Coping With RA Morning Stiffness
Morning stiffness is a classic sign of rheumatoid arthritis (RA) and it is also an indicator your disease is quite active. It makes it harder to move joints especially upon waking after a night of several hours of sleep.
What Is Morning Stiffness?
Many people describe morning stiffness as a freezing up or locking up of their joints. The stiffness makes harder to perform the simplest morning tasks and may even control a person’s morning routine.
Morning stiffness can affect any joint, but it more often affects the hands, feet, spine, and hips. It is generally accompanied by pain, which makes getting up in the morning even harder for people with RA.
The causes of morning stiffness aren’t entirely understood but researchers think a combination of inflammation and joint immobility while resting results in limited mobility and tightening of muscles and joints. Sometimes, after laying down or sitting for long periods, similar stiffness occurs, and but as soon you get up and move, stiffness improves.
Research reported in the BMC Musculoskeletal Disorders journal finds up to 89 percent of people with active RA experience morning stiffness. Moreover, between 44 and 80 percent of people with RA reported experiencing morning stiffness even without an active RA flare.
Tips to Manage RA Morning Stiffness
Research reported in Clinical Rheumatology finds prolonged stiffness in the morning from RA can cause persistent and ongoing fatigue. The research also noted getting morning stiffness under control improves the chance for RA remission, a period where disease activity is low or gone.
Getting your morning stiffness managed makes a difference throughout your entire day, but you cannot start your day if your mornings end up being tougher then they have to be.
Here are some creative ways to manage RA morning stiffness to help you start your day on a positive note:
Use Heat Therapy in Bed
Invest in a heated mattress pad or electric blanket you can time to turn off after your bed warms up. Set your alarm to wake you early to turn the blanket or mattress cover back on for some heat therapy before starting your day.
You don’t need to purchase a specific heated mattress pad or an electric blanket. Just invest in one with a timer, so you can schedule it to turn off after you have fallen asleep and it is not running all night.
Use a Joint Cream Before Bed
If you know you are going to wake up stiff and hurting, ask your doctor about an arthritis joint rub, such as diclofenac gel (Voltaren Gel), to use before going to bed. These products can reduce the amount of pain and stiffness you wake up with.
As a note of precaution, some prescription joint rubs are nonsteroidal anti-inflammatory drugs (NSAIDs) and too many NSAIDs aren’t good for you. It is therefore important to check with your doctor about taking oral NSAIDs with an NSAID gel.
Take Medications Upon Waking
Keep your medications on a table or nightstand next to your bed, along with a glass of water to take as soon as you make up.
NSAIDs, work quickly to help reduce pain and inflammation and taking an NSAID upon waking may help you to start your day with less stiffness and soreness. If you need something stronger, ask for your doctor about a prescription NSAID.
Start Your Day with Movement
As soon as you wake up, before getting out of bed, move your stiff joints gently without stretching. Use gentle circular motions and extend the joints. To improve movement throughout your body, make sure you move all your joints.
Once you are comfortable in bed, lie on your back and start stretching. Start with your upper body moving your joints gently. Turn your head from side to side to loosen your neck and then start moving hands, wrists, elbows and shoulders one side at a time, and do the same with the joints of your lower body, including hips, knees, ankles, feet, and toes.
Make sure movements are slow and gentle. When joints feel less painful and stiff, you can get out of bed.
A physical therapist can help teach you helpful exercises and stretches. Talk to your treating doctor or rheumatologist about a referral.
Take a Warm Shower or Bath
A warm shower or bath is a great way to relieve RA morning stiffness. The warmth of the water will promote blood circulation and warm your joints.
Continue to gently move joints while showering or bathing. Stay long enough to warm your joints up and relieve some tension from joints and muscles.
Take Your Time
Don’t push yourself to start the day. Give yourself plenty of time in the morning and pace yourself so you can get things done without making pain and stiffness worse.
If your morning stiffness lasts longer on some mornings, you may want to ask for special accommodations at work, such as a flexible schedule or the ability to work from home.
Work with an Occupational Therapist
Hands and fingers are most affected my RA morning stiffness. An occupational therapist can fit you for splints to keep your fingers in a resting position while sleeping and reduce morning stiffness in hands and fingers.
Morning stiffness is common in people living with RA but with proper planning, you can manage and reduce symptoms. Moreover, you should work with your doctor to find the right RA treatment to manage the effects and symptoms of RA.
National Institutes for Health (Factors that influence fatigue status in patients with severe rheumatoid arthritis (RA) and good disease outcome following 6 months of TNF inhibitor therapy: a comparative analysis)