Why Your Joints Are Stiff or Painful in the Morning

by Grant Cooper, M.D. Health Professional

"My knee feels stiff when I sit for a long time and it hurts to get up. But, after I walk for a few minutes, the pain eases up."

"My hands are stiff in the morning or after I take a nap during the day. After I have been awake for about twenty minutes, the pain is completely gone."

"My lower back is very tight in the morning and it hurts to get out of the bed. I do a few exercises and my back seems to loosen up."

The above are just a few of the comments I hear on an almost daily basis. In osteoarthritis, joints are commonly sore, stiff, and painful after sleep or after resting them for a while. After getting up, the joints "loosen up" as they move around and are used. In the spine, the small facet joints are a common source of arthritis and back pain. The facet joints work as hinge joints similar to the hinges on a door. In a young, non-arthritic person, the joints glide smoothly over one another. However, as the joints become arthritic, they function more as a rusty hinge joint on a door that squeaks when you first try to move it. However, as you swing the door open and closed, open and closed, the door becomes looser and glides more smoothly. It is a similar phenomenon with the rest of the joints.

What is happening on a pathophysiologic basis within the joints?

With rest, the joint fluid is soaked up by the cartilage within the joint similar to how a sponge soaks up water. When the joint is used, the cartilage is "squeezed" and the joint fluid bathes the joint. The more the joint is used, the more the joint fluid coats and lubricates the inner joint.

In a non-arthritic joint, this process happens quickly and efficiently. However, in an arthritic joint, there is less cartilage, less joint fluid, and the cartilage that is there may be of poorer quality. As a result, in an arthritic joint, the process of lubricating the joint with the joint fluid that is being stored in the cartilage is less efficient and less effective. Note that after an arthritic joint is "warmed up" and starts to feel better, if it is used for a long time, it often starts to become more and more painful until it is rested. Stretching and strengthening the muscles surrounding arthritic joints helps take the pressure off the joint so that they are less painful and less stiff when they first start moving, and also less painful and stiff while they are being used.

Of course, there are many causes of joint pain and stiffness. Morning stiffness may be caused by osteoarthritis, but it may not. Get yourself checked out by your doctor so that you can arrive at an accurate diagnosis and appropriate treatment plan.

See also:

Joint pain? Don't Diagnose Yourself

Grant Cooper, M.D.
Meet Our Writer
Grant Cooper, M.D.

Grant Cooper is a board certified, fellowship-trained physician who specializes in the non-operative treatment of spine, joint and muscle pain. He wrote for HealthCentral as a health professional for Osteoarthritis.