Stiff Hands in the Morning: Non-Arthritic and Arthritic Causes

Waking up with stiff hands is a relatively common problem with a variety of potential causes. Arthritis, tendon changes, and even nerve compression may be to blame for this annoying and potentially disabling concern.

This article will detail the most common causes of morning hand stiffness and how it is typically diagnosed and treated.

Causes of Stiff Hands in the Morning

A wide range of issues can cause you to wake up with hand stiffness. Here are some of the most common ones:

Arthritis

Arthritis is a large category of diseases that cause pain, swelling, or inflammation in a joint. When arthritis affects the joints in the hands or fingers, it can lead to morning stiffness. Three of the most common types of arthritis include:

• Osteoarthritis: One of the most prevalent causes of morning hand stiffness, osteoarthritis occurs when the smooth, slippery cartilage that covers a joint begins to wear away or deteriorate over time.
• Rheumatoid arthritis (RA): This autoimmune disease occurs when your body attacks the lining of its own joints. Rheumatoid arthritis frequently affects smaller joints, like those in the hands and fingers, and leads to morning pain and stiffness.
• Psoriatic arthritis: This type of arthritis is associated with the skin condition psoriasis. It causes your body to attack its own joint linings, leading to swelling and inflammation. The joint damage associated with psoriatic arthritis is frequently seen in the hands or fingers and commonly leads to stiffness when you wake up.

Stenosing Tenosynovitis (Trigger Finger)

The tendons that bend your fingers are enclosed in tunnels called sheaths and normally glide freely through them. Occasionally, a sheath becomes thickened or inflamed, and a tendon’s motion becomes restricted as a result.

This condition, called trigger finger, can lead to stiffness or locking of joints in fingers, particularly in the morning, after a period of nonuse.

Dupuytren’s Contracture

Dupuytren's contracture occurs when the layer of tissue under your skin (called the fascia) becomes abnormally fibrous and thick. Primarily affecting the palm and base of the fingers, this disease leads to slowly progressing stiffness and deformity in the hands.

Carpal Tunnel Syndrome

Carpal tunnel syndrome arises when the median nerve (which travels through the carpal tunnel in the wrist) becomes compressed or inflamed. When this occurs, you can experience numbness, tingling, and stiffness in your hand or fingers.

While these symptoms can be present at any time, they may be worse when you first wake up in the morning.

What Medications Can Cause Morning Hand Stiffness?

Several classes of medications may contribute to morning hand stiffness. These include:

• Statins: This class of cholesterol-lowering medications may cause cramping, aching, and myalgia (muscle pain) in up to 25% of people taking them. Examples include Crestor (rosuvastatin), Lipitor (atorvastatin), and Zocor (Simvastatin).
• Fluoroquinolone antibiotics: Taking this type of antibiotic, such as Cipro (ciprofloxacin), has been shown to lead to muscle stiffness, tenderness, or tendinitis in some individuals.
• Antipsychotic medications: These drugs, which are used to treat schizophrenia, mania, and bipolar disorder, may cause muscle stiffness or joint pain. Risperdal (risperidone) is an example.
• Myfortic (mycophenolate): This antirejection drug, which is taken after an organ transplant, may cause joint pain, swelling, or stiffness.

How to Relieve Hand Stiffness at Home

The following at-home remedies may provide some relief for your hand stiffness first thing in the morning:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil/Motrin (ibuprofen) or Aleve (naproxen sodium)
• Gentle hand exercises, like squeezing a stress ball or repetitively tapping your fingers
• Heat or ice applied to the affected area of the hand
• Nighttime bracing or splinting to prevent stiffness from developing in the first place

How to Treat Hand Stiffness Under a Provider

If the at-home remedies outlined above fail to alleviate your hand stiffness, you may need more specialized treatments. The following interventions may be recommended by your healthcare provider:

• Physical therapy: Outpatient physical therapy can help alleviate stiffness from arthritis, trigger finger, or carpal tunnel syndrome. Your therapist may perform hands-on techniques to improve your mobility or teach you stretches and strengthening exercises to complete at home.
• Prescription medication: Medications like corticosteroids and disease-modifying antirheumatic drugs (DMARDs) are commonly needed to control the symptoms of rheumatoid or psoriatic arthritis.
• Injections: Corticosteroid injections may be used to alleviate hand stiffness caused by arthritis, Dupuytren’s syndrome, carpal tunnel syndrome, or trigger finger.
• Surgery: If more conservative interventions fail to provide relief, a surgical procedure may be needed to improve hand stiffness from arthritis, Dupuytren’s, trigger finger, or carpal tunnel syndrome.

Complications and Risk Factors

Morning hand stiffness is often one of the earlier symptoms of the various conditions that cause it. If left unaddressed, other complications may eventually develop, including:

• Morning pain or pain with activity
• Swelling
• Progressive loss of hand motion
• Mechanical deformity of the hand or fingers.
• Catching, popping, or locking of the fingers.

While anyone can experience hand stiffness, certain individuals may be at a higher risk, including people who:

• Are middle age and older
• Have a family history of arthritis or Dupuytren’s syndrome
• Have diabetes
• Smoke or have alcohol use disorder
• Perform repetitive movements or strong gripping at work

Tests to Diagnose Causes of Morning Hand Stiffness

Because several different conditions can cause morning stiffness, your healthcare provider may need to perform testing to identify the cause of your symptoms. The most common diagnostic tests for hand stiffness include:

• X-ray
• Blood tests
• Electromyogram (EMG) studies of electrical activity in your muscles
• Magnetic resonance imaging (MRI)
• Ultrasound

When to See a Healthcare Provider

If you are experiencing stiffness in your hands when you wake up, it is important to speak to a healthcare provider about your symptoms. This is especially true if the stiffness is getting progressively worse or is not alleviated by at-home treatments.

Failure to properly address your condition may lead to pain, swelling, and even permanent loss of function in the hand.  

Summary

Many conditions, including arthritis, carpal tunnel syndrome, Dupuytren’s syndrome, and trigger finger, can cause morning hand stiffness. At-home remedies like medications, splinting, heat, ice, and hand exercises may provide some relief. In persistent or worsening cases, therapy, prescription drugs, injections, or even surgery may be needed. The first step is having your symptoms diagnosed by a healthcare provider.