Why Do You Wake Up in Pain?

Many people go to bed each night feeling pain-free. But something happens overnight and when they wake up, their joints are stiff and sore, making even simple movements a struggle. Sound familiar?

The Importance of Synovial Fluid

“Morning joint pain is an extremely common problem,” says rheumatologist Marie Kuchynski, MD. “Our joints are designed to move and bend but while we sleep, they are relatively still. This lack of motion slows the circulation of synovial fluid, a gel-like substance that lubricates the joints and allows for smooth, pain-free movement.”

And as you age, the body tends to produce less synovial fluid, so older adults are more likely to have morning joint pain. Regardless of age, the joints most often affected include the shoulders, elbows, wrists, hips and knees, known as the synovial joints.

Motion Is Lotion

Joints are where two or more bones meet in the body, but are not fused together. They are cushioned by a soft tissue called cartilage, which allows the joint to move and bend. The cartilage is lubricated with synovial fluid, which facilitates pain-free, gliding movement.

When the amount of synovial fluid circulating around the joint is reduced due to lack of motion during sleep, it tends to thicken. Upon awakening, the bones are less cushioned and may rub together, causing pain. “I often compare it to watching Jell-O set in the refrigerator – the longer it sits there, the more it thickens,” says Dr. Kuchynski.

The good news is, once movement resumes, the fluid thins and circulates more efficiently. In people without chronic conditions like arthritis, morning stiffness and pain usually resolves relatively quickly once they move around. People with chronic conditions may require additional therapies to manage their pain.

At-Home Remedies

Morning joint pain can often be eased with some simple home remedies and lifestyle changes, including:

Moist Heat. Heat is one of the most effective ways to get your blood and synovial fluid moving in the morning. Try taking a hot bath or shower when you first wake up to relieve stiff joints.

Good Sleep. Poor sleep quality or not enough sleep can increase pain levels and negatively affect your perception of pain. Aim for 7-9 hours of sleep per night and choose a mattress with enough firmness to provide support.

Pain Medicine. Nonsteroidal anti-inflammatory medications like ibuprofen and topical creams that generate heat may help with joint pain. Talk to your doctor about appropriate medication dosing and timing to help provide optimal relief from morning pain.

Healthy Body Weight. Excess body weight puts stress on the joints, especially the weight-bearing joints. “Losing even a small amount of weight can often significantly reduce joint pain,” says Dr. Kuchynski. “In fact, studies have shown that just 10 pounds of weight loss can decrease the pressure on the knees by 100 pounds,” she adds.

Movement. A combination of stretching exercises, strength training and aerobic exercise can greatly improve joint pain, as well as help with weight loss. While exercise won’t increase the amount of synovial fluid, it does improve its quality. Try doing some gentle stretches before getting out of bed to get those fluids moving.

Diet & Nutrition. What you eat can greatly affect your joint health. Avoid refined sugars and processed foods, and increase your intake of foods that have been proven to reduce inflammation and may help increase the production of synovial fluid, including:

• Dark green, leafy vegetables
• Foods rich in omega-3 fatty acids like salmon, mackerel and flaxseeds
• High antioxidant foods like onions, garlic, green tea and berries
• Nuts and seeds

Supplements. Although they won’t cure joint problems, some nutritional supplements have been shown to increase synovial fluid and may help alleviate your pain. Ask your doctor if any of the following supplements might be beneficial for you:

• Omega-3 fatty acids such as fish oil
• Glucosamine or Chondroitin
• Methionine, an amino acid
• Collagen
• Calcium and Vitamin D

Be sure to check with your healthcare provider before taking any dietary supplements. Some can cause negative side effects or interact with other medications.

Stop Smoking. Smoking is a major risk factor for osteoporosis and bone fractures and can worsen joint pain, low back pain and rheumatoid arthritis.

When to Seek Professional Care

If at-home remedies are not effective in relieving morning joint pain, you should consult a medical professional for evaluation. Your doctor may recommend an injection to increase synovial fluid, reduce inflammation and promote healing. The type of injection and the frequency of treatment will vary based on your diagnosis.

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The highly trained rheumatologists at University Hospitals have the experience and expertise to diagnose and treat disorders of the joints, muscles and soft tissues of the body. Our specialists see patients at convenient locations across the region.