How To Relieve Morning Stiffness From Psoriatic Arthritis

Small Changes to Your Morning Routine Could Make a Big Difference

Psoriatic arthritis (PsA) develops in people with psoriasis (PsO), an autoimmune skin condition that causes inflammatory, scaly plaques on the skin. Psoriatic arthritis is characterized by joint pain, inflammation, and stiffness that can be either symmetric or asymmetric, most commonly affecting the hands, feet, and lower back.

Lack of movement (like while you're asleep at night) can lead you to wake up with painful and stiff joints in the morning.

Healthy lifestyle habits that help to decrease inflammation and modifications to your morning routine like stretching and applying warmth 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 find relief.

The hands of a male with psoriatic arthritis

Getty Images / Jacques Hugo

Signs of Psoriatic Arthritis 

Psoriatic arthritis is an autoimmune, inflammatory form of arthritis that causes joint pain, swelling, and stiffness. With psoriatic arthritis, the body produces inflammatory proteins that attack the joints, causing significant and chronic joint inflammation.

Signs of psoriasis often appear on the skin first before joint symptoms of psoriatic arthritis manifest. Symptoms associated with psoriasis or psoriatic arthritis include:

  • Scaly, itchy skin patches
  • Nail changes
  • Pain and swelling within joints
  • Tendon and ligament pain
  • Chronic fatigue
  • Inflammation of the eyes, called uveitis
  • Digestive symptoms, such as abdominal pain, bloating, constipation, and diarrhea
  • Organ damage from inflammation of the heart, lungs, or kidneys

Morning Stiffness 

Morning stiffness is a primary symptom for people with psoriatic arthritis. While joints may be painful, stiff, and inflamed in general with this condition, they're oftentimes worse upon waking after an extended period of immobility.

Psoriatic Arthritis vs. Osteoathritis

Prolonged morning stiffness that lasts more than one hour is often a feature that differentiates psoriatic arthritis from osteoarthritis.

Where It Hurts

Psoriatic arthritis is more often asymmetric. The most common subtype of psoriatic arthritis is asymmetric oligoarthritis that causes pain and stiffness in the joints of the fingers on one side of the body.

While rheumatoid arthritis (RA) can also affect the hands and fingers, joints on both sides of the body are usually affected in a symmetrical fashion.

Arthritis in the distal interphalangeal joints of the fingers (the finger joints nearest the fingertips) can help distinguish psoriatic arthritis from rheumatoid arthritis, although this isn't always the case.

Psoriatic arthritis also causes a unique symptom called dactylitis where inflammation of an entire finger will produce a swollen, sausage-like appearance.

Affected joints are often tender to the touch and may present with a purple hue.

Psoriatic arthritis can also result in pain and inflammation at the sites where tendons and ligaments attach to bones, a condition called enthesitis. Common sites where enthesitis occurs in psoriatic arthritis include attachment sites of the finger flexor tendons, Achilles tendon, and plantar fascia of the feet.

Other joints of the body affected by psoriatic arthritis include the lumbar spine of the lower back, sacrum of the pelvis, and cervical spine of the neck.

Adjusting Your Morning Routine

Taking an active role in your psoriatic arthritis treatment can help aid in the medical management of your condition and slow disease progression. Certain modifications to your morning routine can help decrease morning stiffness and associated joint pain.

8 Ways to Relieve Psoriatic Arthritis Morning Stiffness

Stretches

Gentle stretching of stiff, painful joints before getting up in the morning can help decrease morning stiffness and improve your ability to move and function throughout the day.

Stretching your finger joints all at once by pulling your fingers back away from your palms can help loosen up your fingers and hands. You can also use one hand to grab each finger of your opposite hand and stretch it back and forth through full flexion and extension of all the finger joints.

Heat Therapy

Applying heat helps improve blood flow to areas of the body, which can help promote joint mobility and decrease joint stiffness.

For larger areas of the body like the spine, you can apply a heating pad, either one that you plug into the wall or one that you put in the microwave to heat up. Make sure you have a towel or clothing layer in between your skin and the heating pad to avoid skin irritation and low-level burns.

For smaller areas of the body like the hands and fingers, you can soak a small towel under warm water and place it around your hands to apply heat. Heat should stay on for no longer than 10 to 20 minutes.

Warm Showers or Baths

Taking a warm shower or bath in the morning is another way to apply heat to stiff joints to help loosen them up and improve blood flow.

Taking a warm shower or bath can be very relaxing and help decrease muscle tension as well to get your joints feeling looser and more flexible in the morning.

Time Regulated Thermostat

While keeping the 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 raise the temperature of your bedroom an hour or two before your scheduled wake-up time can help increase your body temperature. This can make it easier to move your joints and decrease joint stiffness. 

A Regular Sleep Schedule

Adequate, uninterrupted sleep is crucial for allowing the body to rejuvenate and detoxify from inflammation. Without adequate sleep, the body doesn’t have enough time to repair and recover from daily stressors and toxins.

Making sure you stay on a regular sleep schedule of seven to nine hours of sleep every night can help calm inflammation throughout the body. This in turn can help decrease joint stiffness and psoriatic arthritis flare-ups.

Extra Time in the Morning

When your joints feel extra stiff in the morning, it can be difficult to move them and it may take you longer to get out of bed.

Waking up earlier than usual can help give you extra time to allow your joints to loosen up, which can help you go about your daily tasks with more ease. Aim to wake up 30 to 60 minutes earlier than usual. 

Anti-inflammatory Diet

Inflammation throughout the body can worsen with the consumption of inflammatory foods that contain gluten, dairy, sugar, and artificial flavors, colors, and preservatives.

Choosing whole foods, minimizing processed items, and opting for organic produce when possible can help decrease inflammation throughout the body. This can have an overall positive effect on decreasing joint inflammation and stiffness over time.

A Regular Medication Schedule

Because psoriatic arthritis is an autoimmune condition, medication is often required to help manage symptoms and decrease inflammation throughout the body.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used on an over-the-counter (OTC) basis to help decrease pain and inflammation. Biologic injections can help decrease autoimmune processes in the body to slow disease progression.

Making sure you stay on a regular dosing schedule with your medication can help decrease the severity of psoriatic arthritis symptoms and the level of joint inflammation, pain, and stiffness that you experience. 

Other Strategies for Relief 

When morning stiffness from psoriatic arthritis is chronic and doesn't improve with conservative methods, other treatment may be required to help manage some of your symptoms.

Stay In Touch With Your Healthcare Provider

Maintaining regular communication and follow-up visits with your healthcare provider can help you track changes over time to determine if your psoriatic arthritis treatment is working.

If you aren’t doing so already, you should regularly see a rheumatologist, which is a medical expert that specializes in inflammatory joint conditions. They can help prescribe the most effective treatment option based on your symptoms and medical history.

Question to Ask a Rheumatologist

Specific questions regarding your psoriatic arthritis may include:

  • How long will it take for me to see symptom improvement with psoriatic arthritis treatment?
  • Will I have to stay on medication for the rest of my life to manage my psoriatic arthritis?
  • Are there any lifestyle changes that can help decrease the severity of psoriatic arthritis symptoms?

Take Supplements

Supplementing with fish oil and vitamin D may help lower inflammation in your body, which can help decrease 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, They can have beneficial effects for reducing inflammation.

Vitamin D is an essential vitamin involved in proper immune system functioning and can help decrease inflammation.

Make sure to discuss supplement use with your healthcare provider to determine an appropriate dose of each supplement.

Focus On What You Can Control 

Psoriatic arthritis is a chronic condition that can sometimes be difficult to treat. Try to maintain a positive perspective and keep your goals in focus as you figure out what course of treatment works best for you. While there’s no “one size fits all” method for relieving morning stiffness, multiple strategies may work best in combination.

Maintaining healthy lifestyle habits can also help manage your psoriatic arthritis symptoms by decreasing inflammation throughout your body and promoting a healthy environment for healing.

Lifestyle Adjustments Can Help Manage Symptoms

Tips for a healthy lifestyle include:

  • Prioritizing getting at least seven to eight hours of sleep each night
  • Eating a healthy diet and managing a healthy weight
  • Staying adequately hydrated
  • Maintaining a positive attitude and learning how to cope with and manage stress
  • Exercising and staying active


Summary

When you're living with psoriatic arthritis, the lack of movement when you're asleep at night can lead you to wake up with painful and stiff joints in the morning. Morning stiffness is a primary symptom for people with psoriatic arthritis.

Certain modifications to your morning routine can help decrease morning stiffness and associated joint pain. These modifications include stretching, applying heat, and getting enough sleep to name a few.

When morning stiffness from psoriatic arthritis is chronic and doesn't improve with conservative methods, other treatment may be required to help manage some of your symptoms.

A Word From Verywell

Consistent habits are key for long-lasting symptom relief from morning stiffness. Improvements aren't seen overnight. It may take some trial and error to see what works best for you. Oftentimes, a combination approach of several different methods can be more effective than any single method alone.

Frequently Asked Questions

  • What triggers psoriatic arthritis joint pain in the morning?

    Psoriatic arthritis joint pain is often triggered by prolonged immobility during sleep. Symptoms tend to improve with exercise and activity.

  • Does morning stiffness from psoriatic arthritis last all day?

    Morning stiffness from psoriatic arthritis can last more than an hour. With bad flares, stiffness can last all day up to several weeks or months unless there's a change in treatment.

  • Do untreated psoriatic arthritis symptoms subside on their own?

    Untreated psoriatic arthritis symptoms typically don't subside on their own. Psoriatic arthritis is often a chronic and progressive condition requiring treatment to manage symptoms and prevent worsening of pain, stiffness, and inflammation.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Busse K, Liao W. Which Psoriasis Patients Develop Psoriatic Arthritis?. Psoriasis Forum. 2010;16(4):17-25.

  3. Eugene AR, Masiak J. The neuroprotective aspects of sleepMEDtube Sci. 2015;3(1):35-40.

  4. Centers for Disease Control and Prevention. 5 proven ways to manage arthritis.

By Kristen Gasnick, PT, DPT
Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey.