in strength and energy and be able to do more without getting as tired. The key to a successful exercise program is to begin gradually, listen to your body and build slowly.  You may also find it helpful to get advice from a physiotherapist or exercise physiologist.
  • Learn ways to get a good night’s sleep.
    • If pain is interfering with your sleep, talk to your doctor about learning ways to manage pain.
    • Limit caffeinated drinks to five or less per day and avoid these types of drinks after dinner.
    • Try different relaxation techniques until you find one that works for you. For example, you could visualise a restful scene or focus on your breathing.
    • The bedroom is for sleep, don’t take your devices to bed.
  • Acknowledge your feelings and seek support. It is natural to feel scared, frustrated, sad and angry at times. During these times your most important allies can be your friends and family members. Enlist their help and understanding. Educate those close to you about fatigue being a part of your PsA and explain to them the ‘ups’ and ‘downs’ you experience.

Conserve your energy and protect your joints

You can also learn ways to save your energy and protect your joints during daily tasks. These tips may also help you cope with fatigue, or reduce its impact on your life:

  • Pace yourself. Carefully plan and organise your activities so you make the most of your energy. Here are some simple tips to help you pace your activities:
    • Try to plan your day so that you can alternate periods of activity with periods of rest.
    • When you know you have a large task to do, such as preparing a meal or cleaning a room, plan ahead and break the job into smaller tasks. Then work on completing the tasks one at a time and follow each with a rest break.
    • Try to prioritise jobs. Do the hardest jobs when you are feeling your best.
    • Take advantage of ‘good days’ to do the things you may have been putting off. Remember not to overdo it on these days as it could result in pain and fatigue the following days.
    • Simplify tasks. For example, buy pre-cut vegetables and meat to make cooking simpler. Find out about equipment that can make tasks easier (see below).
    • If you are having a bad day, be ready to change your plans and not force yourself to work through pain.
    • Ask for help when you need it.
  • Learn about equipment that can make daily tasks easier. There are many gadgets and aids that can make your daily activities simpler and less tiring. These aim to protect your joints by reducing the effort you have to put in. Examples include:
    • ergonomic knives to make cutting and slicing easier
    • adapted cutlery and cooking utensils to allow easy gripping – equipment to help with opening jars or bottles, and turning on taps
    • equipment to make dressing and showering easier (such as long-handled sponges and shoe horns for reaching your feet) – trolleys (rather than carrying shopping bags in your hands).

You can find more information about these types of equipment at an Independent Living Centre. These centres have a wide range of tools and equipment on display. You can get advice, including where to purchase equipment, in person or over the phone.

Occupational therapists are also available at the centres to provide advice about equipment. Although you can drop in at any time, it is preferred that you call the telephone enquiry service beforehand.

  • See an occupational therapist. An occupational therapist (OT) can show you ways to simplify tasks and advise you on suitable aids and equipment. You will need a referral from your doctor to see an OT in the public system (such as at a community health centre). These services are usually free or low cost. You can consult a private OT at any time without a referral from your doctor. Find an OT by contacting Occupational Therapy Australia on 1300 682 878 or use the ‘find an OT’ feature at www.otaus.com.au



To find an occupational therapist, ask your doctor, or contact Occupational Therapy Australia. To find a physiotherapist, ask your doctor, contact the Australian Physiotherapy Association. To find an exercise physiologist, ask your doctor, contact Exercise and Sports Science Australia on (07) 3862 4122 or use the ‘find an exercise physiologist’ feature at www.essa.org.au. For information about sleep, visit www.sleephealthfoundation.org.au, or  National Sleep Foundation (US).


This resource has been developed based on the best available evidence. A full list of references is available upon request.