Psoriatic Arthritis
By
Diana Rodriguez
by
Rosalyn Carson-DeWitt, MD
Updated on September 3, 2019
Many of us wake up in the morning and simply want to crawl back under the covers. That feeling may be especially tempting for people with psoriatic arthritis, thanks to morning joint stiffness, a common symptom of the condition. Psoriatic arthritis often causes joint swelling and tendon and ligament inflammation, which is mainly responsible for morning stiffness, says Anca Askanase, MD, MPH, a rheumatologist and associate professor of medicine and director of rheumatology clinical trials at NewYork Presbyterian Hospital/Columbia University Medical Center in New York City.
Morning stiffness may be the result of a nighttime surge of inflammatory cells caused by your body’s circadian rhythms. Lack of movement while you sleep may also contribute to morning stiffness, says Ana-Maria Orbai, MD, an instructor of medicine in the rheumatology division at Johns Hopkins School of Medicine in Baltimore. Here’s how to keep morning stiffness from stopping your day before it starts.
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Warm Up Your Room
Welcome the morning with a little extra warmth. “In order to get out of bed and function, the joint inflammation that accumulated overnight needs to be diminished from the joints and tendons with movement and warmth,” Dr. Askanase explains. “Warmth and movement dilate the blood vessels, increase the circulation, and allow for a decrease in inflammation.” Try setting a programmable thermostat to raise the temperature in your bedroom by a few degrees before your scheduled wake time or sleep with an electric blanket and turn it up a few notches before you have to get out of bed, the Arthritis Foundation suggests.
Once you’re out of bed, make a large mug of tea or coffee, suggests Dr. Gavin Hamer, PT, DPT, as shared on Tippi Psoriatic Arthritis. “It’s big enough to get both hands around and gets them warm and ready for the day,” he says.
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Stock Your Nightstand
Just getting out of bed with stiff joints can be difficult, so put essentials for easing morning stiffness within arm’s reach before you go to sleep. This might include a heating pad as well as your anti-inflammatory medications, Askanase says. That way you won’t have to drag yourself out of bed to find them, and you can take or use them as soon as you wake up. Don’t forget a water bottle so that you have something with which to wash down your medication.
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Head to the Shower
A warm shower or a soak in a warm tub can make for a soothing start to your day. The warm water and steam from a hot shower can ease morning stiffness, as can immersing yourself in a tub of warm water. Make sure the water isn’t too hot, and take your time and enjoy the water therapy. Use the support of the water to do some gentle stretching while you’re in the bath or shower, the Arthritis Foundation suggests.
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Try Moist Heat
If a morning soak or shower isn’t on the agenda, try a moist heating pad on stiff joints. You can make your own by warming a damp washcloth in the microwave and placing it inside a zip-closure plastic baggie before applying it, according to the Arthritis Foundation. Or try this tip, as shared on Tippi Psoriatic Arthritis: “Take a men’s athletic sock and fill it halfway with flax seed. Tie it at the top and heat in the microwave for two minutes or less. Apply to your neck, fingers, wrists, and lower back.”
Limit heat applications to 20 minutes, Askanase says, and allow the skin to return to its normal temperature before repeating. Also, protect your skin by placing a towel between it and your heat source. For extra warmth, toss the clothes you’ll be wearing into the dryer for a few minutes so that they’re warm when you put them on. Another option is to simply run warm water over your fingers and hands for a few minutes, says Dr. Orbai.
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Stretch Your Joints Gently
Just a few minutes of slow, gentlestretchescan help your joints get going for the day. “Doing a fewstretchesin themorningtoloosen the muscles and joints and flush them with more blood can help a lot,” says Askanase, who recommends working with a physical therapist to identify the best stretching regimen for your sore, swollen joints and muscles.If your hands feel stiff, open and close your fists repeatedly until the stiffness subsides a bit, Orbai suggests. If your back feels stiff and tight, try some simple, gentle stretches that target the area, but make sure your balance is stable before trying any stretches to avoid falling. Yoga is a great alternative therapy that can help with morning stiffness, she adds.
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Set an Early Alarm
When you have morning stiffness with psoriatic arthritis, you may move more slowly and need more time for your morning routine, such as getting dressed, showering, and making breakfast, according to Orbai. Rushing yourself — and your stiff joints — first thing in the morning may only make things worse. Askanase suggests setting your alarm earlier so that you have extra time to ease into your morning and aren’t rushing through your wake-up-and-warm-up routine. This will give you time to heat your joints, take medication and allow it to kick in, and have time for stretches. To make sure you’re getting enough rest, head to bed at about the same time each night and wake up at the same time each morning, the Arthritis Foundation advises.
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Work With Your Rheumatologist
A little stiffness and discomfort due to psoriatic arthritis may come with the territory, but it shouldn’t interfere with your daily life. “If you have a lot of stiffness, talk to your rheumatologist,” Orbai says. Make sure you’re taking all of your medications exactly as prescribed, but if that’s not providing enough control, discuss the possibility of changing your drug regimen. “The extreme stiffness may mean increased disease activity, requiring an adjustment of medications for psoriatic arthritis,” Orbai says.
Askanase also recommends talking to your doctor about taking fish oil as a complement to your treatment. According to research published in the June 2015 issue of theJournal of Physiology and Biochemistry, fish oil has an excellent anti-inflammatory effect on chronic illnesses, including all types of arthritis.
Additional reporting by Susan Jara
