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Rheumatoid Arthritis: Managing Morning Stiffness

Posted on April 07, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Sage Salvo

It’s normal enough to wake up achy the day after a difficult workout or a long day of work. But for people with rheumatoid arthritis (RA), aches and pains can be part of a typical morning.

Morning stiffness is a common symptom of rheumatoid arthritis, affecting almost three-quarters of people with the autoimmune disease. When left unmanaged, RA-related aches can be frustrating, and may even derail your usual morning routine. To quote a myRAteam member, “It’s a fairly good day after the morning stiffness goes away!”

Fortunately, morning stiffness with RA isn’t necessarily inevitable, and you can take certain approaches to soothe or reduce these symptoms.

Rheumatoid Arthritis and Morning Stiffness

Rheumatoid arthritis is well-known for its impact on mobility and joint function. This chronic inflammatory disorder occurs when the immune system attacks the lining of the joints (synovium). Characteristic symptoms of RA include swollen, misshapen, or tender joints, and stiffness that worsens after periods of inactivity.

Morning stiffness is a common and frustrating symptom of RA. When a person with RA gets up for the day, their affected joints may feel stiff or painful, or they may lack a full range of motion. Morning stiffness can make even simple tasks like getting out of bed, preparing breakfast, or commuting to work challenging. “Woke up this morning with stiffness and numbness … but still had to go to work,” a myRAteam member shared.

Many myRAteam members have shared their experiences with morning stiffness. One member noted that they had “stiffer joints” when it was cold in the morning, while another woke up to fingers that felt “a little tight.”

Tips for Managing RA Morning Stiffness

Several simple, at-home remedies can help you limit the effect morning stiffness has on your day. However, if your symptoms grow steadily worse or cause you significant pain, talk to your rheumatologist for medical advice.

Daily Stretching

Gradually “waking up” your joints with gentle movements can help you gain mobility without triggering arthritis pain. Many myRAteam members find morning stretches in bed helpful. If your spine feels particularly tight, try drawing one or both of your knees up to your chest to stretch out your back. To activate your knees, try moving them from side to side or slowly bending and straightening them.

Be careful: You should never push your body past its limits. Although you may experience some mild discomfort at first with some stretches, they should not cause pain. Pushing yourself to the point of pain may put you at risk of injury.

It may help to make an appointment with a professional physical therapist who has experience helping people with RA improve their mobility. A physical therapist can teach you a few helpful range-of-motion exercises and ensure that you’re stretching with proper form.

“I’m doing physical therapy to get blood flow going, keep swelling down, and keep the pain out of my joints,” one myRAteam member shared. “The therapy is covered by Medicare, and my therapist is excellent.”

Schedule Time To Exercise

Morning stiffness worsens with inactivity, so some gentle exercise may help make mornings easier. A walk around the neighborhood or a brief tai chi session in the morning may do wonders for your mobility. “Walking each day helps me,” one myRAteam member shared.

If you work a desk job and are relatively sedentary throughout the day, you may also want to schedule brief 15-minute breaks for a quick walk or stretch. Read more about exercising with RA.

Plan Ahead for the Morning

You can make your life easier by prepping for your morning routine the night before, some members suggest. Try setting your clothes out on your dresser or keeping a bottle of nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin, on your side table with a glass of water. As one myRAteam member noted, “NSAIDs and analgesics are a good first step.”

Having easy-to-prepare breakfasts on hand, such as overnight oats or cereal, may also help you avoid early-morning hand pains from prepping and cooking food.

Eat an Anti-Inflammatory Diet

Some researchers suggest using an anti-inflammatory diet alongside other medical treatments to lessen RA symptoms and improve quality of life. The most popular forms of these diets are the Mediterranean diet, a high-fiber diet, and a vegan diet. Read more about an anti-inflammatory diet for RA.

Take Warm Baths and Showers

“In the mornings, I like a hot bath or shower to help my joints,” one myRAteam member shared.

Indeed, stepping into a warm bath or shower is a recommended way to alleviate your morning stiffness. A dip in warm water encourages blood to flow to the surface of your skin, which helps loosen joints. Generally speaking, you’ll need to set aside 10 to 15 minutes for an effective warming soak. Try not to stand still while in the water. Instead, make small movements to exercise your joints.

Epsom salts can also be added to a bath. Researchers aren’t in full agreement as to whether mineral baths are an effective means of addressing arthritis symptoms. However, some research suggests that mineral-bath soaks may have an anti-inflammatory effect and increase the number of endorphins (pain- and stress-relieving chemicals) circulating in the body.

Apply Heat To Stiff Joints

Research shows that gentle heat can relax muscles, improve pain tolerance, and decrease the intensity of the aches caused by RA. Microwaving a damp, folded towel for a few seconds to a minute and applying it to an affected joint can help relax and soothe away stiffness. You can also purchase heating pads, gloves, and other warming garments, though moist heat tends to be more effective and penetrate more deeply than dry heat.

Try Natural Remedies

Natural remedies should never be used as a substitute for doctor-guided care. With your doctor’s approval, some plant-based treatments may be effective in lessening pain and improving mobility. Here are a few that may provide some relief.

Curcumin

Curcumin is a yellow pigment and spice taken from turmeric, a flowering plant in the ginger family. It has been used for centuries in cooking and as an anti-inflammatory ingredient in ancient Chinese and Indian medicines. Several studies have confirmed curcumin’s usefulness as an antioxidant and anti-inflammatory spice. Incorporating curcumin into your diet may help lessen inflammation in your body and reduce RA symptoms.

White Willow Bark

Tea and other remedies distilled from white willow bark are among the oldest natural remedies for pain and inflammation. The ancient Egyptians, Romans, Indians, and Greeks all relied on the bark as a pain reliever and fever reducer. Today, it’s occasionally used by people who have GI problems and can’t take aspirin. People with RA might consider using white willow bark as a remedy for mild aches and pains.

Capsaicin

The active component in hot peppers, capsaicin, may provide a numbing effect when applied topically to aching areas. Capsaicin has also been found, in some studies, to be a potential pain reducer for conditions that cause chronic musculoskeletal pain, such as rheumatoid arthritis

Topical capsaicin lotions are available for over-the-counter purchase. Be careful during your first application, though: Some people may experience an allergic skin reaction once capsaicin is applied.

Why Do People With RA Experience Morning Stiffness?

Feelings of joint stiffness or tightness in the morning can be attributed to what doctors call the gel phenomena. Essentially, when a person with RA is at rest for long periods, the synovial lining (a slick, lubricating fluid that lines certain joints and promotes movement) becomes thick, limiting joint movement.

Researchers believe the gel phenomena has something to do with the daily rhythms of pro-inflammatory cytokines — the proteins used in cell signaling. In people with RA, cytokine levels peak in the early hours of the day but fade by lunchtime. As a result, some people with RA find that their stiffness improves as the day goes on. “I was stiff this morning,” wrote a myRAteam member, “but I’m feeling loose now.”

RA-related morning stiffness can last longer than morning stiffness caused by other forms of arthritis. People with osteoarthritis — a noninflammatory form of arthritis — also commonly experience morning stiffness, but their symptoms tend to disappear within 30 minutes or so after rising. But for people who have RA, joint stiffness might persist for much longer, averaging about 90 minutes.

Morning stiffness that lasts for longer than an hour is also commonly associated with advanced spondyloarthropathies (inflammatory arthritis conditions affecting the spine), such as ankylosing spondylitis and psoriatic arthritis.

Meet Your Team

Living with rheumatoid arthritis isn’t always easy, especially when you don’t know anyone else with your diagnosis. But finding people who truly understand what you’re going through may not be as difficult as you think.

By joining myRAteam — the social media platform for people with rheumatoid arthritis — you can connect with more than 147,000 people from across the world to ask questions, offer advice, and share stories of life with RA.

How do you deal with morning stiffness? Share your thoughts or tips in the comments below or by posting on myRAteam.

References

  1. Prevalence of Morning Stiffness in a U.S. Registry Population of Rheumatoid Arthritis Patients — American College of Rheumatology
  2. Rheumatoid Arthritis — Mayo Clinic
  3. Rheumatoid Arthritis — National Health Service
  4. Morning Stiffness — ScienceDirect
  5. Morning Stiffness and Its Influence on Early Retirement in Patients With Recent Onset Rheumatoid Arthritis — Rheumatology
  6. Your Arthritis Morning Routine — Arthritis Foundation
  7. Design of an Anti-Inflammatory Diet (ITIS Diet) for Patients with Rheumatoid Arthritis — Contemporary Clinical Trials Communications
  8. Anti-inflammatory Diet in Rheumatoid Arthritis (ADIRA) — A Randomized, Controlled Crossover Trial Indicating Effects on Disease Activity — The American Journal of Clinical Nutrition
  9. Heat Therapy for Rheumatoid Arthritis — Harvard Health Publishing
  10. Epsom Salt and Mineral Baths for Arthritis: Do They Help? — CreakyJoints.org
  11. Natural Anti-Inflammatory Agents for Pain Relief — Surgical Neurology International
  12. How Do Synovial Joints Work? — Arthritis-Health
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sage Salvo is a content creator who specializes in developing savvy, SEO-aware content strategies and top notch ghostwritten articles for a wide variety of industry niches. Learn more about her here.

A myRAteam Member said:

Wow, you are an RA star! All those exercises, I wish I was that good about things like that. I mostly feel that just cleaning the house is exercise. But… read more

posted 1 day ago

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