Morning Stiffness is Not Only Pain

[Guest guest]

I've seen a lot of discussion on morning stiffness following 's post.

Although the joints involved would not necessarily be free of pain, morning

stiffness in particular joints is NOT the same thing as articular pain.

Doctors question you regarding this phenomenon to help decide a diagnosis

or, if you already have been diagnosed with RA and are being treated, to

assess your condition. If you don't report morning stiffness or have it for

less than 15 minutes, that would be a non-RA or remission-like state. 30

minutes or more and RA is looking like the culprit or your RA symptoms are

still serious. Over an hour of morning stiffness is one of the ACR (American

College of Rheumatology) criteria for classification of RA.

If you wake up and you can't make a fist (the fingers just won't bend and

they may be painful, too), you have stiffness. If you can make a fist and it

hurts like hell, you have pain but not stiffness. The doctor usually will

ask how far you can bend your fingers into a fist. If you can go only a

quarter of the way, he/she will record 25%. If you can make a fist easily,

100% is noted.

Or maybe you've napped on the couch for a few hours. You may get up and try

to walk and your knees just can't bend to do it easily. That's stiffness.

Your medication can make a big difference in the amount of stiffness you are

experiencing. The drugs lessen the inflammation and, usually, the amount of

stiffness improves.

" The presence of inflammation, the period of " gelling, " and systemic effects

are important findings. Inflammatory disease is suggested by morning

stiffness of more than one hour (a similar " gel " phenomenon occurs with

sitting or resting), swelling, fever, and systemic fatigue. Osteoarthritis,

also called degenerative joint disease, is not associated with

constitutional manifestations, and the joint pain is characteristically

relieved by rest. In contrast to the prolonged morning stiffness of RA, a

brief 5- to 10-min. period of gelling may be observed in osteoarthritis and

sometimes in normal individuals. The appearance of warm, swollen, obviously

inflamed joints is a sign of articular inflammation that is prominent in RA

but usually minimal in osteoarthritis. "

Source:

http://www.pdr.net/gettingwell/arthritis/consumers/dt_5_6_96.html

" The second most important step in arriving at a correct diagnosis that will

form the basis of treatment is determining if the disorder is inflammatory

or noninflammatory. A patient with inflammatory articular problems will have

a history of 1 or all of the following: joint swelling, warmth and, on the

rare occasion, redness (e.g., a septic joint is red, but a rheumatoid joint

is not). These signs are not associated with noninflammatory articular

problems. An inflamed joint will be stiff in the morning for at least 30

minutes and after periods of rest during the day (gelling); noninflammatory

forms of arthritis such as osteoarthritis will not be associated with

morning stiffness (or the morning stiffness will last less than 30 minutes),

and gelling will last no more than a few minutes. "

Source:

http://www.cma.ca/cmaj/vol-162/issue-7/1011.htm

Hope this helps clear this up!