Pain can be very tiring. When I'm having a flare-up, I also find it hard to concentrate too. Celebrex helps me a lot. I don't like any of the smelly creams, but Aspercreme does give some relief. Seriously consider starting some type of water exercise: gentle water-walking, water aerobics, laps of whatever strokes you feel comfortable doing. I swim regularly, and keeping my pool membership is as important to me as any other medicine. In the water, you get exercise without jarring impact, and the exercise also gives you more oxygen and better circulation which really improves the fatigue.