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One of the most common conditions in aging is waking up in the morning with stiff, swollen, painful joints. Usually the underlying problem is osteoarthritis. That's the kind of arthritis that is caused by wear and tear of the bone around joints; rheumatoid arthritis is caused by an attack on the lining of joints by the immune system. Once you get up and start moving, the pain may not go away, but it's usually a lot more bearable.

In osteoarthritis, back pain usually results from damage to the facet joints in the spine. The facet joints act more or less the same way as the hinge on a door. If the hinge becomes rusty, it's harder to open the door. If the facet joints wear down, the spine gets stiffer. Similar processes occur in other joints in osteoarthritis.

The reason that getting up and getting moving makes a difference is that the cartilage around a joint is porous. When a joint is resting, as it is while you sleep, it absorbs the lubricating fluid from the joint it surrounds. It only releases the lubricating synovial fluid when the joint is exercised. Until you use the joint, it remains swollen, stiff, and painful. Once you start moving the joint, the synovial fluid helps it move more flexibly. Strengthening the muscles around a joint takes pressure off it so pain is less, stiffness is less, and swelling is less. 

If you have osteoarthritis, you have less cartilage. You also have less synovial fluid. It hurts more to move, and you get less benefit from moving. So what can you do to reverse the process?

1. Don't load up on non-steroidal anti-inflammatory drugs (NSAIDs), such as Aspirin, Ibuprofen, and Tylenol. Taking NSAIDs interferes with your body's ability to generate the new collagen that could eventually heal the joint.

2. Sleep on your back or on your side, not on your stomach. Sleeping on your stomach stresses your spine all night long, and continues wear and tear on the facet joints.

3. Don't sleep in cold, damp conditions. Don't sleep with the air conditioner cranked up in the summer, and don't turn down the heat in the winter. If you need an extra blanket or an electric blanket to feel warm, use them. Your muscles and your joints will be more limber the next morning.

4. Do a little gentle stretching while you are still in bed when you wake up in the morning. Stretch out your harms and hold them for a few seconds. Touch your toes while you sit on the edge of your bed.

5. Then begin the day with a warm shower. (Hot showers can make your skin dry out and flake.) Taking a warm shower and drying off in a warm room (or with a hair dryer, or both) helps your muscles support your joints.

6. Move! Get some exercise every day, but don't let walking be your only exercise. Find some other activity that puts all of your joints through their range of motion gently, like swimming, tai chi, or yoga.

7. If you are overweight, lose enough weight to take the load off your joints. You may not need to achieve your ideal weight. Losing just a few pounds can be enough to prevent problems with your joints.

8. If you reach the point you need a walking aid, use a cane, not a walker, if at all possible. Nearly everyone hunches over when using a walker, and the stress on the shoulders and neck can cause new problems.

9. Most people who have osteoarthritis have knee problems. Exercises for the quadriceps, such as gentle knee bends, help most people who have knee problems by taking pressure off the knee joints.

10. Crepitation, or creaking joints, can be an annoyance, or an embarrassment. You can eventually reduce creaking joints by building up the muscles that surround them, but don't overdo your exercise.

How can you tell that you probably have osteoarthritis, the kind nearly everyone gets, and not the more serious rheumatoid arthritis?

Only your doctor can tell you for sure, but here are some hints of what the diagnosis will be: Rheumatoid arthritis causes "feverish" joints while osteoarthritis causes "cold" joints. Rheumatoid arthritis tends to have a definite beginning, often after an infection. Osteoarthritis "sneaks up" on you over a period of years. Osteoarthritis is improved with physical activity. Rheumatoid arthritis often does not. The good news about osteoarthritis is that for many of us, it can go away on its own after a few years of good exercise habits. Rheumatoid arthritis nearly always requires medication.

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