How to Cope With Rheumatoid Arthritis Morning Stiffnessby Lene Andersen, MSW Patient Advocate
One of the defining characteristics of arthritis is morning stiffness. Depending on the kind of arthritis you have, it may last a shorter or longer period of time.
When you have rheumatoid arthritis (RA), morning stiffness typically lasts more than an hour, even hours, seriously getting in the way of what you can do. However, there are techniques you can use to reduce morning stiffness so you can get on with your day.
What Is Morning Stiffness?
Stiffness in joints affected by RA is due to swelling caused by the inflammation of active disease.
Although it can happen at any time after an extended period of inactivity, such as sitting still, it is especially prevalent in the morning. This is partly because you don't move much overnight while you’re sleeping. However, studies have also shown that inflammation follows the circadian rhythms of the body. This can explain why you sometimes feel awful early in the day and much better toward the evening.
What Does Morning Stiffness Feel Like?
When I was a child my doctor asked how long my morning stiffness lasted. I had no idea what the word “stiff” was, so I would say, “I just ‘crack’ my bones!” If only the doctor had asked me how many times a day I needed to “crack.” — Stephanie
If you have RA already, you know very well the painful stiffness that accompanies mornings, making you move like the Tin Man from The Wizard of Oz. It’s a difficult-to-describe unique blend of feeling locked in place mixed with a creaking pain accompanying every move. It's almost as if your joints have set, similar to the way gelatin does.
Morning Stiffness Impacts Your Whole Day
Morning stiffness can have a significant effect on quality of life. Not only does the pain and stiffness make your morning a miserable experience, it can also affect your activity for the rest of the day.
For instance, one study found that in the early years of having RA, severe morning stiffness led to an increased rate of early retirement. Not surprisingly, other studies have found that morning stiffness leads to frustration and emotional distress. So what can you do to cope? Keep reading for tips.
Talk to Your Rheumatologist About Solutions
Your rheumatologist is your partner in dealing with the challenges of RA. Talk to them about your morning stiffness. Although many people with RA experience some level of stiffness in the morning, if it lasts a long time, it might be an indication that your treatment needs to be adjusted.
Try Range-of-motion Exercise
I do stretching exercises — really helps. — Vanessa
Start your day with gentle exercises. Before you even get out of bed, stretch your limbs through bending and stretching within their range of motion. Expect some achiness, but don't move past the point that hurts. You can talk to your rheumatologist about guidance on range-of-motion exercises, or ask for a referral to a physical or occupational therapist who can help show you what to do.
Apply Heat to Your Joints
I turn on an electric throw. Some days it takes me a long time to get moving! — @alinnzy
Some people with RA find heat to be an excellent way to warm up their stiff joints in the morning. You may want to have a heating pad ready next to your bed and use that before — or at the same time — as you are doing range-of-motion exercises. Once you do get out of bed, a warm bath or shower can also be very helpful to make your movements less uncomfortable.
Chill Your Joint Stiffness With Ice
On the other end of the spectrum, some people find ice to be more useful in treating their pain and stiffness.
Usually getting an ice pack involves having to get out of bed, but you can get packs that turn cold when you bend or crack them — check with your local pharmacy.Keep a couple in your nightstand for use on bad mornings. Remember to wrap the ice pack in a towel before you apply it to your skin and limit the application to no more than 20 minutes at a time.
Sometimes I use a hand-held massager to get my knees “into gear.” — @heidipaterson
Massage is a great way to get the blood flowing and to loosen up your joints. You can learn ways to self-massage. It is usually recommended to start with long, vigorous strokes, but this might be difficult when your body is aching.
Do what feels good and don’t worry about technique. Using essential oils can help with the emotional aspect of morning stiffness. You may want to consult a massage therapist to learn how to self-massage.
Try Starting Your Day With Meditation
Meditation can help you live better with chronic illness and pain. Studies indicate that regular meditation can reduce anxiety, pain, and depression.
Learning to meditate is simple — there are many books and recorded programs that can show you how. Starting the day with a meditation or body scan can help you reset a body that is consumed by morning stiffness. Combined with some of the other techniques mentioned, it can help you have a better day.
Medication Might Help Get You Moving
I keep water and my pill bottles on my night stand. — Jennifer
I spent a lot of time in hospitals as a child and learned a trick that I still use today. Set your alarm clock to a couple of hours before you need to get up. Take your pain medication, plus eat a cracker or half an apple to protect your stomach, and go back to sleep. When you wake up, your meds are working, which helps you start the day ahead of the pain. If you wake up in the middle of the night because of pain, talk to your doctor about this and potentially about a prescription that can help you sleep.
Change Your Routine to Allow Time to Care for Your Joints
Changing your routine can also be a good tool to cope with morning stiffness. This can include anything from getting up an hour early to make sure your body has time to catch up, arranging a later start time with your employer, preparing lunches and wardrobe choices the night before, and never waiting until you are in a lot of pain to take your meds. Play around with different choices to see what works for you.