7 Tips for preventing or reducing morning stiffness

Morning stiffness occurs when you’re stiffer in the morning than before you went to bed. Could it be caused by the same things that may trigger a flare? Here are a few possible things that may aggravate your RA during the night.

First of all, if your feet, hands, shoulders or whole body are cold during the night, cold can trigger the release of tumor necrosis factor (TNF) alpha and IL-6 (1, 2). These cytokines provide an inflammatory environment. They can increase the swelling, pain and redness.

Do these cytokines cause the swelling, pain and redness? Biologic medications like Enbrel, Humira, and Remicade reduce TNF alpha and provide relief for many RA patients (up to 70% in some trials). Likewise, Actemra blocks IL-6 signaling and provides relief in many RA patients. Thus, reducing TNF and IL-6 or preventing an increase in TNF and IL-6 during the night may be helpful for many RA patients.

Theoretically, it may be feasible to relieve at least some of the pain, inflammation, and morning stiffness by maintaining joints sufficiently warm.

In addition, low thyroid activity, called hypothyroid disease, is becoming more prevalent. One of its main symptoms of hypothermia is cold feet and hands.

These seven tips for helping your body to prevent or reduce morning stiffness are grouped by potential triggers: cold stress, low thyroid activity, and potential reasons for low thyroid activity

Morning stiffness from Cold stress

1. You’re slightly cold while you sleep. How to test: Sleep in a sleeping bag where your arms and legs are kept warm. Add flannel or fleece sheets to your bed as the fuzziness increases the air pockets which help hold in the warm air.

2. Feet were stiff and had trouble getting to sleep. Feet sometimes get cold more easily than the legs or torso. A loose fitting set of down booties can help keep the feet warm. It may also indicate that your thyroid is not functioning efficiently.

3. Arms or shoulders are cold and stiff in the morning. When I get too warm during the night, my arms will come out from under the covers. Since we keep our home on the cool side, they can get chilled. After waking and moving them under the covers for 5 or so min, the warmth quickly soothes them and stiffness disappears within minutes. The trick is to catch it early.

Does low thyroid activity contribute to morning stiffness?

4. If your hands and feet are always cold, consider getting your thyroid activity checked. If it is low, I’d first recommend adding an adequate source of iodine. Iodine is essential for thyroid function and healthy breasts. Good sources of iodine include seafood, and kelp.

5. Supplements for iodine are available and you may want to discuss your potential needs for iodine with your healthcare provider. I personally take Min-Tran from Standard Process which is an organic food-based supplement for trace minerals. It is available from healthcare providers. I usually take 2 tablets of Min-Tran before bed, as having sufficient trace minerals to help repair the body can sometimes help with sleeping.

6. Note that swimming in swimming pools treated with bromine-based sanitizers also affects your iodine levels. In fact, bromine can replace iodine in the thyroid.

7. Bromine is present in the diet. In 1997 survey, the average British person consume approx. 14 times more bromine (3.6mg/day) in their diets than iodine (0.25 mg/day) (3). Brominated vegetable oil are found in several drinks (Mountain Dew, Gatorade, Sun drop, Squirt, Fresca, and other citrus flavored drinks) and some citrus based cleaning solutions. Brominated compounds are also in conventional breads.

Thus, drinking water rather than commercially prepared citrus drinks and eating more foods high in iodine (most seafoods, if you’re not allergic to them) may help provide much needed iodine.

Hope these tips help you reduce your morning stiffness. Other triggers may also induce inflammation during the night.

BTW, I usually have no pain and no additional stiffness in the morning. My morning routine begins with turning off the alarm and getting up (no waiting). Often I’m dressed and downstairs within 10-15 min, preparing breakfast and lunch for my daughter. Please note that these tips may or may not be applicable to you.

Hope these insights may spur you to find what’s bothering you.

Next month: The Mind Game: Convincing your mind that you can get better.

Personal consultations are available for those interested in a second opinion.

A 5 week telephone seminar series on various potential causes of RA and RA flares that are reported in the scientific and clinical literature will begin on May 8th. A 1 hour Question and Answer period will follow each of the 5 teleseminar series. Recordings will be available. Additional info on the series will be available next month.

Here's to your healing!



Katherine Molnar-Kimber, Ph.D.


This is for information purposes only and the information is not intended to diagnose, treat or cure any disease. Please see the disclaimer.