Fatigue is a symptom rather than a condition, it is all too common in today’s demanding world. It affects people of all ages, at any stage of life, and can be associated with a lack of energy and motivation. Healthcare professionals sometimes find it difficult to distinguish fatigue from other common symptoms, such as tiredness, and often treatment does not commence until the situation has become chronic.
Fatigue in spinal cord injury (SCI) is under-reported, under-researched and not sufficiently understood. Females tend to be more affected than males and the level of injury appears to be relevant too: people living with tetraplegia report more fatigue than people living with paraplegia. These findings come from a longitudinal study of 300 British SCI people who have been living with their injury for more than 23 years.
If your injury is incomplete or you are able to walk, you are just as likely to experience fatigue as people with complete injuries.
Take fatigue seriously, it may be associated with how long you have been injured and it probably won't go away on its own.
What causes fatigue?
Fatigue can be caused by a combination of factors:
How can fatigue be treated?
Treating the symptoms
For example, if pain is keeping you awake at night you should seek treatment for your pain.
Try to ensure that the person you see is registered with one of the professionally recognised bodies in your country, who has experience of working with SCI people.
Cognitive Behavioural Therapy (CBT)
This therapy helps manage your problems by changing the way you think, and ultimately the way you behave.
Seeking medical advice
Try to seek specialist medical advice before fatigue affects your daily life. You may require bloods tests to eliminate conditions such as anaemia or an underactive thyroid. There may be a local specialist clinic or facility where you can get advice or treatment and have your fatigue level monitored.
This doesn’t necessarily mean going it alone, you can still engage family and friends to help you. Also, there are self-help books including audio books which can be obtained.
You may consider using complimentary (alternative) therapies on their own, or in conjunction with conventional treatments such as drug therapy.
Complimentary therapies include massage, relaxation techniques, acupuncture, hydrotherapy and mindfulness (meditation).
The therapies work for some people and not others and there is generally a cost implication. Some therapies may be difficult to access in your area or country, so try to source therapists where you have a personal recommendation; it may be wise to check with your medical team that your chosen therapy is safe for you.
Cautionary effects of fatigue in SCI
Quality of life
Chronic fatigue, if left unchecked, can impact on many aspects of a persons’ life. Living with a spinal cord injury will alter the way you prioritise and set goals and cause you to reassess the things you value in life; you need to set realistic goals and learn how to pace yourself. Fatigue is one issue that you may have to deal with and adapt to, so that it has a minimal effect on the quality of your life.
Keeping in touch with extended family and meeting up with friends can be energising. Don’t be afraid to share your concerns with those closest to you, and don’t forget that your able-bodied friends will also experience fatigue and aches and pains, along with other effects of ageing.
Avoid the company of negative people as they can affect your mood; this may be unintentional but the effect is just the same.
The key aspects of managing fatigue in advancing years are recognising that it is a problem and then implementing the necessary changes/adaptations in order to minimise the impact on your life. Eating healthily, exercising within your capability, pacing yourself and making time for rest are all important. Equally, staying positive and involving family and friends, along with proper assessment by the appropriate healthcare professionals, will help in controlling levels of fatigue.
This fact sheet has been prepared by ESCIF and contains general information and guidance which we hope will assist you in ageing well with your spinal cord injury. The information should not be used as a substitute for professional or medical advice. ESCIF does not accept any liability arising from its use. Please note that the inclusion of named agencies, websites, companies, products, services or publications in this fact sheet does not constitute a recommendation or endorsement by ESCIF.
Date of publication: March 2018