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Waking Up with Ankylosing Spondylitis

Updated: Jan 26

September 11th, 2020

Mornings with Ankylosing Spondylitis and joint stiffness

I am acutely aware of my Ankylosing Spondylitis every morning when I wake up (along with the several times I wake in the middle of the night). Waking up with AS isn’t fun.


I’ve never been a morning person, per se-- I’m always up for sleeping in and slow to rise from bed. AS has made mornings even more complicated for me. When I wake, I’m now torn between staying in bed, knowing that my pain will likely get worse, or getting out of bed to face my morning activities complicated by joint pain and stiffness.


One of the hallmark symptoms of AS is morning stiffness, especially in the spine. In fact, one of the many questions a rheumatologist will ask when AS is suspected is about morning stiffness and whether it lasts longer than 30 minutes. For many, this stiffness can last well beyond 30 minutes, and even linger for hours. In this way, joint stiffness can affect the entire morning.


What Do Mornings with Ankylosing Spondylitis Feel Like?


With AS, I find it hard to get a good start on the day. Joint pain and inflammation worsens with inactivity, which means laying in bed all night can make these symptoms exponentially worse upon waking. Some mornings are worse than others. For me, it usually depends on how much sleep I get during the night, and how ‘restful’ that sleep actually is.


Waking up to joint pain and stiffness

When I don’t get good sleep at night, my entire body feels achy and fatigued in the morning. Waking with full-body aches usually signals a rough day ahead with increased joint pain and fatigue, possibly a flare-up. When I get a good night’s sleep (this is definitely relative, and sometimes I yearn for those restful sleeps from years ago when I wasn’t plagued by AS pain), I still wake with stiffness and pain, but that pain is often localized.


For example, when I’ve been laying on my side for too long I often wake up with intense hip pain that feels like my hip joints are being squeezed by an iron vise. This kind of pain comes with an urgency to move, but also a hesitation to move and cause more pain. On other mornings, I wake with mild-to-moderate axial pain and stiffness ranging anywhere from my neck down to my hips, and often affects the majority of my spine.


Morning stiffness is difficult to put into words, but this description captures the imagination: it “feels like I am waking up in the Tin Man’s body.” I feel that. I feel like my joints have rusted over during the night. They’ve become rigid, sore, and more difficult to flex. It’s unpleasant, to say the least.


Movement can stave off joint stiffness and increase flexibility so it’s important to find ways to keep moving, especially in the morning hours.


How to Ease Morning Stiffness


Luckily, this rigidity doesn’t last all day, and there are some remedies that may help. Here are several techniques that help me ease away moderate morning stiffness:


1. Take a Long, Hot Shower

This is an absolute must for me! I find that heat treatments help ease my joints a bit more than cold, and nothing helps my back in the morning better than the flow of hot water. On mornings when my back is extra stiff, I just stand under that water for a little bit longer. Also, I prefer hot showers over hot baths because the hard surface of the bathtub can actually inflict more pain on my lower spine than relief.


Ankylosing Spondylitis in the mornings

2. Practice Stretching or Yoga

Honestly, I don’t do this enough. Even a short session of yoga can help loosen stiff joints and ease away joint pain. With that said, it’s important to recognize how your body feels each morning and to choose the yoga routine that will be beneficial without causing more pain. Since AS can limit flexibility, avoid a routine that involves positions that involve too much bend or stretch, and avoid anything that’s too strenuous to start out with. The last thing you want to do is induce a flare when you’re trying to ease AS symptoms.


3. Move Around Frequently

This is something I’m constantly reminding myself of. Working an office job that involves sitting at a desk, it’s easy to get sucked into your work and become complacent. Movement can stave off joint stiffness and increase flexibility so it’s important to find ways to keep moving, especially in the morning hours. This may include taking short walks around the office every hour, or around the house, or taking the dogs outside for a few minutes. Whatever you can manage, do it, and do it often!


4. Utilize Heat Pads or Heated Blankets

If it’s one of those days that frequent movement just isn't going to happen, make sure to keep a heat pad or heated blanket handy. I always keep an extra-large heat pad on my office chair and turn it on several times throughout the day to ease away pain in my lower back. This can be useful for stiffness in the mornings too. If it’s an especially bad morning, slide that heat pad under your back while still in bed. You might also try wrapping up in a heated blanket and throwing that thing on high!


I’m still coming to terms with this particular Ankylosing Spondylitis symptom. It’s certainly a frustrating symptom because it pops up each and every morning without fail. I’m glad I’ve found some techniques that help manage it, and I hope this short read is helpful to others out there battling daily life with AS!


-Jessica

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