Getting out of bed when you have arthritis can produce a chorus of creaks and pops. Morning stiffness is an all-too-common symptom of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and osteoarthritis (OA).
In RA and PsA, stiff morning joints are related to the release of inflammatory chemicals during the night. With OA, the prolonged lack of movement during sleep can cause joints to tighten up.
“Arthritis responds to movement. When we’re sleeping, we move a little, maybe once every two to three hours, but it’s not enough motion to facilitate movement within the joint itself,” says Maureen McDonough, PT, DPT, senior physical therapist at NYU Langone’s Rusk Rehabilitation.
How stiff you feel—and how long that stiffness lasts—depends on the stage of your disease, how long you slept, and what you did the day before. In general, OA joints should start to loosen up within 30 minutes, while RA stiffness can last for more than an hour.
Practicing an anti-stiffness morning routine can help ease your joints into the day, and get you moving faster.
Stretch tight joints
Movement is the key to loosening up tight joints, McDonough says. “Motion is lotion for your joints. The more you move, the more you lubricate the joint surfaces.”
She suggests starting the day with some gentle stretches to increase blood flow to your joints. Pull one or both knees into your chest to stretch your back. Limber up your knees by bending and straightening them. Rock both knees from side-to-side to work the kinks out of your hips.
As you stretch, don’t move past the point of comfort. “Listen to your body,” McDonough advises. “If it hurts you to move there, back out of it.” And if you have RA, be cautious about exercising during an active flare. Check with your rheumatologist to make sure you don’t aggravate your disease.
For people who aren’t accustomed to exercising, a good place to start is with a visit to a physical therapist. The therapist can break down each movement and teach you how to do it correctly.
Bring on the heat
Both cold and heat are recommended for arthritis relief, but heat has the edge when it comes to combatting stiffness. “Moist heat is a little more effective than dry heat,” McDonough says. She recommends taking a warm shower, which combines movement with heat.
Just don’t linger under the showerhead for too long. “More than 15 minutes is going to make the joint go to sleep, and we don’t want that.” Keep the water warm—not hot—to avoid scalding your skin or further irritating inflamed joints.
To keep your joints lubricated, you need plenty of fluid in your system. Put a glass of water on your nightstand for when you wake up, and drink more throughout the day.
How much to drink daily is an individual decision. Ask your doctor and a dietitian for advice.
Take a stroll
Once you get out of bed, walking is another effective way to ease stiffness. In addition to getting your joints moving, it offers additional benefits like improving strength and cardiovascular fitness. The CDC recommends at least 30 minutes of brisk walking or other aerobic activity, five times a week, but the more you walk the better.
Start slowly if you haven’t been active. Walk 5 or 10 minutes at a time, and then gradually increase the length and intensity of your walks.
If these measures don’t budge your pain and stiffness, your doctor can recommend medicines. Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids address both the inflammatory and pain aspects of arthritis. Ask your doctor if you can take medicines when you first wake up, to alleviate morning discomfort. Stephanie Watson