Morning Stiffness

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Morning stiffness is a very frequent symptom of Fibromyalgia that seems to combine multiple other symptoms into a volatile mix of unique suffering. The hallmark symptoms of Fibromyalgia – widespread chronic pain, tenderness, muscle aches, sleep disturbances, and deep pervasive fatigue – are often very noticeable when waking up in the morning. This “morning stiffness” can cause discomfort to radiate through the body in patients with Fibromyalgia. Individuals who suffer from morning stiffness may feel as if it takes a few hours for their bodies to “warm up” or “loosen up” before they can become fully mobile. Morning stiffness can interfere with an individual’s ability to move and limit their range of motion, which can exacerbate muscle strains, aches, and generalized pain. The impact of morning stiffness on individuals with Fibromyalgia can be profound. It can make even the simplest morning tasks – including getting out of bed, driving a car, going to work –  incredibly difficult.

As many as 90% of Fibromyalgia patients report suffering from morning stiffness at various times, and 70% report having to deal with it on a regular basis. Morning stiffness most commonly affects the hands, feet, arms, or legs, as well as the back. Many people report that their morning stiffness worsens in cold or humid weather -including when weather frontal systems may be moving through their location, and the co-occurrence of other conditions such as sleep disturbances make symptoms worse

The reason why morning stiffness occurs is not known. Some theories include overuse of muscles, lack of physical activity (i.e., exercise), overweight/obesity, poor diet, physical stress resulting from inappropriate limb movements, poor sleeping posture, and accumulation of fluid in the joints.

Symptoms of Morning Stiffness

The symptoms of morning stiffness vary from person to person but generally include the following:

  • Muscle tightness upon awakening
  • Stiffness in hands, fingers, feet, and toes
  • Tightness of the muscles after periods of rest, such as riding in a car or sitting for a long period of time
  • Limited range of motion in joints (i.e., unable to fully extend your arm or leg)
  • Tension headaches that begin at the base of the neck and extend up over the head
  • General stiffness in the back, neck, and head
  • Inability to sleep (insomnia)

Treatment for Morning Stiffness

There is little information available with regard to specific treatment for morning stiffness associated with Fibromyalgia. A 1999 study by Russell et al. discovered that Fibromyalgia patients who took the drug known as interferon-alpha (IFN-alpha) at a 50 IU dose once per day had significant improvement in morning stiffness. An earlier study by Finnish researchers evaluated the effectiveness of the drug zopiclone on sleep quality, morning stiffness, and widespread pain and tenderness. Although the findings were mixed, the researchers generally found no difference in outcome between those treated with zopiclone and those who took a placebo (“fake” pill, or “sugar pill”) (Gronblad et al., 1993).

Nevertheless, there are some behavioral modifications individuals can make that may help relieve or reduce the severity of morning stiffness, including the following:

  • Get as much sleep as possible and avoid stomach sleeping
  • Sleep in a warm room and avoid drafts
  • Stretch while lying in bed, then while sitting up. Stretching can include things like arm stretches and bending from side to side. This helps improve blood flow to the muscles.
  • Take a hot shower to promote blood flow and relieve muscle spasms.
  • Drink pure, filtered water
  • Eat a healthy, well-balanced diet that is free from artificial ingredients (including artificial sweeteners, preservatives, and additives)
  • Learn and utilize stress-management techniques to help you relax and allow you to fall asleep quicker – and stay asleep longer.
  • Low- to moderate-intensity physical exercise has been shown to greatly improve symptoms associated with Fibromyalgia and improves circulation
  • Dress appropriately for cold weather

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References

1.        Russell IJ, Michalek JE, Kang YK, Richards AB. Reduction of morning stiffness and improvement in physical function in Fibromyalgia syndrome patients treated sublingually with low doses of human interferon-alpha. J Interferon Cytokine Res. 1999;19(8):961-968.

2.      Gronblad M, Nykanen J, Konttinen Y, Jarvinen E, Helve T. Effect of zopiclone on sleep quality, morning stiffness, widespread tenderness and pain and general discomfort in primary Fibromyalgia patients. A double-blind randomized trial. Clin Rheumatol. 1993;12(2):186-191.

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