A change in the weather, a late night on the town, an unexpected work trip, a call from your mother-in-law — once you’ve been diagnosed with inflammatory arthritis you suddenly become aware of all the strange things that can trigger a flare. But while some arthritis triggers are individual, there’s one that seems common to almost everyone living with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and other types of inflammatory arthritis: dawn.
Morning stiffness, pain, and immobility are so common that having these symptoms for an hour or more after waking up is part of the diagnostic criteria for rheumatoid arthritis (RA).
Why Are Mornings So Miserable for People with Arthritis?
One reason may be that inflammation creates a vicious cycle in the body. Inflammation causes swelling. This swelling overnight in an immobile joint causes the surrounding muscles and tissues to tighten up, which in turn causes pain and stiffness.
Another reason is that in inflammatory arthritis, the immune system attacks the synovium or lining of the joint, which causes it to become inflamed and swell. During the night, while your joints aren’t moving, the inflammatory materials can cause joint fluid to collect in and around the joint, which makes even more swelling, which leads to the pain and stiffness you feel first thing in the morning.
The frustrating part is that the very thing that can help prevent and reduce the symptoms — movement — is the thing that symptoms can make it feel impossible to do, says Nelson E. Dalla Tor, MD, a family medicine doctor at PIH Health who treats many patients with arthritis.
And once you’re off to such a tough start, everything else in your morning routine feels so much harder.
“Mornings are the worst, especially with my hands and fingers,” says Angie Kynaston, a mom of eight and a nurse in Utah. “When my arthritis is flaring, I can’t make lunches for the kids, help them get dressed, feed them breakfast, or brush their teeth, much less take care of myself. It’s enough to make me not want to get out of bed at all some days.” (Trying these hand exercises for arthritis can help.)
Angie isn’t the only arthritis patient who hates mornings. In fact, it’s such a problem that morning pain and stiffness was the arthritis symptom that had the biggest negative impact on a person’s quality of life, according to a study published in the Journal of Medical Economics.
So mornings with arthritis totally suck. Now what? We asked experts and arthritis patients to share the tips and tricks that make the biggest difference in their mornings.
1. Wear heated gloves
“My hands are incredibly painful in the mornings and the only things that really helps is heat. I have some microwavable heating pad mittens that I warm up first thing in the morning and wear them.” — Angie K.
2. Take your meds before you get out of bed
“Before bed I put a water bottle and my RA medication on my nightstand. Then I set two alarms on my phone. At the first alarm I take my meds and then go back to sleep. By the second alarm, an hour later, my meds have kicked in and I can get up no problem.” — Marcella J.
3. Eat more of an anti-inflammatory diet
“Changing my diet to eat more foods like salmon and nuts and less food like bread and sugar made a big difference in how swollen my joints are in the morning. Less swelling means less pain — as long as I stick to it.” — Annette H.
4. Take turmeric supplements
“I take turmeric capsules the first thing when I wake up every morning and I feel like they’ve helped a lot with my morning stiffness, especially when I’m consistent. If you don’t like to take supplements you can also make turmeric tea.” — Melinda P.
5. Do some stretches in bed
“Stretch in bed prior to getting up. Make sure to stretch everything, including your smaller joints. This can decrease the pain and stiffness that you may experience later on.” — Dr. Dalla Tor
6. Talk to your boss about flexible work arrangements
“Sometimes my joints are so painful I can’t even wrap my fingers around the steering wheel to drive to work. I finally had a talk with my boss and he agreed to let me work from home those mornings. Just having that stress gone has helped too.” — Lisa B.
7. Relax in a hot shower
“I turn on the shower as hot as I can stand it. Then I stay in for at least 10 minutes. The combination of the heat and steam really help loosen up my joints in the mornings.” — Angela A.
8. Warm up your clothes in the dryer
“I tell my patients to throw their clothing in the dryer for a few minutes. The heat can help relax stiffness.” — Dr. Dalla Tor
9. Bring on the chili peppers
“Capsaicin is the active ingredient in chili peppers and it can be used topically over symptomatic joints first thing in the morning to help ease the pain. It doesn’t work for everyone, but some find it helpful. Be careful, it does burn a little at first!!” — Don R. Martin, MD, a rheumatologist with Sentara RMH Rheumatology
10. Rub on some essential oils
“I swear by essential oils. On mornings that are really rough, I use deep blue polyphenol complex, frankincense, lavender, and ginger. I make a concoction and rub them on my hands.” — Elisabeth L.
11. Ask your doctor about switching your meds
“Celebrex has made all the difference for me. This may sound like too obvious of a tip but until I found this drug, nothing else worked for me and mornings were agony. Finding the right medication has been life-changing.” — Marsha W.
12. Moisturize with hemp lotion
“I mix a little hemp oil with my lotion and rub it into my joints, it definitely helps with getting out of bed.” — Barbara S.
13. Sleep in special gloves
“I sleep in infrared gloves made by Back on Track specifically for arthritis, especially if the weather is changing and I feel a flare up of my RA coming on. They keep my joints warmed up and loose so they aren’t awful in the morning.” — Marcus J.
14. Move your bedroom to the ground floor
“I technically sleep in the ‘office’ because it’s on the ground floor of my home. Since I’ve been diagnosed with ankylosing spondylitis I’ve found that I just can’t do stairs at all when I’m flaring. So not having to go down stairs first thing in the morning has made my life so much easier.” — Catherine K.
15. Have some easy breakfasts on hand
“Overnight oats are my favorite breakfast. You put all the ingredients together in a jar the night before, cover it with plastic wrap, and let it sit in the fridge overnight. There are tons of yummy recipes online. Having an easy healthy breakfast that doesn’t have to be cooked makes my mornings much smoother.” — Catherine K.
16. Prepackage smoothie ingredients
“My other favorite breakfast are protein smoothies. I take yogurt, berries (or whatever fruit you like), spinach, and protein powder and freeze them together in sandwich bags. Then all I have to do in the morning is dump the frozen mix into the blender, add water, and blend.” — Catherine K.
17. 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 you’ll have.” (Check out top assistive devices to make your life easier here.) — A. Lee Osterman, MD, professor of hand and orthopedic surgery and president of the Philadelphia Hand Center
18. Take an NSAID
“It’s not a long-term solution but on mornings where my ankles are fused up really badly, taking some anti-inflammatory pain meds, like ibuprofen, can make the difference between being able to walk to work and having to call in sick. Another option is meloxicam. It’s an NSAID like ibuprofen but it lasts a lot longer, up to 24 hours. It’s prescription though, so talk to your doc. ” — Jocelyn T.
19. Skip happy hour
“I learned the hard way that drinking alcohol is the absolute worst for morning stiffness, brain fog, and overall pain. Even one drink will make my next morning hell. I’ve had to completely give up all alcohol, even wine, and I’m in college so that’s saying a lot! But it’s worth it.” — Michelle G.
20. Keep a tube of Bengay cream in your nightstand
“On particularly painful mornings, try using Bengay cream, rubbing it on the joints before you get out of bed.” — Dr. Dalla Tor
21. Take a warm bath with Epsom salts
“Taking a bath with Epsom salts the night before seems to make things less painful for me the next morning.” — Angie K.
22. Put your keys in key holders
“Putting rubberized key holders around your keys can help lower the stress of the morning rush by helping you to grip your keys better and reduce the risk of dropping them.” — Dr. Osterman
23. Try CBD oil
“Using CBD [cannabidiol] oil on my hands in the mornings is the only home remedy that has ever helped my rheumatoid arthritis. It’s not pot and it doesn’t make you high (although sometimes I wish it did!).” (Read more about taking CBD for arthritis pain here.) — Steve J.
24. Sleep under an electric blanket
“I have an electric blanket that I keep on all night. The consistent heat helps keep my joints from locking up. They are still swollen in the mornings but they’re not as stiff and painful and it’s definitely made my mornings easier.” — Eleanor O.
25. Take a pass on toast
“Eating a gluten-free diet may decrease signs and symptoms of inflammatory arthritis for certain people even if you don’t think you’re sensitive to gluten. Gluten can cause inflammation, and eliminating it may help reduce pain, stiffness, redness, and increase mobility.” — Anca Askanase, MD, rheumatologist and director of rheumatology clinical trials at Columbia University Medical Center
26. Add some raw garlic to your scrambled eggs
“I know it sounds weird but my doctor told me to eat raw garlic and adding a chopped clove to my eggs at breakfast has seemed to make a difference in my morning symptoms.” — Eleanor O.
27. Invest in a heated mattress pad
“If you have soreness and stiffness all over, like I do, a heated mattress pad is a game changer. It can warm more than just one or two problem areas.” — Jill M.
28. Become a night owl
“My mornings are bad no matter what I do so I’ve learned to shift anything I can to the evenings. I exercise, work, and socialize after noon and ideally after 4 pm. Then I’m usually up until about 2 a.m.” — Joanne S.
29. Cut out sugar
“My body doesn’t react immediately but if I eat inflammatory foods, especially sugar, I know that the next morning I’ll be in a ton of pain. The more closely I stick to a low-sugar diet the better my mornings are.” — Michelle G.
30. Take a morning walk
“Movement is important for joint health but you don’t have to do anything that feels too hard. For example, you may benefit from tai chi, yoga, stretching, or swimming pool exercises. Doing it first thing in the morning can help loosen you up but if that is too much, doing it later in the day is still helpful.” —Dr. Dalla Tor