Fatigue

What Is Fatigue?

Fatigue is a sense of tiredness or lack of energy that significantly interferes with your daily routine. Fatigue is not normal tiredness, but is a feeling that is out of proportion to the degree of effort you’re exerting or your level of disability.

People with disabilities may experience either acute or global fatigue. 

• Acute fatigue happens when someone has exerted himself or herself, for example, engaging in an extended workout or racing to catch the bus. It affects localized muscle groups such as in the arms or legs.
• Persistent and global fatigue is an overall sense of tiredness that affects a person’s whole body.

Why Do People with Physical Disabilities Have Fatigue?

People with physical disabilities tend to have more fatigue than people who are nondisabled. Among the many possible reasons for this are:

• Fatigue may be one of the primary symptoms of some types of physical disabilities, such as multiple sclerosis, Parkinson’s, or post-polio syndrome.
• Fatigue may come from overuse of muscles that are being used in a way they were not intended to do, such as in cerebral palsy or spinal cord injury.
• Fatigue may be a by-product of dealing with chronic pain or depression, which people with physical disabilities may also experience.
• Fatigue may be a side effect of some medications. 

How Do People with Physical Disabilities Successfully Deal with Fatigue?

There are a number of strategies that could be helpful for reducing fatigue. What works might be very different for each individual, though, depending on your circumstances and needs. You can talk about these possible strategies with your doctor. (When we refer to "your doctor," this includes other health care professionals you work with, such as a nurse, physical therapist, or other provider.)

• Understand your fatigue. Read up on your disability and its relationship to fatigue. Keep a daily Energy Diary for at least a month to figure out times of the day when you feel more fatigued, or activities that leave you more fatigued than usual. Also note people with whom you interact that leave you feeling more or less fatigued. Look for patterns and use them to plan your day. Talk it over with your doctor.
• Take control of your day. Using your diary, or just what you know about yourself, plan your day to tackle higher energy tasks when you know you have more energy, figure out when and how to modify your daily activities, schedule naps, and plan in other ways to take advantage of your strengths.
• Take a good look at your mobility devices. If you use a wheelchair, walker, cane, or crutches, make sure they are adjusted to fit your body. For example, a wheelchair that is improperly adjusted might cause muscle imbalance as you use it through the day, leading to fatigue.
• Examine your diet. Some foods, such as high carbohydrates (large amounts of sugar and/or starches, such as sodas, desserts, pastas, etc.) may cause energy surges followed by “crashes.” Do your homework on the best nutritional mix for you, or talk to a nutritionist about a diet that will help cut down on fatigue. 
• Take a look at your medications. If you are like many other people with physical disabilities, you are on a regimen of multiple medications, all for various purposes. Read up on the side effects of these medications to see if fatigue is possibly one of them. Talk to your doctor or pharmacist about any interaction effects of the different drugs you might be taking. There may be alternate medications that do not carry fatigue as a side effect. 
• Consider your sleep patterns. Most adults need a good eight hours of sleep a day, and most adults don’t get that much. If you are spending more energy doing tasks due to your physical disability, you may need even more than eight hours. Check your Energy Diary to see how much sleep you are getting. If you are not getting enough sleep, or if your sleep is disturbed (trouble falling asleep, trouble staying asleep), consider some strategies such as an established bedtime routine, using a white noise machine or relaxation techniques.
• If snoring interferes with your sleep. Chronic snoring has a variety of causes. Besides being a nuisance for a partner, it may signal sleep apnea, which means you literally stop breathing for short periods of time while you are asleep. This is dangerous and over time can lead to heart attacks or stroke. In the short term, it is a cause of fatigue. There are strategies (such as use of a C-Pap machine) that can help. Your doctor can refer you to a sleep clinic for diagnosis if apnea is a possibility.
• Look into exercise. This may sound counter-intuitive, but research shows that regular exercise can be very helpful in reducing fatigue. Talk to your doctor. Ask for a referral to a physical therapist who can help you put together an exercise routine that is right for you. 
• Accept your limits. Everyone, with or without a disability, has limits. Learn where yours are. Set priorities and goals so that you can tackle the things you really want to do – and as for the rest, get help or just let go. Focus on meaningful, valuable, and rewarding activities. Incorporate rest into your day. 

You Can Take Charge!

You don’t have to accept fatigue as a part of your life that you can’t change. Look over these strategies. Talk to your doctor. Talk to your independent living specialist. Problem solve with your friends and family. You CAN make a difference in your life!

NOTE: This fact sheet is for informational purposes and is not meant to take the place of health care services you may need. Please see your health care provider about any health concerns.