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Lupus & You Q&A: Understanding Fatigue and Pain Management
Lupus & You is a free educational series where people with lupus and their family and friends can learn more about the latest in lupus research and managing the disease.
Speakers Dr. Daniel Clauw and Dr. Julius Birnbaum, discussed the interrelation of fatigue and pain, which are among the most common symptoms of lupus patients, and highlighted both pharmacological and non pharmacological strategies for managing these symptoms.
If you missed the event, you can watch the video below and view the presentation slides here:
Can I suffer from fatigue even when I’m not in a flare?
Fatigue may or may not occur without a flare, depending on the underlying condition. Other conditions like anemia, hypothyroidism, vitamin D deficiency, and certain medications can all contribute to fatigue, even when not associated with a flare. Therefore, it is important to identify non-lupus causes of fatigue to ensure that appropriate treatment and management strategies are incorporated.
The Expert Series: Managing and Preventing Flares
What are the strategies for explaining pain and/or pain level to health care providers?
When explaining pain to a healthcare provider, it is important to be very clear and honest. Keeping a pain diary can help your doctor get a clear picture of your pain and how it impacts you and aid in the development of an effective treatment plan for managing your pain.
"What's important is that you should have enough conviction and courage that however you describe your pain and fatigue," said Dr. Julius Birnbaum, a rheumatologist at the University of Pittsburgh Medical Center, "you do it in a way that's trusting your own gut and bringing your own set of convictions and how to use language to an appointment really helps."
"Instead of focusing on the pain itself, ask yourself, 'what is the pain not enabling me to do, and what strategies might I be able to use so that I could do those things again?'", said Dr. Daniel Clauw, a professor of anesthesiology, medicine (rheumatology) and psychiatry at the University of Michigan.
Here are some tips in communicating pain with your provider:
- Be able to rate your pain on a scale of 0-10
- Know what triggers your pain and what relieves it
- Be able to locate the site of your pain
- Be able to describe your pain in terms like dull, sharp, throbbing, burning, stabbing or aching
- Know the time and duration of pain
Learn more about how to track your symptoms here.
What are the strategies for managing pain & fatigue including holistic/lifestyle options?
It is important to evaluate and address the underlying cause of fatigue and pain to ensure appropriate management. However, some lifestyle/holistic strategies for the management of lupus related pain and fatigue include:
- Promote emotional health through stress reduction techniques like breathing exercises, meditation, and participating in support groups.
- Establish a regular sleep schedule to ensure quality and adequate sleep
- Incorporate low impact activities like walking, swimming, and tai chi which may help with inflammation and mood.
- Maintain a healthy diet, limit highly processed food, smoking cessation, and limit alcohol intake
"We can use drugs to treat some symptoms of pain and fatigue, but we really have to use non-drug therapies, getting people moving again, getting people sleeping again, managing stress," Dr. Clauw said. "Getting them access to some of these non-drug therapies that can really be very helpful to treat pain."
It is important to always consult with your doctor before incorporating any new lifestyle regimen.
Strategies for Managing Fatigue
Do any medications help with lupus fatigue?
While lupus medications may help with symptoms of fatigue, it is frequently associated with type 2 lupus. According to Dr. Birnbaum, the treatment of symptoms associated with lupus type 2 such as mood disorders, pain, and sleep disturbance may help with the symptoms of fatigue.
"There's this understandable inclination to understand with regard to medication and what's on the horizon and what's being developed because that gives you a sense of hopefulness and optimism," Dr. Birnbaum said. "But while there are meditations certainly on the horizon, there's so much more that you can do that doesn't involve medication."
How can I prevent pain and fatigue related to lupus?
Preventing lupus related pain and fatigue involves medication adherence as well as lifestyle adjustments. Here are some strategies to help prevent lupus related pain and fatigue:
- Take your lupus medications as prescribed by your healthcare provider and communicate any change in new symptoms or side effects you may experience
- Engage in low impact exercises like walking, swimming and tai chi which can help improve strength, inflammation, and pain alleviation. Be sure to consult with your doctor before incorporating any new exercise regimen
- Apply heat therapy which can help improve blood flow and relax tense muscles. Cold packs can help with inflammation
- Practice stress management techniques like breathing exercises, meditation and yoga which can help prevent and manage stress induced pain and fatigue
- Eat a healthy and balanced diet which may help with symptoms of pain and fatigue and support your overall health
"Try going for a five-minute walk a day," Dr. Birnbaum said. "Going down that exercise route can be enormously helpful. You can keep things slow at once, and then you can build up after that."
Are there any supplements you would recommend to help with fatigue?
Certain supplements like Vitamin D may help with fatigue. However, It is important to note that supplements can interact with your lupus medicines, so it’s important to talk with your doctor before you start taking any supplements.
Eating Healthy When You Have Lupus
Are there current studies being done on any new lupus medications or possible pain control methods?
Numerous research initiatives are actively investigating new medications to improve the prevention, diagnosis, and treatment of lupus.
"There's a lot of active work in the pain field," Dr. Clauw said. "Certainly there are a lot of biologics being developed, and we're really learning more and more."
At the Lupus Foundation of America, Inside Lupus Research provides you with updates on the latest research findings in lupus science. Get to know more about Inside Lupus Research and our coverage of important lupus research here.
Our health education specialists are specially trained to provide people affected by lupus with non-medical support, disease education, information, and helpful resources. You have lupus, but you are not alone.
The Lupus Foundation of America and our health education specialists have answered some of your most common questions. The provided answers are for educational and information purposes only. Consult with your doctor/health care team for medical advice.