Morning stiffness

Introduction In the morning, the joint of the lesion appears to be stiff for a long time (half and a half hours) after standing still, such as the feeling of adhesiveness, and gradually relieved after the appropriate activity is called morning stiffness. Morning stiffness is a manifestation of rheumatoid patients (of course, it can also occur in diseases such as osteoarthritis). That is, the patient has a stiff feeling in the affected joint in the morning or after a period of cessation of activity, and the activity is limited. In severe cases, there may be a feeling of joint stiffness, and the symptoms may be alleviated or disappeared after being activated or warmed up after getting up.

Cause

The reason for the morning stiffness is that when the sleep or activity is reduced, the tissue surrounding the affected joint is exuded or congested and edema, causing tension in the muscle tissue around the joint, causing joint swelling or pain and discomfort. As the muscle contracts, the edema fluid is The lymphatics and venules are absorbed, and the morning stiffness is also relieved. Fibromyalgia and osteoarthritis can also have a certain degree of morning stiffness, but rarely last for more than 1 hour like RA. When RA is relieved, the duration of morning stiffness is shortened and reduced. Therefore, morning stiffness is a good indicator of the severity of systemic inflammation.

an examination

The patient has a stiff feeling in the affected joints in the morning or after a period of cessation of activity. The activity is limited. In severe cases, there may be a feeling of joint stiffness. After getting up, the symptoms may be alleviated or disappeared after being activated or warmed. According to the history of illness and symptoms and signs, hip X-ray examination, spinal X-ray examination, and simultaneous rheumatism examination can be performed.

Differential diagnosis

Morning stiffness symptoms need to be distinguished from ankylosing spondylitis (AS).

Ankylosing spondylitis (AS) is common among young people aged 16 to 30 years old. It is more common in men. The first time after 40 years old is rare, accounting for 3.3%. The disease is insidious onset, slow progress, and mild systemic symptoms. In the early stage, there are often lower back pain and morning stiffness, which are relieved after the activity, and may be accompanied by symptoms such as low fever, fatigue, loss of appetite, and weight loss. At the beginning, the pain was intermittent, and it developed into persistence after several months. Afterwards, the inflammatory pain disappeared, and the spine was partially or completely stiff from the bottom to the top, and there was a hunchback deformity. Invasion of the surrounding joints of female patients is more common, with slower progression and lesser spinal deformity. The patient has a stiff feeling in the affected joints in the morning or after a period of cessation of activity. The activity is limited. In severe cases, there may be a feeling of joint stiffness. After getting up, the symptoms may be alleviated or disappeared after being activated or warmed.

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