Your Step-by-Step Morning Ritual for Calming Joint Pain
Everyone wants to get their day off to a great start, but for those with psoriatic arthritis (PsA), there's a bit more to overcome than simple morning grogginess. Joint stiffness, skin discomfort, and swelling are a.m. staples of PsA, not to mention the annoying fatigue and brain fog that keep the snooze button engaged. We spoke to top experts who all agree, a holistic and intentional morning routine can lead to drastically reduced pain. With their help, we’ve created this step-by-step guide to help you navigate your mornings.
Step 1: Start With a Good Night’s Sleep
The best way to set yourself up for a good morning is by practicing good sleep hygiene the night before. According to Neda Yazdi M.D., a rheumatologist at Kaiser Permanente Zion Medical Center in Bonita, CA, studies show that “when you have a restful night of sleep you will feel better, have decreased pain in your joints, and feel more energetic.” Plus, “a restful night of sleep can lead to decreased anxiety and a clearer mindset. This helps to decrease pain in general, without adding more medications to regimens.”
Step 2: Make Your Bed a Haven for Rest and Sex…
…And nothing else. As comfy as it may be, working from bed has been shown to make it harder for your brain to switch into sleep mode at night. “Getting rid of screen time an hour before sleeping helps your body begin to rest,” says Micah Yu, M.D. a rheumatologist and owner of the Dr. Lifestyle Clinic in Newport Beach, CA. And yes, that includes ditching the TV from your bedroom.
Step 3: Watch What You Take Before Bed
While the science is still catching up, there are many anecdotal reviews showing that chamomile tea, melatonin or valerian supplements can each be extremely helpful for getting to sleep. “Avoid caffeine after noon and try not to eat for two to three hours before bedtime,” says Dr. Yazdi. This can help prevent late night indigestion and heartburn from waking you up and eating into your precious snooze time. Sidenote: Oral steroids can cause insomnia, so if you’re prescribed them, Dr. Yazdi suggests taking them in the morning.
Step 4: Stretch It Out
Here’s the rub: “Inflammation from PsA causes swelling in the joints, and because our joints are immobile overnight while sleeping, they become stiff causing the surrounding muscles and soft tissue to tighten,” says Angelo Labrinakos, D.P.T., a physical therapist and partner at Kinetic Physical Therapy in Chester Springs, PA. “By doing light stretches, blood flow increases to the muscles allowing them to relax and the body’s natural lubricant (synovial fluid) moves around within the joints eliminating stiffness.” Start your day with some gentle stretches in bed (think: rocking your head from side to side)—before even sitting up. You’ll feel the difference immediately.
Step 5: And Then Stretch Some More
“It may be difficult to get motivated at first to perform these stretches in the morning, especially because you are experiencing discomfort,” says Dr. Labrinakos. But the more you do them, the better you’ll feel. Try out these stretches (20-30 reps, holding for a couple of seconds per rep).
- Ankle Pump: Flex and point feet.
- Fist Clench: Open and close hands.
- Heel Slide: While on your back, slide heel along sheets to bend and straighten your leg.
- Knees to Chest: Pull knees to chest.
- Trunk Rotation: With your arms at your sides and knees bent, look to one side while dropping legs to the opposite side.
Step 6: Learn to Meditate
Meditation is all the rage, and for good reason. One study found that mindfulness meditation reduces the sensitivity of our brains’ pain receptors. Some studies have even found a reduction in the proteins that promote inflammation, known as cytokines. Just 10 minutes of deep breathing can make a huge difference. “I absolutely love the CALM app,” says Dr. Yazdi. “It starts the day off right by helping you set your intentions,” says Dr. Yazdi. There are many different ways to practice mindfulness, so take some time to explore methods and find what best serves you.
Step 7: Slather on Moisturizer
If you don’t mind the thickness, Mona Mislankar M.D., a dermatologist with Advanced Dermatology in Mason, OH, recommends ointments for their superior moisturizing abilities (they literally seal water into skin). “Ointments tend to be thicker than creams and lotions, [and] are the most effective at maintaining a skin barrier…,” she says. “In my opinion the greasier the better!” For further relief, Dr. Mislankar shares a trick many of her patients enjoy—keep non-medicated moisturizing creams in the fridge. The cooling effects ease inflammation.
Step 8: Exfoliate Gently
Aside from ointments, there are a few other ingredients worth adding to your bedtime or morning skin routine. Salicylic acid is a peeling agent that can help remove scaly layers that form in the upper layers of your skin and lead to irritation. “Clinically, this can help the psoriatic plaques appear softer and less scaly,” says Dr. Mislankar. Another great skin-smoothing ingredient: “[Coal tar], which decreases inflammation, erythema, itching, and improves the appearance of psoriatic scales by decreasing the rapid growth of skin cells.”
Step 9: Don’t Skip Breakfast
“Sixty to 70 percent of our immune systems are housed in our gut,” says Dr. Yu. Eating anti-inflammatory foods helps prevent the bad bacteria from overwhelming the good bacteria in our gut microbiome, which helps calm inflammation. “This is especially important for people with PsA because it is an inflammatory autoimmune disease.” Powering your body with foods that won't further aggravate the inflammatory response is huge. Dr. Yu suggests starting the day with a green smoothie. “Toss leafy greens into a blender with frozen berries and bananas for a bit of sweetness. Add flax, chia seeds, or turmeric for their anti-inflammatory properties.”
Step 10: Wake Up (Slightly) Earlier
Setting your alarm 15 to 30 minutes earlier each day helps ensure you have time to stretch, meditate, take care of your skin, and make a healthy breakfast, which helps you manage your pain and increase your mobility. “Lifestyle is very important with PsA,” says Dr. Yu. If you’re looking to incorporate these tips into your life, start with one change at a time. Says Dr. Yu, “Commit to one new thing each week and gradually build up to the full-scale change.”
- Pain and Mindfulness: The Journal of Neuroscience. (2015). “Mindfulness Meditation-Based Pain Relief Employs Different Neural Mechanisms than Placebo and Sham Mindfulness Meditation-Induced Analgesia.” jneurosci.org/content/35/46/15307