Fatigue and Axial Spondyloarthritis

Reviewed by: HU Medical Review Board | Last reviewed: January 2023

Fatigue is a common symptom of axial spondyloarthritis (axSpA). Fatigue can negatively affect your daily life. But, like other symptoms of axSpA, it can be managed and treated.1

What is fatigue?

Fatigue is an extreme feeling of tiredness that does not go away no matter how much sleep you get. It may feel like physical, mental, or emotional exhaustion.1

Featured Forum

View all responses caret icon

Why does fatigue happen with axial spondyloarthritis?

AxSpA can cause fatigue in different ways. It may directly result from inflammation. Or it can stem from other health conditions that are common in people with axSpA.1


Chronic (long-term) inflammation affects not only the joints but the whole body. Inflammation causes a release of a type of protein called cytokines. These proteins may cause fatigue. Your body uses energy to deal with inflammation, which leaves less available energy overall.1


Oxygen is carried to your body's tissues by your red blood cells. Not having enough healthy red blood cells can cause a condition called anemia. People with anemia do not have enough red blood cells or hemoglobin. Hemoglobin is the part of the red blood cell that carries oxygen. Anemia can make you feel tired and weak.1,2

There are different types of anemia, and they have various causes. One form of anemia that can occur with axSpA is called anemia of chronic disease (ACD). The chronic inflammation of axSpA causes this type of anemia. During the inflammatory response, cytokines can reduce the production of red blood cells.2,3


Some drugs used to treat axSpA or other conditions can cause you to feel tired and drained. They can make fatigue worse for people with axSpA.1

How is fatigue treated?

For people with axSpA, fatigue can happen every day for a long time. Sometimes dealing with fatigue may be harder than dealing with your other symptoms of axSpA. Everyone's experience is unique. But there are some tips that may help manage some of these feelings:1

  • Treat any underlying causes of fatigue. Treating axSpA can help reduce fatigue in many people. As the inflammation in your body is reduced, your energy levels may rise. Also, address and treat other conditions such as depression or anemia.
  • Stay active. While it may not seem to make sense, moderate exercise can help improve fatigue. Exercise releases endorphins, which have mood-boosting effects. Just be sure to listen to your body and do not overdo it. Discuss any new exercise routine with your doctor before you begin.
  • Eat a healthy diet. Eating nutritious foods helps your body function at its best. This includes iron-rich foods, such as leafy greens, lean red meat, and beans. You can get personalized advice and support from a nutritionist or registered dietitian.
  • Rest when you need to. It is important to balance activity with rest. Pace yourself throughout the day to help prevent fatigue from getting worse.
  • Talk to your doctor. Tell your doctor how fatigue affects your life. They can help you develop a plan to manage your symptoms.

By providing your email address, you are agreeing to our privacy policy.