As summer fades and the crisp air of autumn arrives, many people find their schedules ramping up. The leisurely pace of summer gives way to the busy routines of fall, with vacations ending, school starting, and work hours returning to their usual pace. For individuals with chronic illnesses like spondyloarthritis, this transition can present unique challenges. Cheryl Crow, a licensed occupational therapist and advocate for people living with inflammatory arthritis, uses her training as well as her own experiences living with chronic illness to offer valuable insights into managing seasonal shifts while battling chronic fatigue and pain.
Adjusting to Weather Changes
The shift from summer to fall can impact people with chronic illnesses differently. Cheryl says, “Some people, like me, get horribly fatigued in hot weather and thus welcome the cooler temperatures of fall. Others love the heat and struggle with the cold. For others, it’s not the temperature itself but the fluctuations in either temperature or humidity that can spark a flare up of fatigue or pain.”
She advises paying attention to personal patterns and coming up with a plan that considers these variables. “Given that you can’t control the weather, can you control the degree to which you have to spend time outside, or can you control where you live? Can you control your body temperature if you must be outside by having personal cooling or heating items?”
Cheryl suggests looking into the appropriate temperature-regulating items, including battery-heated socks and mittens for cold weather and wearable fans and cooling shirts for hot weather.
Also, it’s important to be realistic about what activities you can do given your body’s typical reaction to weather changes. If you know that a dip in temperature can affect you adversely, you may need to opt out of that evening tailgate.
Finding a Work-Life Balance
Maintaining a work-life balance is difficult for everyone, but for those dealing with the fatigue and brain fog of spondyloarthritis, managing career, family, and social obligations can feel nearly impossible.
Cheryl emphasizes the importance of a two-pronged approach: planning ahead and accepting the inevitable bumps along the way. “By planning ahead, I mean to schedule in some rest breaks for yourself, and delegate anything you can so that the transition [into a busier schedule] goes more smoothly.” she explains. “By accepting, I mean simply knowing that no matter how perfectly you plan, sometimes ‘life happens’ and that it’s helpful to relieve yourself of the burden of trying to do everything ‘right.’”
With a chronic illness, you might feel that your body is out of your control and can’t handle everything you need and want to do (e.g., work long hours, cook dinner for your family, and squeeze in a hobby or two). Paradoxically, the solution might be to loosen your grip on control.
Cheryl says, “It’s been extremely helpful for me to accept that no matter how great a job I do managing my energy, some days will just be hard, and that’s okay and not my fault.”
Balancing Flexibility and Consistency
Recognizing the need to lose one’s grip on control is one challenge; actually practicing flexibility presents another, especially for those who thrive on structure and routine.
For Cheryl, maintaining flexibility in her routine has been necessary due to the unpredictable nature of flare-ups. And unfortunately, there’s not one quick way to learn flexibility.
“I could tell you specific strategies to develop flexibility, but it won’t matter if you’re too fixated on having control to use them,” Cheryl says. “You have to do the ‘internal work’…to become OK with flexibility. For me personally, that required therapy for my anxiety, which manifested as a need for control. I found Acceptance and Commitment Therapy (ACT) incredibly helpful for coping with chronic illness.”
Practicing Activity Pacing
Activity pacing is a crucial strategy for managing fatigue. Cheryl explains, “Activity pacing means thinking ahead before you start an activity about how you can conserve your energy. If you have to do a lot of shopping in one day, for example, can you schedule little rest breaks in between each store you go to? Can you delegate some of the energetically taxing tasks to someone else?”
She emphasizes that while conserving energy is important, it’s also essential to recognize that some activities, like exercise, can actually increase energy levels later in the day. “Multiple repeated studies have shown that for people with inflammatory arthritis, consistent engagement in exercise leads to better sleep, fatigue levels, pain, and overall mental wellness.”[1]
Incorporating Relaxation and Mindfulness Practices
Relaxation and mindfulness practices can enhance energy conservation. Cheryl prefers “micro-moments of mindfulness” over prolonged sessions. “My favorite definition of mindfulness is ‘nonjudgmental awareness of the present moment,’” she explains. “It’s a bit of a mysterious process, but I have found that connecting with the present moment, even if it’s painful, has paradoxically led to a greater sense of peace with my body.”
Even though it may seem counterintuitive, studies have shown that ACT and other mindfulness practices can help alleviate chronic pain and fatigue over time.[2] The theory behind ACT is that by gaining awareness and acceptance of physical sensations, even if they are unpleasant, individuals can experience these sensations as transient thoughts and feelings rather than as immutable facts. This approach fosters psychological flexibility, allowing individuals to respond to their pain and fatigue in more adaptive ways.
“There’s a saying in ACT: it’s not about ‘feeling better,’ it’s about ‘feeling better,’ improving your capacity to truly feel and connect with whatever you’re experiencing,” says Cheryl.
Modifying the Home Environment
Cheryl, drawing from her experience as an occupational therapist, advocates for making small tweaks to the home environment to reduce fatigue and manage pain more effectively. “For home modifications, this could include everything from improving your sleep environment through pillows, using pain relief tools like calming pain relief creams, reorganizing your kitchen so items you use most often are easily available, putting in gadgets to reduce pain and strain throughout the day, and more.”
Some occupational therapists even do home visits to help people modify their home and workspaces. Check with your insurance provider to see whether this service is covered by your plan. You can also listen to an episode of Cheryl’s Arthritis Life Podcast, featuring occupational therapist Lindsay Delong, in which they discuss home modifications and adaptations for people living with arthritis.
Beyond Symptom Management
Navigating the nuances of seasonal change alongside chronic illness transforms the journey beyond symptom management to cultivating a deeper understanding of your body’s needs and capacities. It involves a continuous exploration of balance, where flexibility and self-compassion are pivotal. By integrating these insights into daily life, individuals adapt to external shifts while nurturing an inner resilience that transcends seasons, empowering them to live more fully and authentically, regardless of the weather’s challenges.
[1] Boudjani, R., Challal, S., Semerano, L., & Sigaux, J. (2022). Impact of different types of exercise programs on ankylosing spondylitis: a systematic review and meta-analysis. Disability and Rehabilitation, 45(24), 3989–4000. https://doi.org/10.1080/09638288.2022.2140842
[2] Ye L, Li Y, Deng Q, Zhao X, Zhong L, Yang L (2024) Acceptance and commitment therapy for patients with chronic pain: A systematic review and meta-analysis on psychological outcomes and quality of life. PLoS ONE 19(6): e0301226. https://doi.org/10.1371/journal.pone.0301226
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