Kristen Gasnick, PT, DPT, is a medical writer and physical therapist at the Holy Name Medical Center in New Jersey.
Riteesha G. Reddy, MD, is a rheumatologist and physician in a private clinic in Dallas, Texas.
Psoriatic arthritis (PsA) occurs in patients with psoriasis (PsO), an autoimmune skin disease that causes inflammatory scaly patches on the skin. Psoriatic arthritis is characterized by joint pain, inflammation, and stiffness. It can be symmetrical or asymmetrical, and most commonly affects the hands, feet, and lower back.
Lack of exercise (such as when you sleep at night) can cause joint pain and stiffness when you wake up in the morning.
A healthy lifestyle helps reduce inflammation and changes in daily activities in the morning, such as stretching and keeping warm, can help relieve joint pain and stiffness in the morning.
This article will discuss the connection between psoriatic arthritis and morning stiffness and how to relieve it.
Psoriatic arthritis is an autoimmune, inflammatory arthritis that causes joint pain, swelling, and stiffness. For psoriatic arthritis, the body produces inflammatory proteins that attack joints, leading to severe chronic joint inflammation.
Signs of psoriasis usually first appear on the skin before the joint symptoms of psoriatic arthritis appear. Symptoms associated with psoriasis or psoriatic arthritis include:
Morning stiffness is the main symptom of patients with psoriatic arthritis. Although in this case, the joints are usually painful, stiff, and inflamed, it is often worse when you wake up after a long period of immobility.
Prolonged morning stiffness lasting more than an hour is usually a feature that distinguishes psoriatic arthritis from osteoarthritis.
Psoriatic arthritis is usually asymmetrical. The most common subtype of psoriatic arthritis is asymmetric oligoarthritis, which causes pain and stiffness in the joints of the fingers on one side of the body.
Although rheumatoid arthritis (RA) can also affect hands and fingers, the joints on both sides of the body are usually affected in a symmetrical manner.
Arthritis in the interphalangeal joints of the distal fingers (the finger joints closest to the fingertips) can help distinguish psoriatic arthritis from rheumatoid arthritis, although this is not always the case.
Psoriatic arthritis can also cause a unique symptom called dactylitis, in which inflammation of the entire finger can produce a swollen sausage-like appearance.
The affected joints are usually soft to the touch and may appear purple.
Psoriatic arthritis can also cause pain and inflammation in the area where the tendons and ligaments attach to the bones. This condition is called enthesitis. Common sites for enthesitis in psoriatic arthritis include the attachment sites of finger flexor tendons, Achilles tendons, and plantar fascia.
Other body joints affected by psoriatic arthritis include the lumbar spine in the lower back, the sacrum in the pelvis, and the cervical spine in the neck.
Playing an active role in the treatment of psoriatic arthritis can help you medically manage the condition and slow down the progression of the disease. Certain modifications to your morning routine can help reduce morning stiffness and related joint pain.
Gently stretch the stiff and painful joints before getting up in the morning to help reduce morning stiffness and improve your ability to move and function throughout the day.
Stretching the joints of the fingers by pulling the fingers away from the palm can help relax the fingers and the hand. You can also use one hand to grab each finger of the other hand and stretch back and forth with full flexion and extension of all finger joints.
Heating helps to improve blood flow to various parts of the body, which helps promote joint mobility and reduce joint stiffness.
For larger body areas like the spine, you can use a heating pad, insert it into the wall or put it in a microwave to heat it up. Make sure there is a layer of towel or clothing between your skin and the heating pad to avoid skin irritation and mild burns.
For smaller parts of the body such as hands and fingers, you can soak a small towel in warm water and place it on your hands to heat it up. The heating time should not exceed 10 to 20 minutes.
Taking a hot bath in the morning is another way to heat up stiff joints to help relax them and improve blood flow.
Taking a warm bath or a hot bath can be very relaxing and help reduce muscle tension and make your joints feel more relaxed and flexible in the morning.
Although keeping your bedroom cool at night can help you fall asleep faster and promote better sleep, it can be challenging in the morning when your joints feel stiff.
Using a time-controlled thermostat to increase the temperature in the bedroom one or two hours before the scheduled wake-up time can help increase body temperature. This makes it easier to move the joints and reduce the stiffness of the joints.
Sufficient, uninterrupted sleep is essential to rejuvenate the body and detoxify from inflammation. Without adequate sleep, the body does not have enough time to repair and recover from daily stress and toxins.
Ensuring you maintain a normal sleep schedule of seven to nine hours a night can help relieve inflammation throughout the body. This in turn can help reduce joint stiffness and psoriatic arthritis attacks.
When your joints feel particularly stiff in the morning, it may be difficult to move them, and it may take longer for you to get up.
Getting up earlier than usual will give you more time to relax your joints, which can help you complete your daily tasks more easily. Try to get up 30 to 60 minutes earlier than usual.
Eating inflammatory foods containing gluten, dairy products, sugar, artificial flavors, colors and preservatives can exacerbate systemic inflammation.
Choosing whole foods, minimizing processed foods, and choosing organic products where possible can help reduce systemic inflammation. Over time, this can have an overall positive effect on reducing joint inflammation and stiffness.
Because psoriatic arthritis is an autoimmune disease, medications are usually needed to help control symptoms and reduce systemic inflammation.
Non-steroidal anti-inflammatory drugs (NSAIDs) can be used on an over-the-counter (OTC) basis to help reduce pain and inflammation. Biological injections can help reduce the autoimmune process in the body, thereby slowing down the progression of the disease.
Making sure you take your medications on time can help reduce the severity of the symptoms of psoriatic arthritis and the degree of joint inflammation, pain, and stiffness you experience.
When the morning stiffness caused by psoriatic arthritis is chronic and cannot be improved by conservative methods, other treatments may be needed to help control some of your symptoms.
Maintaining regular communication and follow-up with your healthcare provider can help you track changes over time to determine if your psoriatic arthritis treatment is effective.
If you have not done so, you should see a rheumatologist regularly, a medical expert who specializes in inflammatory joint diseases. They can help prescribe the most effective treatment plan based on your symptoms and medical history.
Specific questions about your psoriatic arthritis may include:
Supplementing fish oil and vitamin D may help reduce inflammation in the body, thereby helping to reduce the pain and stiffness associated with psoriatic arthritis.
Fish oil supplements contain docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which are omega-3 fatty acids, which have a beneficial effect on reducing inflammation.
Vitamin D is an essential vitamin that participates in normal immune system function and can help reduce inflammation.
Be sure to discuss the use of supplements with your healthcare provider to determine the appropriate dosage of each supplement.
Psoriatic arthritis is a chronic disease and sometimes difficult to treat. When determining which treatment option is best for you, try to maintain a positive perspective and always focus on your goals. Although there is no “one size fits all” method to alleviate morning stiffness, a combination of multiple strategies may work best.
Maintaining healthy lifestyle habits can also help control the symptoms of psoriatic arthritis by reducing systemic inflammation and promoting a healthy healing environment.
Tips for a healthy lifestyle include:
When you have psoriatic arthritis, lack of exercise at night can cause joint pain and stiffness when you wake up in the morning. Morning stiffness is the main symptom of patients with psoriatic arthritis.
Certain modifications to your morning routine can help reduce morning stiffness and related joint pain. These modifications include stretching, heating, and getting enough sleep.
When the morning stiffness caused by psoriatic arthritis is chronic and cannot be improved by conservative methods, other treatments may be needed to help control some of your symptoms.
Consistent habits are the key to long-term relief of morning stiffness symptoms. Improvements will not be seen overnight. It may take trial and error to see which method works best for you. Generally, a combination of several different methods is more effective than using any one alone.
Psoriatic arthritis joint pain is usually caused by prolonged immobility during sleep. Symptoms often improve with exercise and activity.
The morning stiffness caused by psoriatic arthritis can last for more than an hour. For severe flares, the stiffness can last a whole day, as long as several weeks or months, unless the treatment is changed.
The symptoms of untreated psoriatic arthritis do not usually go away on their own. Psoriatic arthritis is usually a chronic progressive disease that requires treatment to control symptoms and prevent pain, stiffness, and inflammation from worsening.
Deal with chronic inflammation? An anti-inflammatory diet can help. Our free recipe guide shows you the best foods to fight inflammation. Get yours today!
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Dhir V, Aggarwal A. Psoriatic arthritis: a critical review. Clin Rev is allergic and immune. April 2013; 44(2):141-8. doi: 10.1007/s12016-012-8302-6. PMID: 22294201.
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Eugene AR, Masiak J. The neuroprotective aspects of sleep. MEDtube science. 2015;3(1):35-40.
Centers for Disease Prevention and Control. 5 proven ways to treat arthritis.
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