Several diseases cause morning stiffness, including arthritis, headaches, fibromyalgia, bone diseases and cancer. Trauma or overuse of a joint also contributes to stiffness. Stiffness may be worse in the morning after a night of physical inactivity or because medications have worn off. This is typical of individuals with rheumatic arthritis or Lupus.
Inflammatory Diseases
Doctors typically ask patients with rheumatoid arthritis if they experience morning stiffness, how long it lasts and its severity. Therapists often evaluate the duration, location and severity of morning stiffness to determine the disease status. Improvement can indicate that a medication is working well, and increased stiffness may indicate a flareup. Commonly affected joints include hips, shoulders, knees, wrists and knuckles.
Ankylosing spondylitis is another inflammatory joint disease that causes morning lower-back stiffness and pain as a result of ligaments loosening during the night. As they move around, the ligaments tighten and generally feel better.
Fibromyalgia and Headaches
Fibromyalgia is a syndrome that causes widespread pain and tenderness in muscles. Morning stiffness is a common symptom and may be so severe that it is difficult to get out of bed. Although fibromyalgia is not an inflammatory disease, it has similarities in that stiffness may be due to inactivity and collection of fluid in joints. Stiffness generally improves with activity.
Severe headaches can cause morning stiffness, especially in the neck area. Headaches are symptoms that accompany many diseases and conditions, including fibromyalgia, Lyme's disease, heart disease, liver disease and thyroid dysfunction.
Bone Diseases and Cancer
Bone diseases that cause morning stiffness include aseptic necrosis and sickle cell arthritis. Aseptic necrosis most commonly affects the hip and leg bones. Blood supply to the bones is reduced, causing pain, loss of range of motion and eventually bone death. Sickle cell anemia is a blood disease characterized by the sickle-shaped cell. It may cause sickle cell arthritis that causes acute or chronic pain and stiffness.
Cancer involves abnormal cell growth that may invade blood vessels and spread to various parts of the body. Some types of cancer can cause morning stiffness. Breast cancer causes swelling and stiffness around the shoulder and arm that contributes to pain and weakness. Cancers involving the head and neck contribute to postural changes, limitations in reaching and stiffness. Treatments, such as radiation and surgery, may contribute to stiffness as well.
References
- Rheumatic Disease: Occupational Therapy and Rehabilitation; Jeanne L. Melvin; 1989
- Handbook of Severe Disability; Walter C. Stolov, M.D., & Michael R. Clowers, Ph.D.; 1981
