Morning stiffness often affects osteoarthritis patients, but it is also an accompanying symptom in other diseases. The discomfort is manifested by stiff joints, i.e. limited mobility, and start-up pain. The latter means that the first movements in the morning are difficult. All this is a sign that something is wrong with the joints.
What is morning stiffness?
Morning stiffness describes a symptom that can occur with numerous different conditions. Joint diseases in particular are associated with severe morning stiffness, especially osteoarthritis and rheumatism. What usually begins insidiously is ultimately the first noticeable sign of impaired health. In those affected, the joints are less mobile than usual after a longer period of rest, for example in the morning after getting up. The extent of the symptoms decreases again in the course of the day, but also with increased movement of the joints. Around five million people in Germany suffer from the wear and tear disease of the joints and thus also from morning stiffness. The alarm signals should be taken seriously. If not early enough something is done against it, a serious aggravation of the disease must be expected. The symptoms can extend to immobility. Therefore, if morning stiffness occurs, action should be taken.
Causes
The joints are mainly stressed by nocturnal inflammatory processes, which leads to morning stiffness and limited mobility. Normally, the nocturnal rest period is for regeneration. Tissue renewal and removal of cellular debris occurs. Therefore, cortisol levels drop at night, so the immune system is inhibited. However, this can become a problem in arthritically altered joints. The body’s defenses are very busy trying to remove the cartilage debris resulting from wear and tear in the joints. However, when the immune response is excessive, healthy cell structures are also attacked, resulting in inflammation and the worsening of the disease. Cartilage can function well for a lifetime, but only if it is not overused. This includes, for example, incorrect loading, but too much rest can also be a cause. For a certain period of time, overstressing can be compensated, but after longer periods, osteoarthritis is pre-programmed. If morning stiffness occurs, however, this can have numerous different causes. These can only be determined by a detailed examination and tests. Therefore, if symptoms are noticed, it is important to see a doctor.
Diseases with this symptom
- Osteoarthritis
- Spondyloarthritis
- Rheumatism
- Ankylosing spondylitis
- Arteritis temporalis
- Tendonitis
Diagnosis and course
Careful diagnosis is very important in morning stiffness, because it allows to initiate appropriate treatment. At the beginning, the anamnesis is always done by the doctor. Here he asks the patient about the previous history. This is followed by examination and palpation. In addition, the physician has special functional and pain tests at his disposal, which enable him to check the stability of the ligaments and muscles as well as the mobility of the joints. If there is a suspicion of osteoarthritis, the physician will resort to instrumental diagnostics, for example ultrasound, X-ray or MRI examinations. This gives a good indication of the condition of the joint and the bones. In the case of redness and severe swelling, a joint puncture is also often performed in order to analyze the joint fluid in the laboratory. Blood testing is another examination method. This can be used to examine the number of immune cells in the synovial fluid, the viscosity of the synovial fluid, and the presence of the rheumatoid factors. This helps to determine whether it is osteoarthritis, rheumatoid arthritis or gout due to which the morning stiffness is caused.
Complications
Scintigraphy and magnetic resonance imaging are available for meniscal damage or changes in bone metabolism. It is always important to see a physician early to determine the cause and initiate appropriate therapy. The disease can otherwise lead to progressive joint destruction.Morning stiffness is mainly caused by a disease of the joints. These can carry various complications. One possibility of morning stiffness is gout. In this case, the uric acid crystals that are deposited in the joints can become inflamed, causing severe pain and swelling of the joint. In addition, there is also fever. In addition, the uric acid can also be deposited in the bones and lead to corresponding damage there. In some cases, deposits can also occur in the kidneys, which can lead to kidney failure (renal insufficiency). Wear and tear of the articular cartilage (arhtrosis) also leads to permanent complications. Similar to gout, inflammatory reactions and joint effusions occur. In addition, the structure of the joint changes. Since arthrosis cannot be cured, there is constant abrasion of cartilage down to the bone, so that in the late stages bone can rub on bone. Not only does this cause severe pain, but it can cause the bone to collapse and debris to scatter. In addition, an inflammatory disease of the joint (arthritis) can also trigger stiffness. An example of this is rheumatoid arthritis. This autoimmune disease not only affects the joints and causes them to be destroyed, but it can also affect other organs such as the heart or blood vessels, leading to inflammatory degenerative reactions.
When should you see a doctor?
Morning stiffness can have a wide variety of causes and is usually temporary. A doctor should be consulted if the symptoms occur for several days in a row or lead to significant restrictions in private and professional life. If simple movements can no longer be performed and movement is severely reduced, the affected joints and muscles must be treated by a doctor. Sometimes the complaints are also caused by incorrect posture or overloading of the back. Those affected can then often reduce the morning stiffness by light stretching exercises and rest. However, if the complaints persist or even increase, medical advice should be sought. If an arthritic condition or stress-related morning stiffness is suspected, a visit to the family doctor is recommended. The same applies if the stiffness gradually spreads to other parts of the body and causes accompanying symptoms such as joint pain or migraine. Patients who already suffer from a joint or muscle disease should discuss morning stiffness with their attending physician. A visit to the doctor is particularly urgent if the complaints occur quite suddenly and increase rapidly. Then there is possibly a herniated disc underlying, which must be treated immediately emergency medical to avoid a serious course.
Treatment and therapy
In the case of morning stiffness, treatment is always based on the identified cause. If osteoarthritis is present, it is usually not enough to simply discuss the treatment plan prescribed by the physician. Often, lifestyle habits must also be changed. This includes, for example, types of exercise that are easier on the joints or a different diet. Morning stiffness can be addressed through physical therapy, but it should be done under professional guidance. Otherwise, the clinical picture and symptoms could worsen. In addition, drug therapies are often used to minimize inflammation within the joint and thus stop or at least slow further or worse disease progression. Anti-inflammatory drugs are the so-called NSAIDS, for example ibuprofen and diclofenac. These are the basic medication for diseases such as rheumatism and osteoarthritis, which are very often the cause of morning stiffness. In addition, if an autoimmune disease is present, especially in rheumatoid arthritis, drugs that suppress the immune system are often a good support. Cortisol represents a very important component of treatment in rheumatism.
Outlook and prognosis
Morning stiffness primarily causes patients to experience limitations in movement and pain. These occur more frequently in the morning after getting up, but can also burden the entire daily life and greatly reduce the quality of life. It is not uncommon for many patients to experience psychological complaints and depression as a result of the pain and restrictions, so that psychological treatment is also necessary.It is not uncommon for swelling and redness of the joints to occur as a result of morning stiffness. A diagnosis can be made relatively well with the help of various imaging techniques, so that treatment can begin at an early stage. In most cases, those affected suffer from arthritis or osteoarthritis. If morning stiffness is not treated, the joints can become inflamed. It can also be gout, which must be treated by a doctor in any case. There is increased fever and very severe pain. In severe cases, the kidneys can also be damaged by deposits, resulting in renal insufficiency. If the bones rub against each other, they can be damaged. For this reason, treatment of morning stiffness is necessary in any case to prevent secondary damage.
Prevention
Since overload, but equally a lack of exercise can be the reason for morning stiffness, changes should be initiated in this regard. Incorrect loads at work and a lack of mobility, even in overweight people, promote osteoarthritis and thus trigger morning stiffness. A good prevention is therefore sufficient exercise without overstraining. A healthy and balanced diet is also important, in which industrially processed foods should be avoided as far as possible in order to prevent metabolic diseases. In the case of a genetic predisposition, regular laboratory checks are recommended in addition to the measures mentioned. In addition, it is advisable not to expose the body to too much cold, because this aggravates morning stiffness.
Here’s what you can do yourself
Regular morning stiffness indicates osteoarthritis or a similar condition and should be discussed with the doctor. Accompanying affected persons can alleviate the discomfort by resorting to various measures. It often helps to change the diet and to pay attention to movements that are gentle on the joints. It is also possible that morning stiffness is due to a lack of exercise, which can be compensated for by sports and gymnastics. In case of a genetic predisposition, it is recommended to protect the body from heat or cold, as these can aggravate morning stiffness. If morning stiffness is caused by a chronic disease, it must be treated first. In the morning, gymnastics and yoga help loosen the joints. Before going to bed, light relaxation exercises, as well as heat wraps and cold applications, can relieve the discomfort. Morning stiffness associated with pain can be treated with various home remedies such as Swedish herbs or jonene ointment, as well as essential oils of pine, camphor, mint, cypress or eucalyptus. Medicinal plants that are said to have a soothing effect include angelica, arnica, comfrey and juniper. Pain patients and allergy sufferers should clarify appropriate applications with their family doctor beforehand.