4 Rheumatoid Arthritis Symptoms That Appear At Night

Rheumatoid arthritis (RA) is a long-term disease where the body’s immune system attacks its own healthy joints. Over time, this can lead to pain, swelling, and loss of movement. While these problems often happen during the day, many people find that some of their symptoms grow worse once the sun sets and they try to rest.

It might seem strange that RA symptoms often flare up at night. One reason is that our bodies follow a daily pattern, also known as the circadian rhythm. In people with RA, certain chemicals in the body that cause inflammation can rise when it gets dark. This can lead to more swelling and pain when you are trying to sleep. Also, after a long day, our joints may have had enough stress and movement, making them feel more sore when we finally lie down.

In this article, I will explain four of these nighttime symptoms and offer helpful tips to deal with them.

1. Aching and Stiff Joints

One of the most common complaints from people with RA is stiff, aching joints that feel worse at night. During the day, gentle movement can keep joints a bit more flexible. But at night, when you are not moving, your joints can become stiffer. You might wake up feeling as though your fingers, wrists, knees, or ankles are locked in place. This stiffness can make it hard to find a comfortable position in bed, making sleep difficult.

To reduce stiffness at night, experts suggest adding gentle stretching or a warm bath before bed. A warm bath helps increase blood flow and can ease tense muscles around your joints. Once you are in bed, you may try placing a heated pad on the aching area. However, be careful not to fall asleep on an electric heating pad. Instead, consider using a warm compress that will cool down over time, or set a timer if your heating pad has one. You might also want to talk with your doctor about adjusting medication schedules so the drugs that help prevent inflammation are still active when you settle in for the night.

2. Throbbing Pain in Hands and Feet

Another symptom that tends to trouble people at night is throbbing pain in the hands and feet. According to health experts, this happens because RA often targets the smaller joints first. The Mayo Clinic notes that “Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet.”

When you are active during the day, you might not notice the pain as much since your mind and body are busy. But when night comes, this pain can become the center of your attention. Throbbing pain can interfere with getting a good night’s sleep, and lack of rest can make you feel tired and less able to handle pain the next day.

Try elevating your hands or feet slightly while you rest. Putting a soft pillow under your arms or legs can help reduce swelling by improving blood flow. Gentle massage is another way to help calm throbbing pain. You could use a light, non-irritating lotion and slowly rub the aching area. If the pain is severe, speak with a medical professional about pain relief methods that can help you sleep. Sometimes taking an over-the-counter pain reliever an hour before bedtime can help ease discomfort enough so that you fall asleep more easily.

3. Worsening Morning Stiffness

You might wonder why morning stiffness counts as a nighttime symptom. Well, it starts building up during the night while you sleep. When you wake up, you feel that dreadful stiffness, which can last for an hour or longer. While the morning is not technically nighttime, the issue begins during those evening hours as you lie still. The inflammation builds up, and because you have not been moving for several hours, your joints are not as flexible as they were during the day.

One of the best ways to reduce morning stiffness is to keep your body gently active before bed. Light exercises, such as a short walk around the block or simple stretches, can improve blood flow and help your joints.

Another helpful idea is to keep your bedroom warm. Warmth can ease inflammation, so consider using a mild space heater or heavier blankets—just remember to be safe and avoid overheating the room. In the morning, you can try a warm shower or a heated towel to help loosen the joints. Stretching soon after you wake up can also help relieve some of the stiffness before you start your day.

4. Night Sweats and Fatigue

RA is not just about the joints. It can affect your whole body, causing general discomfort and even low-grade fevers. At night, this can show up as night sweats, where you wake up feeling hot, damp, and uncomfortable. Night sweats can disturb your sleep, leaving you feeling worn out and fatigued.

Fatigue, in turn, makes it harder for your body to deal with inflammation and can make other RA symptoms feel worse. The cycle continues, which is why it is important to manage these symptoms.

To handle night sweats, consider sleeping in layers so you can remove a blanket if you get too warm. You may also try cotton pajamas, which allow your skin to breathe. Keeping a cool glass of water by your bedside and sipping it if you wake up hot can help.

Fatigue can be reduced by making sure you have a good bedtime routine: go to sleep at the same time each night, keep the lights low, and avoid TV or intense activities before bed. If night sweats and fatigue continue or get worse, it may be worth talking with a medical professional about reviewing your treatment plan. Adjusting your medications, changing your diet, or adding a mild exercise routine in the morning might improve your overall comfort.

When to Seek Professional Help

If you find that your nighttime RA symptoms are getting worse or are not responding to the home methods described here, it is wise to see a healthcare professional. They may suggest changing the dose of your current medication, switching to a different drug, or adding therapy sessions, such as physical therapy or occupational therapy, to help you cope with pain and stiffness. A doctor might also recommend tests to ensure there are no other health issues making your RA worse at night.