Hen I wasn't sure if it was the medication...other

The following theme highlights self-management interventions utilised by St produced me feel like a zombie...I felt worse". A further Participants such as experiences and challenges. It just comes on you..." whereas another participant implied "I never ever located that I was tired normally, only soon after a flare up." Work commitments were on 1 hand viewed as a motivator for life, one participant stated "it [job] keeps me going", but alternatively a further participant who finished operate due to fatigue in AS stated "I have completed operate now so I'm managing a great deal improved, but when I was operating I found it extremely difficult, you can just cry or you felt physically sick due to the fact you felt so tired." In agreement one particular participant stated "In the finish I just gave up function...it made it less difficult physically not obtaining to go in, but I nonetheless find I am having periods of mood swings and depression...the longer it [sleep problems] goes on then the much more mood swings kick in." One more participant identified it "hard to concentrate in perform because you felt so tired." There was a general consensus over the uncertainty of whether the symptoms of AS (such as discomfort, impaired sleep) triggered fatigue or if fatigue was a symptom of AS. One particular participant questioned "Has the humira [adalimumab] helped me using the fatigue or has it helped with my sleeping pattern which has indirectly helped with my fatigue?". The subsequent theme highlights self-management interventions utilised by participants like experiences and challenges. (2)Current limitations (of self-management) Participants have been encouraged within the concentrate group to talk about what interventions or treatments they had tried, or wanted to attempt with regard to self-managing their fatigue. Responses ranged from; getting a positive attitude "just retain on going" and "trying to see the glass half full not half empty", self-medication "I will take more co-codamol",Davies et al. BMC Musculoskeletal Disorders 2013, 14:163 http://www.biomedcentral.com/1471-2474/14/Page four ofkeeping active "every day I stroll for a very good hour together with the dogs, I swim and I keep active", and getting a member of a gym. Hydrotherapy was a well known activity, but getting a warm pool and also the cost involved were viewed as problematic "it will be lovely to swim in a warm pool however the prices these locations are charging." A single participant stated they felt they "had to workout that was the leveller.....if I never do it [exercise] I'm in real difficulty." Other participants reported sleeping for brief periods of time "a ten minute power nap and I'm fine again". Some participants implied they tried to not rely on medication for managing their AS because of the lots of sideeffects seasoned. The following quote illustrates this circumstance: "I was taking indomethacin for the pain however it brought on the bowel to flare up and I was hospitalised with that....so I try and manage without drugs if I can...but of course you have to in the event the discomfort is quite poor." As component in the focus group participants have been shown a 3 minute video clip on amitriptyline medication [24] (which is usually prescribed just before bedtime for fatigue and pain in chronic musculoskeletal conditions), which includes how it works, dosage and its advantages for managing chronic nerve discomfort. 4 out of 14 participants had used with this kind of medication previously.