by Chris Miller | Posted on 8/9/2012

One of the most common - yet impactful - complications of ankylosing spondylitis (AS) is fatigue. As detailed in SAA's book, "Straight Talk On Spondylitis" fatigue can be caused by many things related to spondylitis such as loss of sleep because of physical discomfort. But it can also be a by-product of the disease itself.

Spondylitis causes inflammation. When inflammation is present, your body must use energy to deal with it. The release of cytokines during the process of inflammation can produce the sensation of fatigue as well as mild to moderate anemia. Anemia may also contribute to a feeling of tiredness. Treating the inflammation caused by ankylosing spondylitis can assist in decreasing fatigue and anemia.

A study examining fatigue in AS and published in the journal, Musculoskeletal Care states that in those who participated in the study, "Fatigue impacted on social life, relationships and work." The authors of the study concluded that, "Future practice should include a comprehensive fatigue assessment and the development of treatment programmes" to help those affected self-manage their fatigue.

Speaking with your physician / rheumatologist is a first step in order to find the exact cause of the fatigue (e.g. lack of sleep, inflammation, anemia, another cause or a combination thereof). That said, most medications used for AS are aimed at helping with inflammation including NSAIDs (non steroidal anti-inflammatories) and the TNF-a Inhibitor / biologic medications. Proper exercise can also help with fatigue. In the case of anemia, where the body does not produce enough red blood cells, certain diet changes such as supplements may also be helpful.

As the study points out, "fatigue has a negative impact on quality of life in people with AS."

You can read the study's abstract about: "Fatigue in Ankylosing Spondylitis: Causes, Consequences and Self-Management".

How Does Fatigue Feel? Quotes From SAA Members...

"Some days it feels like wanting to blend into the sofa, so that none of my family members will notice that I am there and ask or expect me to do anything."
--Christie, Huntington Beach, CA

"I liken it to wearing a jacket containing 40 pound weights in each pocket, while slogging through a vat of molasses with suction cups glued to the bottom of your shoes."
--Michael, NY, NY

"No amount of sleep will reduce the fatigue that makes me feel like I'm walking around all day with one of those lead aprons that they use at the dentist's office for x-ray protection. It feels like when you experienced a BAD case of the flu - pre AS."
-- Tim, Phoenix, AZ

"I lie in bed at night and will myself to move because it hurts so much to actually do it. In addition, when I "wake up" in the morning, if I actually managed to get some sleep, I feel like I haven't even been in bed. It's such an overwhelming sense of exhaustion. Arms and legs feel like lead - and there is a sense of failure - even though you know this is not the case."
-- Crystal, Cleveland, OH

About the writer: Chris Miller is the Director of Programs at the Spondylitis Association of America and is Managing Editor of SAA's news magazine, Spondylitis Plus. He has been at SAA for nine years.

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