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woman holding shoulder next to depleting battery; chronic pain and fatigue

Fatigue: How Chronic Pain Causes It and Ways to Alleviate It

Those who experience chronic pain often experience fatigue as well. Both of these symptoms feed off of one another, making it hard to manage and improve your health. For those with diabetes, this is even more complicated because pain and fatigue both interfere with the ability to self-regulate blood sugar levels.

How diabetes causes pain

Diabetes causes pain by damaging tiny blood vessels all over the body due to sugar accumulation within arteries. Around 20 to 60 percent of diabetes patients report chronic pain to their physicians. Diabetes patients are also prone to back, neck, and joint pain, as well as abdominal pain caused by damage to the nerves in the gut.

Peripheral neuropathy is another common pain for those with diabetes to experience. This is when poor circulation causes pain, numbness, and tingling in the hands and feet. If not treated by regulating blood sugar levels, neuropathy can lead to tissue death and amputation.

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How chronic pain causes fatigue

The Arthritis Foundation says, “The pain-fatigue connection can be a vicious circle. Dealing with pain for months at a time over many years can wear you down. It can affect your sleep habits, which adds to your exhaustion. Being fatigued, in turn, can worsen pain and make it more difficult to manage.”

Here are five specific ways pain can cause fatigue.

  1. Lack of quality sleep. Experiencing pain while you sleep will almost certainly lead to poor sleep. Even worse, the kind of fatigue you may experience from poor sleep can further compound your pain.
  2. Painful walking. Pain may also make it difficult for you to walk, creating even more fatigue from the physical exertion or unnatural movements.
  3. Inactivity. If you’re in pain, you probably don’t want to move and make it worse. However, inactivity may increase the very pain you’re trying to prevent or alleviate.
  4. Depression. Living in chronic pain can lead to depression and a decrease in quality of life. Fatigue is a major symptom of depression.
  5. Poor diet. Chronic pain can make it hard for a person to maintain a healthy diet, and encourage them to reach for unhealthy, readily available food that will make them crash later.

Tips to alleviate fatigue

  1. Have your doctor review your medications. Many commonly prescribed medications can cause or exacerbate fatigue, like medications for pain, high blood pressure, sleep disorders, and depression. Talk to your doctor or pharmacist about your prescriptions, and ask if fatigue may be a side effect.
  2. Get better sleep. Getting better sleep is one of the most significant ways to improve your fatigue and limit the pain it causes. Start by getting evaluated and/or treated for sleep apnea. Create a sleeping environment that promotes restful sleep, and stick to a strict sleep schedule. You can also try things like blackout curtains, eye masks, and weighted blankets.
  3. Try to get light exercise. The University of Georgia published a study which found that low-intensity exercise decreases fatigue by 65 percent. In the study, participants engaged in 20 minutes of low-to-moderate exercise three days per week for six weeks, and reported more energy. Try gentle exercises like walking, yoga, or water aerobics.
  4. Cut out your vices. No one should be smoking, but people with diabetes should definitely refrain from cigarettes. Smoking worsens many conditions that can lead to pain, including neuropathy. Excessive alcohol use can also cause fatigue and should be refrained from as well.
  5. Consider your mood. Fatigue is one of the most commonly reported side effects of depression. This brief questionnaire can help you decide if you need to talk to your doctor about the possibility of depression being the cause of your fatigue.
  6. Improve your diet. Foods that are high in sugar and carbohydrates can lead to crashes hours after eating them. Filling your diet with fresh fruit, vegetables, and lean meats is the best way to sustain your energy levels through your diet.
  7. Ask for help. There’s no shame in asking for help. If your loved ones have difficulty understanding your fatigue, try framing it in a different way, like the popular spoon theory. In this disability metaphor, spoons represent the finite energy a person with chronic pain and fatigue has allocated for everyday tasks. When they perform a task like showering or washing the dishes, they lose a spoon they could have spent doing laundry or cooking dinner.

The pain-fatigue cycle can be a difficult one to break, but addressing one problem may help you alleviate the other. Listen to your body and its limits, and talk to your doctor about managing your pain and fatigue.