Energy, Fatigue, and Pain

If you have endured pain for any length of time, you know that one of the most common associated features is a lack of energy. There are many reasons for this fatigue including inflammation, loss of sleep or medication side effects, but you should know that there are ways to boost your energy. From eating a healthier diet to exercising regularly and limiting stress, you can feel energized and more like yourself.

Fatigue often accompanies chronic pain making the pain considerably worse. Constant exhaustion can make it difficult to function normally which can induce stress and depression, and the desire to remain in bed can stiffen joints and muscles. You should keep in mind that your brain processes pain, depression and fatigue using similar neurochemical pathways which can conflate these conditions.

What Is Fatigue?

You may assume that fatigue is equivalent to everyday tiredness, but, from a medical point of view, it is in an entirely different class of sensation.  Medically speaking, fatigue is extreme exhaustion that involves muscle weakness and difficulty performing tasks normally.

Although fatigue may be felt differently depending on the person, in some cases, it may manifest as an unrelenting desire to sleep. Fatigue also has mental as well as physical components; it may induce profound feelings of sadness or helplessness. In many people, fatigue can also inhibit concentration and decision making.

For some people, fatigue symptoms may be so persistent that it qualifies as a health condition in itself. Chronic fatigue syndrome or CFS is marked by six months or more of severe fatigue and is accompanied by muscle or joint pain; cognitive impairment; headaches; or tender lymph nodes.  As many as 2.5 million Americans suffer from CFS.

How Chronic Pain Produces Fatigue

Pain and fatigue are intimately related, but there are many specific ways that chronic pain may lead to fatigue.

  • Inflammation—many chronic health conditions like arthritis and lupus may cause swelling, especially in the joints. Inflammation places your body under stress by releasing cytokine proteins into the bloodstream. If there is heightened disease activity this may lead to exhaustion. Also if the condition persists for a long period of time, fatigue may set in.
  • Muscular stress—many people who experience pain for extended periods of time respond by tensing muscles or assuming bodily positions that place structural stress on joints. Over time, this muscular tension can create lactic acid and soreness, much like from a high energy workout.
  • Anemia—diseases like rheumatoid arthritis can produce anemia, a condition in which fewer red blood cells are made. Anemia may lead to fatigue because the lower amount of red blood cells limits the amount of oxygen your body obtains.
  • Drugs—many drugs have sedative effects that can sap your energy.  Some of these drugs may directly produce drowsiness or lethargy, while others may do so more indirectly. For example, drugs like Advil and Aleve may cause bleeding in the stomach which in turn leads to anemia, and eventually fatigue.
  • Lethargy—it is only natural to want to stay immobilized in bed if you are in pain, but this can lead to a vicious cycle of inactivity and more pain. Your body’s natural state is one of activity, so you are actually damaging it by being too sedentary.  If you are too inactive, you may experience more pain and fatigue in the long run.
  • Overexertion—although it seems obvious, many people fail to modulate their activity schedule when they have a chronic condition. By pretending that they are not sick, they expend too much energy. This can not only lead to fatigue, but it may exacerbate the underlying health condition as well as cause additional injury.
  • Depression—it is quite common for people in chronic pain to feel helpless and hopeless.  Eventually, this depression may become a permanent fixture of the pain condition that requires medical intervention.

How to Manage Fatigue

Fatigue may be a common component of pain conditions, but it can be managed if you implement some healthy steps.  Consider the following plans:

  • Monitor your day—if you are like most people, you will experience energy highs and lows throughout the day.  Use a journal to note these times as well as your responses to events like meals, exercise routines or social interactions.
  • Limit stress—if possible, cut out sources of undue stress like personal conflicts or professional duties that may cause a pain flare-up.  If you can limit your pain, the fatigue should diminish as well.
  • Obtain therapy—counseling may not seem like the ideal solution for chronic fatigue, but it can help you manage your anxiety and depression symptoms which detriment your pain and, in turn, your fatigue.
  • Learn biofeedback techniques—biofeedback and other cognitive training tools can help you minimize your pain by limiting stress and other negative emotions.
  • Practice mindful meditation—another important way to reduce pain and anxiety is to engage in mindful meditation which helps you accept the pain and negate it. In some cases, mindful meditation has almost completely nullified pain symptoms in longtime practitioners.
  • Yoga—yoga is a mind-body technique that combines controlled breathing with mild exercise and spiritual peace. The physical exercise helps reduce pain while suppressing stress.
  • Design an activity schedule—if you have difficulty striking a balance between rest and activities, it can be helpful to make up a schedule.  If you find yourself overtaxed or too inactive, just modify your schedule.
  • Sleep well—sleep is essential for managing fatigue and chronic pain. Not only is a good night’s rest important in recovering energy, but it is vital for healing. You should practice good sleep hygiene like sleeping at a regular time, but if you have trouble falling or staying asleep, consult your doctor.
  • Eat right—your diet is especially important if you have pain or fatigue issues.  Avoid foods that cause inflammation like sugar, fried foods and processed meats. Many foods are fine as long as you eat them in moderation, but you may want to keep a food journal to assess your own reactions.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information. 

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