Ask The Doctors: July 2011

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Morning stiffness is characteristic of patients with rheumatoid arthritis (RA). Some patients can be stiff for hours, even all day. The physiology of the stiffness is not entirely clear, but it is related to inflammation in the bodys soft tissues and joints, which may cause a feeling of tightness. If you have morning stiffness that persists for more than 30 minutes, it is usually a sign of joint inflammation (synovitis), especially when there is also swelling. The treatment is to use drugs that are commonly prescribed for RA. These include nonsteroidal anti-inflammatory drugs (NSAIDs), over-the-counter drugs such as Aleve and Advil, or prescription medications such as plaquenil, methotrexate, sulfasalazine, and leflunomide. For patients with persisting synovitis after these other medications, biologics (Enbrel, Humira, Remicade, Orencia) are recommended. These drugs all have side effects, so their use should be carefully monitored.
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