Thursday, November 30, 2023

Is Rheumatoid Arthritis Worse In The Morning

Managing Morning Stiffness From Rheumatoid Arthritis

Rheumatoid Arthritis – Signs & Symptoms | Johns Hopkins Medicine

Morning stiffness is a hallmark of RA, making it hard to get out of bed. Learn about relieving RA stiffness and improving mobility.


Do your RA symptoms greet you at the start of every new day? Morning stiffness, a sign that your rheumatoid arthritis is active, makes it hard to move your joints. Joint stiffness can affect any joint, but youre most likely to feel it in your hands, feet, hips, knees, and spine. Most problematic is that it can keep you feel achy for the first hour of your morning, making many people dread the dawn.

In fact, morning stiffness has such an impact on daily life that a British study, published in the Journal of Medical Economics, found that easing this single RA symptom leads to significant improvement in quality of life. And yet, ironically, there’s no research to show just how pervasive the problem is. But if you have morning stiffness from RA, you probably dont need a study to tell you that youre in distress and that improving mobility is an RA must-do.

Morning Stiffness: an RA Quandary

Relieving RA Stiffness

To get going in the morning, try these strategies for improving mobility with RA, starting while youre still in bed:

Targeted stretches done in bed can help, too. Sandy B. Ganz, PT, DSc, GCS, a physical therapist at the Palm Beach Institute of Sports Medicine in Boca Raton, Fla., offers the following tips:

Buying Time: Tips for Your Workplace

What Do Doctors Do

It’s not always easy for doctors to diagnose JIA right away. JIA itself can have lots of different symptoms, and some infections, like Lyme disease, have similar symptoms to JIA. So doctors will want to rule out any other possibilities before deciding something is JIA.

If a doctor suspects a patient has JIA, he or she will ask about the person’s symptoms, find out if others in the family have had arthritis, and do a complete physical examination to look for joint swelling, eye problems, and rashes. A doctor may do blood tests and X-rays. In some cases, doctors may use a needle to take a sample of synovial fluid from a person’s joint.

Sometimes, a doctor might need to see a patient for several months to determine the particular type of JIA the person has.

Is Morning Stiffness Of Rheumatoid Arthritis Like Morning Sickness

Some Rheumatoid Arthritis patients have morning stiffness, but for others stiffness is not limited to mornings. For me, stiffness has always been the same all day: bad. After a couple of minutes in one position, its tough to move. Some days its like Im in concrete other days its more like cookie dough.

After I met a few more patients like me, I started to wonder, Is Rheumatoid Arthritis morning stiffness like pregnancy morning sickness? Some women are sick to their stomachs all day. Some are worse in the morning. Some dont have any morning sickness but they are still pregnant. The same RA doctor I mention in my last video, Doc Space Heater, wrote in my chart that I had no morning stiffness at all because I insisted that it lasted all day.

Ive said before that my joints didnt read the books. I did not rehearse at all for this job of professional patient. Im just taking it one day at a time and the only thing I know about my RA is what I live with. Thanks for telling me about yours.

What about you? Do you only have morning stiffness in the morning? Is morning stiffness an accurate gauge of your disease activity?

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My Ra Has Made It Difficult To Perform At Work

Struggling to be productive or having to miss work because of painful flare-ups can be a real worry for people with RA.

In fact, a survey of 1,000 people with RA found that a third of them had given up work because of their disease and less than half had been offered support by their workplace.14

If you work with someone with RA, understanding that they can have good days and bad days can help to relieve the stress and pressure they sometimes feel at work.

Managing Mornings With Ra

Zilaxo Advanced Pain Solution: 2017

First, I give myself plenty of time to wake up in the morning. This means setting my alarm earlier than normal so I can lay in bed longer and prepare myself to get up. One of the best things in life for me is to lay in bed under the covers and rest.

It feels comfortable and cozy and, although I am in more pain in the morning with headaches, joint stiffness, etc., I try to incorporate some time experiencing this feeling every morning. Ive found that it helps calm and relax me, even if it means waking up earlier.

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Ra Vs Oa: Clinical Manifestations

RA symptoms have a rather rapid onset where the condition can worsen in a matter of weeks. On the other hand, OA symptoms slowly develop and gradually worsen over a long period of time.

RA symptoms affect joints all the over the body including hands, fingers, elbows, knees, and hips. Meanwhile, OA frequently affects the small finger joints and thumb, as well as the knees. RA always affects multiple joints on both sides of the body, whereas OA may only affect one particular joint or area of the body.

At the onset of RA, symptoms like fatigue, fever, weight loss, and loss of appetite are indicative of the diseases development. OA doesnt produce these types of systemic symptoms as it is considered a local disease.

RA commonly produces symmetrical symptoms, meaning both sides of the body are affected similarly. OA is based entirely on wear and tear of individual joints.

RA causes prolonged morning stiffness lasting greater than 30 minutes. OA patients may feel morning stiffness, but it generally subsides within the first 30 minutes.

Here is a summary comparison between RA and OA symptoms:

RA Symptoms:

  • Joint pain, stiffness, swelling affecting multiple joints
  • Symmetrical symptoms affecting both sides of the body
  • Morning stiffness lasting longer than 30 minutes
  • Systemic symptoms like fatigue, fever, and malaise

OA Symptoms:

Paulas Symptoms And Strategies

Diagnosed with seronegative RA at age 38, Paula Mair of Woodbury, Minnesota, has lived with the disease for 19 years. I experience morning stiffness daily, but to varying degrees, she says. It can range from 10 minutes to 2 hours. When I wake, I try moving my hands, elbows, feet, and other joints. I try to make a fist, then stretch my fingers straight. I fall back asleep and wake 15 minutes or so later, and I repeat as many times as I have time for, she says.

It helps, she adds, unless I am flaring. Nothing helps a flare.

Her doctor has asked her to tell her if the stiffness is regularly lasting 15 minutes or more. Morning stiffness is disruptive when severe, says Mair, but some days it is not terribly disruptive. The worst days become TV days.

Her current treatment seems to help with morning stiffness.

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Worsened Ra Symptoms In The Morning

For instance, for the past two nights, Ive fallen into a routine where I fall asleep relatively quickly. However, once 3:30 am to 4:30 am strikes, my body and mind spring awake. My mind is spinning, my joints are stiff, and I have a headache. Its uncomfortable.

Given these recent flares and uncomfortable feelings, Ive had to find new ways to make mornings easier. I wanted to write today about what I do to mitigate the negative side effects of morning fatigue and pain.

What Does Morning Stiffness Feel Like

Rheumatoid Arthritis (RA) Part 2: Definition, Etiology& Epidemiology

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. Its 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.

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Living With Rheumatoid Arthritis

Rheumatoid arthritis can be life-changing. You may need long-term treatment to control your symptoms and reduce joint damage.

Depending on how much pain and stiffness you feel and how much joint damage you have, you may have to adapt the way you carry out simple daily tasks. These can become difficult or take longer to complete.

Some things you can do to help keep the condition under control include:

Make Cooking Breakfast Easier With The Right Tools

There are a number of ergonomic tools that can help with painful morning hands. Look for kitchen tools that decrease joint stress, mounted jar openers instead of trying to twist open jars, knives with saw handles. The more you take advantage of these, the more you can rest your hand and the less pain youll have. A. Lee Osterman, MD, professor of hand and orthopedic surgery and president of the Philadelphia Hand Center

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Other Causes Of Joint Pain

Neurologic causes of pain may be determined by characterization apart from numbness and burning pain, the pain is unlikely to worsen with joint movement and is likely to worsen at night. Combinations of causes might make characterization of pain difficult. For example, a neurologic cause of pain might be combined with a rheumatologic cause, leading to mixed characteristics.

Extra-articular symptoms can help narrow the diagnostic options. For example, weakness may be a sign of neuromuscular disease, whereas dry mouth, dry eyes, Raynaud phenomenon, pleuritic chest pain, nasal ulcers, oral ulcers, alopecia, adenopathy, or rash might suggest systemic inflammatory rheumatologic conditions. Constitutional symptoms such as weight loss, night sweats, fever, and fatigue are also more common with systemic illnesses.

What Causes Stiffness In The Morning With Arthritis

Causes of Rheumatoid Arthritis Pain Aside from Inflammation

Morning stiffness that lasts more than an hour and in some cases up to several hours is characteristic of rheumatoid arthritis or other inflammatory types of arthritis. Morning stiffness that is less prolonged is more likely to be osteoarthritis or another non-inflammatory, musculoskeletal condition.

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I Can Still Lead A Normal Life

With earlier diagnosis and more effective, tailored treatments available, it is now possible for more people with RA to lead a more normal life.

This makes it especially important for people living with RA to have regular and open conversations with their doctor to discuss personal goals and their options.


  • Symmons D, et al. The global burden of rheumatoid arthritis in the year 2000. Available at . Last accessed September 2016.
  • Gabriel SE and Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther. 2009 11:229.
  • Arthritis Foundation. More than just joints: how rheumatoid arthritis affects the rest of your body. Available at: . Last accessed September 2016.
  • NHS Choices. Rheumatoid Arthritis symptoms. Available at: . Last accessed September 2016].
  • Arthritis Foundation. Rheumatoid Arthritis and Depression. Available at: . Last accessed September 2016.
  • Ra Vs Oa Epidemiology

    The primary difference between RA and OA is the underlying nature of the disease. RA is an autoimmune disorder that produces inflammatory joint symptoms throughout the body. OA is a degenerative condition that is the result of increased wear and tear on joints. OA may produce inflammatory symptoms as well, but it primarily destroys joint cartilage over time.

    OA affects an estimated 27 million Americans while only 1.3 million Americans have RA. Both RA and OA are more prevalent in women than in men. RA can develop in patients anytime between the ages of 30 and 60 years old. OA generally develops later in life.

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    Causes Of Morning Stiffness From Arthritis

    Feeling stiff when you first wake up in the morning is a common problem associated with arthritis. Morning stiffness causes you to hurt all over as you get out of bed. As you take your first steps, your joints and muscles ache so much, you want to crawl right back into bed. In fact, morning stiffness can be the most severe pain you feel all day and it can impair or interfere with your ability to function and perform routine tasks and activities of daily living.

    Paying attention to the duration of your morning stiffness will help both you and your healthcare provider decide how to deal with it. Morning stiffness that lasts more than an hour and in some cases up to several hours is characteristic of rheumatoid arthritis or other inflammatory types of arthritis. Morning stiffness that is less prolonged is more likely to be osteoarthritis or another non-inflammatory, musculoskeletal condition. In spite of having a regular treatment regimen, morning stiffness is a persistent problem for many people with arthritis.

    Stiffness Symptoms And Changes In Perception

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    The 1987 classification criteria for rheumatoid arthritis from the American College of Rheumatology listed morning stiffness in and around the joints, lasting at least one hour before maximal improvement among the signs of the condition. However, when the classification criteria was updated in 2010, morning stiffness was not included. The revised criteria focused on earlier stages of rheumatoid arthritis and features that are definitively associated with RA. In fact, while morning stiffness is a common characteristic of RA, it is not specific to RA it is a characteristic of all inflammatory types of arthritis.

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    Which Early Morning Activity Reduces The Symptoms Of Rheumatoid Arthritis

    Yoga, tai-chi, swimming, easy bike rides, and other gentle exercise are all good options. Avoid sitting or lying down for too long, and take frequent breaks to move around a bit throughout the day. Using heat. Using heat pads or taking hot baths or showers can loosen the joints and ease inflammation in the body.

    Rheumatoid Arthritis: How To Manage Morning Stiffness

    The most common and prominent symptom of rheumatoid arthritis is morning stiffness. Rheumatologists consider morning stiffness that lasts at least an hour a key sign of RA. Although the stiffness usually loosens and goes away, it can take some time.

    Here are eight things you can do to gently ease morning stiffness.

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    Are There Best Practices For Morning Stiffness

    What we know for sure about morning stiffness: people with RA who experience it regularly must find the best way to manage it and what works for one person might not work for everyone.

    A small group of RA patients offered their opinions and experiences after I posed these questions:

    • Have you experienced morning stiffness associated with RA?
    • Do you experience it daily, or only when you have a flare?
    • How long does morning stiffness last?
    • What helps morning stiffness subside?
    • Do you tell your doctor about your morning stiffness, or does it just come with territory when you have RA?
    • How disruptive is it to your usual routine?

    Explain The Pain Is It Osteoarthritis Or Rheumatoid Arthritis

    Do You Wake Up in the Morning with Swollen and Stiff Hands ...

    If opening jars becomes more difficult because of painful hands, or if climbing stairs produces pain in your knees, “arthritis” is often the first thing that comes to mind. The two most common forms of arthritisosteoarthritis and rheumatoid arthritiscan cause similar aches and pains, but there are a few key differences between them. For example:

    Onset. Osteoarthritis occurs when cartilage wears away. Pain occurs when bone rubs against bone. This type of arthritis pain tends to develop gradually and intermittently over several months or years.

    Osteoarthritis is the most common type of arthritis affecting 27 million Americans. Many people believe it’s a crippling and inevitable part of growing old. But things are changing. Treatments are better, and plenty of people age well without much arthritis. If you have osteoarthritis, you can take steps to protect your joints, reduce discomfort, and improve mobility all of which are detailed in this report. If you don’t have osteoarthritis, the report offers strategies for preventing it.

    Rheumatoid arthritis, on the other hand, is an inflammatory condition in which your immune system attacks the tissues in your joints. It causes pain and stiffness that worsen over several weeks or a few months. And joint pain isn’t always the first sign of rheumatoid arthritissometimes it begins with “flu-like” symptoms of fatigue, fever, weakness, and minor joint aches.

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    Symptoms Affecting The Joints


    The joint pain associated with rheumatoid arthritis is usually a throbbing and aching pain. It is often worse in the mornings and after a period of inactivity.


    Joints affected by rheumatoid arthritis can feel stiff. For example, if your hands are affected, you may not be able to fully bend your fingers or form a fist.

    Like joint pain, the stiffness is often more severe in the morning or after a period of inactivity. Morning stiffness associated with other types of arthritis usually will wear off within 30 minutes of getting up. However, rheumatoid arthritis morning stiffness usually lasts longer than this.

    Swelling, warmth and redness

    When rheumatoid arthritis affects a joint, the lining of that joint becomes inflamed. This can cause the joints to swell and become hot and tender to touch.

    In some people, firm swellings called rheumatoid nodules can also develop under the skin around affected joints.

    Additional symptoms

    As well as problems affecting the joints, some people with rheumatoid arthritis experience a range of more general symptoms, such as:

    • tiredness and a lack of energy
    • a high temperature

    The inflammation associated with rheumatoid arthritis can also sometimes cause problems affecting other areas of the body. For example, dry eyes if the eyes are affected and chest pain if the heart or lungs are affected.

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