Everyone is advised to maintain a healthy diet and exercise. This advice can be especially important to people who have rheumatoid arthritis and chronic fatigue.

See Lifestyle Factors and Fatigue Associated with Rheumatoid Arthritis (RA)

Stay active. People dealing with painful joints and fatigue may find it difficult to stay active; however, moderate activity like walking can restore energy levels and fights fatigue. Research shows that people with RA often have significantly less fatigue after engaging in physical activity. 1 United Kingdom National Health Service. Non-steriodal anti-inflammatory drugs (NSAIDS) – side effects. NHS Choices: Your health, your choices http://www.nhs.uk/Conditions/Anti-inflammatories-non-steroidal/Pages Last reviewed April 6, 2014. Accessed December 1, 2014.

Start an exercise program. Research suggests that a regular exercise regimen can improve symptoms of RA, decrease pain levels, and even reduce fatigue. 2 Løppenthin K, Esbensen BA, Jennum P, Østergaard M, Christensen JF, Thomsen T, Bech JS, Midtgaard J. Effect of intermittent aerobic exercise on sleep quality and sleep disturbances in patients with rheumatoid arthritis - design of a randomized controlled trial. BMC Musculoskelet Disord. 2014 Feb 21;15:49. doi: 10.1186/1471-2474-15-49. PubMed PMID: 24559487. , 3 Balsamo S, Diniz LR, dos Santos-Neto LL, da Mota LM. Exercise and fatigue in rheumatoid arthritis. Isr Med Assoc J. 2014 Jan;16(1):57-60. Review. PubMed PMID: 24575509. Of course, sometimes joints are too painful or range of motion is too limited to manage walking or biking. If this is the case, people with RA may want to consider activities like tai chi, water therapy, or Pilates. A healthcare professional specializing in exercise rehabilitation or physical therapy can also offer advice about individual exercise choices.

See Exercising with Arthritis

Eat well. A nutritious diet can boost energy reserves. A well-balanced diet should include fruits and vegetables, whole grains, low-fat dairy, and lean protein such as fish, nuts, and beans.

See The Ins and Outs of an Anti-Inflammatory Diet

While controversial, some experts believe certain patients may have “trigger foods” that promote inflammation and should be avoided. For example, there is evidence that a vegan, gluten-free diet may reduce inflammation and improve rheumatoid arthritis symptoms. 4 I. Hafstrom, B. Ringertz, A. Spangberg, L. von Zweigbergk, S. Brannemark, I. Nylander, et al. A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford), 40 (10) (2001), pp. 1175–1179 , 5 Elkan A-C, Sjöberg B, Kolsrud B, Ringertz B, Hafström I, Frostegård J. Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study. Arthritis Research & Therapy 2008;10(2):R34. doi:10.1186/ar2388. , 6 Castillo-Ortiz JD, Durán-Barragán S, Sánchez-Ortíz A, Ramos-Remus C. [Anti-transglutaminase, antigladin and ultra purified anti-gladin antibodies in patients with a diagnosis of rheumatoid arthritis]. Reumatol Clin. 2011 Jan-Feb;7(1):27-9. doi: 10.1016/j.reuma.2010.03.006. Epub 2010 Jun 23. Spanish. PubMed PMID: 21794776. (Abstract only, article in Spanish.)

Watch: Video: Parmesan & Balsamic Vinegar Roasted Cauliflower for Arthritis Pain Relief


Stay hydrated. Doctors advise drinking plenty of water, because dehydration can trigger fatigue.

Watch: Video: The Best-Tasting Anti-Inflammatory Cocktail You've Never Tried

Limit caffeine intake. Caffeinated coffee and soda provide a short-lived energy boost, but once it wears off it can leave a person feeling more tired than before. Caffeine can also negatively impact sleep quality.

Avoid energy drinks and energy supplements. While the very name of these drinks and supplements are enticing, many of them contain caffeine and other natural stimulants. In some cases this may give a temporary boost in energy level, but it can ultimately create problems with insomnia, high blood pressure, and increased fatigue.

See Therapies for Treating Insomnia


Eating well and exercising typically will not eliminate fatigue altogether, but they can help reduce fatigue. Incremental improvements made over time can add up to a notable difference in everyday energy levels. There is no quick fix, only a healthy change in lifestyle that will make positive change.

Dr. Erich Widemark is a faculty member of the Nurse Practitioner program and the Director of Simulation Education for the University of Phoenix, College of Health Sciences and Nursing. He has held various roles with the University of Phoenix, including Director of Nursing, Lead Faculty Area chair, and Subject Matter Expert for Curriculum Development within the Nurse Practitioner Program.