What does it mean when inflammation is under control but pain and fatigue continues?

[Damaged]

Is this remission ? Does this mean , I will always feel this bad? I am confused. I am so very very very tired.

[Hidden]

Does your rheumy say you're in remission?  It's a difficult situation when doctors' assessment of how we're doing definitely does not match with our own.  

By inflammation being under control do you mean that your blood tests do not show high ESR / CRP?  Or that joints are no longer swollen / tender .... or both?  I have PsA which notoriously does not always show inflammation in bloods, though mine did at first and at intervals even after starting treatment.  So when the ESR returned to normal and stayed there I was a little concerned about what my rheumy might have to say as I still had stiff & swollen joints.  Fortunately he said that he treats 'the patient, not the blood test results'.  

Fatigue, though invisible, is a genuine sign of disease activity, I'm pretty sure of that.  It's important to do everything we can ourselves in terms of lifestyle but if you're getting some regular exercise and eating well (both of which might help with fatigue) then you need to lay it on the line with your rheumy that things are NOT good.  

Signs that inflammation is lower are great news.  But I cannot believe they're the whole story.  I don't quite understand the blood tests myself ... I mean, how come people with severe PsA and obvious systemic inflammation can still have low ESR?  It would seem that inflammation can 'hide'.  

[lornaisobel]

Its awful being tired all the time - I can sleep for 12/14 hours at a time.  It is part of the disease I'm told.  I had a wonderful answer from someone a long time ago on this site which I'm sorry I deleted but it was all about pacing yourself - get plenty of exercise to slowly build up energy levels - eat well fresh veg fruit etc yoga helped me also swimming and walking and I now try and do some thing I really like every day all helps to lift spirits and energy.  There are lots of books free from RA society on tiredness. As for the pain it just seems to be par for the course - I take pain killers.  Good luck x

[ambita]

I know how you feel, my ESR is 22 and CRP 11 and I am on Rituximab infusions.  It has helped the RA but I feel so very tired and lethargic, got no energy and can sleep for hours and still wake up as if I have had no sleep at all! It's just so debilitating and I still have pain in my shoulder, upper arm, lower back, neck, upper back, knees, hips, ankles and wrists which I have been told is due to Osteo plus I have Sjrogrens so my skin is very dry and my eyes are very dry.  I was expecting a miracle as I find walking and standing so painful and such an effort. Everything is too much of an effort, even to get up in the morning, get washed and dressed and to do my stretching exercises and I just feel like I am existing day to day and time is just going by! 

[ambita]

Sorry I meant to say I was expecting a miracle after having the rituximab infusions! I don't do cooking or shopping, just a bit of dusting every now and then when it gets thick with dust as I can not do it every week and I still feel so very fatigued! I was diagnosed with chronic fatigue syndrome many years before the RA so don't know if it that or not but I feel so discouraged! Life is just passing by and I see other women my age being able to enjoy themselves and do the things I wish I could do and I just feel like an old woman.  Sorry!

[Damaged]

Nice to know I am not alone. My inflammation is under control but I am still in excruciating pain and fatigue does not seem strong enough a word to describe this bone weery exhaustion. Not to sound negative, but I find myself hoping they will find anything that ensures this nightmare ends sooner rather than later. Sorry, the death of business yesterday was the death of me.