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How to manage morning stiffness with rheumatoid arthritis

Many with people with rheumatoid arthritis are familiar with stiff joints in the morning. But what causes this morning stiffness, and how can people get rid of it?

Rheumatoid arthritis (RA) is an autoimmune condition that attacks the joints, causing inflammation, pain, and stiffness, including morning stiffness.

Morning stiffness is a widespread problem among those with RA. According to a 2014 review of two studies, between 79 and 89 percent of people with active RA experienced morning stiffness.

The report also noted that morning stiffness affected between 44 and 80 percent of people who were not experiencing an active RA flare.


Tips for managing morning stiffness

Senior taking a bath which can help alleviate rheumatoid arthritis morning stiffness
A warm bath can help ease morning stiffness.

Morning stiffness makes moving the joints feel slow and difficult. Some people may have trouble getting out of bed. This stiffness usually involves both sides of the body and gets better with movement.

One of the most beneficial things that people with RA can do to ease their morning symptoms is to develop a morning routine.

Planning ahead to deal with morning stiffness can help people act as soon as they wake up. This might help reduce the stress and frustration of stiff joints.

Include some or all of the following methods in a routine to increase mobility and help manage morning stiffness and other RA symptoms:

1. Start the day with gentle and slow movements

Upon waking, before standing up, move the stiff joints slowly and gently without pulling or stretching. Making gentle circular motions, bending and extending the joints is helpful.

To improve mobility all over the body, move all the joints, including the wrists, neck, shoulders, elbows, knees, and fingers.

2. Do targeted stretches

People can do targeted stretches while still in bed:

  • Stretch each affected joint.
  • Hold for 20–30 seconds and repeat two to three times.
  • Move slowly and do not overstretch. Stretching should never be painful.

People may benefit from working with a physical therapist to create a personalized exercise and stretching program for relieving their pain and preventing symptoms.

3. Use heat therapy in bed

Using a heated blanket or having a warm bath first thing in the morning can help to ease the stiffness and loosen the joints.

4. Exercise

As little as 5 minutes of exercise can ease symptoms. Try some range-of-motion exercises, which involve moving the joints as far as possible in different directions.

Gently pedaling on a stationary bike can also help to loosen stiff joints in the morning. A physical therapist can provide personalized ideas as well.

5. Taking medication

Medication can help people control the symptoms of morning stiffness. In some cases, over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) can help.

In other cases, people may need to take prescription medication. Talk to a doctor to find the appropriate remedy for the best results.

6. Keep medication by your bed

Keeping medicines near the bed, such as on a nightstand, is helpful. This means a person can take their medication as soon as they wake up, allowing symptoms time to ease before it is time to get up.

7. Use a joint cream

Apply joint creams, such as diclofenac gel, first thing in the morning. This can help relieve morning stiffness by easing inflammation and should help get the joints moving.

8. Eat a healthful breakfast

Nutrition is essential for a healthy body. Eating a light and nutritious breakfast can give the body the energy it needs to get going.

An anti-inflammatory diet can help reduce inflammation and pain. Make sure to eat well throughout the day.

9. Work with an occupational therapist

Sometimes, joints are put under pressure overnight. If a person closes their fingers into a fist while they are sleeping, the joints can be really tight by the morning.

An occupational therapist can provide a splint that will keep the fingers in a resting position overnight. This should reduce the chance of morning stiffness.

10. Make arrangements with work

Sometimes, morning stiffness lasts longer than just early morning; sometimes it can last for hours or days.

When symptoms are particularly severe, ask for special accommodations, a flexible work schedule, or an opportunity to work from home. Taking breaks to move around can also be helpful.


Preventing morning stiffness

woman doing yoga
Doing yoga regularly can help prevent morning stiffness.

The following strategies can help to prevent morning stiffness:

  • Taking medication. NSAIDs can help reduce inflammation. Talk to a doctor to find the best medication and see what other options are available. Anyone who is taking a prescribed medication should talk to their doctor before taking any OTC medicines.
  • Exercising and stretching. Regular exercise and stretching throughout the day can help with joint movement. Yoga, tai-chi, swimming, easy bike rides, and other gentle exercise are all good options. Avoid sitting or lying down for too long, and take frequent breaks to move around a bit throughout the day.
  • Using heat. Using heat pads or taking hot baths or showers can loosen the joints and ease inflammation in the body.
  • Taking vitamin D and calcium. These nutrients are both essential for bone and joint health.
  • Eating an anti-inflammatory diet. Try removing inflammatory foods, such as refined sugars and processed foods, from the diet. Replace these foods with fiber-rich whole foods that can help prevent and reduce RA symptoms.
  • Taking it slow. Go easy and reduce activity if it feels too strenuous on the joints. Identify and reduce RA triggers as much as possible.
  • Working with complementary and alternative practitioners. Acupuncture, chiropractic, massage therapy, essential oils, nutritional therapy, and other complementary and alternative methods can be beneficial to those with RA.

Why does RA cause morning stiffness?

Doctors do not fully understand the exact cause of morning stiffness in RA.

However, it is possible that the body’s natural rhythms contribute to morning stiffness. During the night, the body increases production of certain hormones, which can trigger swelling that leads to morning stiffness.


How long does morning stiffness last?

For some, joint stiffness only lasts for the early hours of the morning. For others, it is an all-day problem.

According to a small 2014 study published in the journal Rheumatology, some people with RA experienced morning stiffness that lasted long beyond the early morning hours.

Joint stiffness can last for part of the day or throughout the entire day. Prolonged stiffness can adversely affect a person’s activity levels, psychological well-being, and quality of life.


Outlook

Morning stiffness is common among those with RA. With proper planning and strategies, people can effectively manage and reduce their symptoms.

It is essential to work with a doctor to find the right medication, while physical therapists can assist with personalized exercise and stretching plans.

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