EDITORIAL - The enigma of fatigue

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Journal of Rheumatology

Editorial

Dec 2009

The Enigma of Fatigue

Fatigue is an enigma: Everyone seems to know what it is, but a

detailed definition is hard to provide. Like water, it slips away and

cannot be grasped. There are no laboratory tests, no magnetic

resonance image can quantify it objectively, and no specific treatment

is available.

Fatigue is a common and often severe complaint. In the adult US

population, 9.4% have fatigue during at least one month1, and as many

as 22% of working adults were fatigued in The Netherlands2, as

summarized in the article by Bergman, et al in this issue of The

Journal3.

When a patient with rheumatoid arthritis (RA) starts talking about

fatigue, the doctor will look for anemia, hypothyroidism, and other

treatable explanations first. But when fatigue persists, the doctor

does not know what to say: as a patient with RA recently told me,

“Doctors do not seem able to understand or to handle fatigue, so

despite the fact it is one of my main problems, I stopped talking

about it in the clinic.” This fits in with the findings of a postal

questionnaire among Dutch rheumatologists4, and with in-depth studies

in UK patients, most of whom did not discuss fatigue with their

clinicians, but when they did they felt it was dismissed5.

Fatigue is a significant problem for people with rheumatic diseases as

it contributes to many aspects of life. Studies have found the

prevalence of fatigue in RA patients to be 88%—98%6. Patients with

osteoarthritis (OA) experience notable amounts of fatigue and indicate

it has substantial impact on their lives7.

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Read the whole editorial here:

http://www.jrheum.org/content/36/12/2630.full

Not an MD