Managing Arthritis Joint Stiffness and Inflammation

Got joint pain? Then you're joining the one in three American adults who have some form of arthritis, the broad term encompassing more than 100 types of joint disorders. Osteoarthritis, the most common type, is often referred to as the "wear-and-tear" version of arthritis while rheumatoid arthritis is driven by a faulty immune system.

No matter which type you have, if you're living with arthritis, it means your joints—which you rely on for everything from walking to cooking—become stiff and painful, making daily activities more difficult. Managing joint inflammation and stiffness with arthritis starts with the right lifestyle adjustments to help you reduce discomfort and stay active.

What Causes Arthritis Joint Pain and Inflammation?

Arthritis is caused by the smooth, strong, flexible connective tissue, called cartilage, that protects the ends of your bones breaking down. Over time, this results in the bones rubbing directly against each other, causing pain.

The broken-down cartilage is also responsible for inflammation in the surrounding tissues, experts believe, due to the fact that it deposits tiny broken-off fragments into the joint space, where they irritate the joint lining. The broken-down cartilage also places joint cells under stress, which in turn stimulates immune cells, which then release harmful proteins that continue the inflammation cycle.

For people carrying extra pounds, being overweight exacerbates arthritis pain, since fat tissue releases proteins that contribute to systemic inflammation.

How Inflammation Affects the Joints

Inflammation leads to tender, swollen joints as your body tries to repair the damage arthritis has caused. In turn, this causes pain and joint stiffness, per the Arthritis Foundation. If left untreated, it can result in a vicious cycle in which chronic inflammation in the joints damages cartilage even further, eventually affecting the surrounding bones and tendons as well.

Despite the progressive nature of joint damage, the good news is that there are many things you can do to manage inflammation so that it does not worsen your joint pain and stiffness.

Best Ways to Manage Arthritis Inflammation

Step one: Talk with your doctor about an inflammation-management strategy that's right for you. "The real control of inflammation comes from proper treatment," says Diana Girnita, M.D., Ph.D., a board-certified rheumatologist and founder of Rheumatologist OnCall in Irvine, CA. "Don't try to manage it on your own—that's exactly what your health care team is there for."

The first thing your provider will likely recommend? Exercise. "Stillness feeds stiffness," says Dr. Girnita. She advises regular, gentle movement, starting with a warm shower as soon as you get up, followed by easy range-of-motion movements to loosen up before placing any meaningful stress on your joints.

But while some movement is beneficial, too much will backfire. "Alternate activity with rest so you don't overload a joint," says Dr. Girnita, who suggests when you're creating an inflammation-management plan, you keep the following in mind.

Gentle Movement and Daily Exercise

Strength training and full range of motion work are both key, says Lori Diamos, PT, a Chicago-based physical therapist and founder of Pearls from a PT. "Many people with arthritis feel pain and instinctively stop moving, but movement is what increases blood flow, lubricates the joints, and maintains the strength and stability those joints need to function," Diamos explains. "Movement also creates a muscle pumping action that supports the lymphatic system, helping to clear excess fluid out of the joints, which is part of why range of motion and strength work are so helpful for managing inflammation."

To trigger that inflammation-managing process, Diamos recommends the following simple exercises:

• Ankle pumps. Sit on the floor with your legs straight out in front of you. Flex your feet as far as you can (imagine your toes reaching back toward your head), then point your toes down to the floor and away from your body. Do 10 times.
• Ankle circles. Sit in a chair, knees bent, feet flat on the floor. Raise one foot off the floor slightly and slowly make wide circles in the air. Do 10 circles clockwise then the same number counterclockwise. Switch and repeat with your other foot.
• Glute sets. Lie flat on your back with your knees bent and feet flat on the floor. Clench your buttocks together as tightly as you can, holding for 3 seconds before releasing. Do 10 times.
• Quad sets. Lie down with your legs straight out in front of you. Tighten your right thigh muscles (your quadriceps), holding the squeeze for 5 to 10 seconds before releasing. Repeat on the opposite side. Do 5 total on each side.

Anti-Inflammatory Diet

There's no specific diet proven to reduce arthritis symptoms, but experts recommend one that's rich in whole fruits, vegetables, beans, fish, and nuts, with limited saturated fats and processed foods—often referred to an anti-inflammatory diet. The Mediterranean diet is one diet that's often highlighted as having anti-inflammatory properties; an analysis of existing studies in the journal Aging Clinical and Experimental Research found that a Mediterranean diet was associated with a reduced risk of developing osteoarthritis.

Maintaining a Healthy Weight

Your joints are affected by ground reaction force, gravity, body mass, and momentum every time you move. "The more you weigh, the more stress goes through joints that may already be irritable or degenerating," Diamos says. "Keeping weight in a healthy range reduces the load on parts of the body that are already under strain."

If you need help creating a plan for weight management or aren't sure how much weight you should be trying to lose, speak to your doctor.

Staying Active Without Overdoing It

The key to establishing an exercise plan and sticking to it for the long term is finding movement you enjoy and that works for your body, says Diamos. "It has to be something you can do consistently without producing pain or irritation," she adds.

Diamos advises starting small, limiting how long you're doing something for, and taking rests as needed. "You can build from there as your tolerance increases," she says. "A healthy mix of low-impact aerobic activity, strength, and mobility work is a great foundation, since it keeps the joints moving without adding excess stress."

She also encourages people to make use of "developmental" positions, such as lying on your back, lying on your belly, getting on all fours, sitting, and kneeling. These positions are ones your body transitioned through as you went from infant to adult, and they are generally considered stable and safe. "Our bodies are meant to function in all those positions, not just upright," Diamos says. "Utilizing them maintains the mobility and stability that supports better dynamic control when you are upright and active."

Best Ways to Relieve Joint Pain

Dr. Girnita approaches joint pain management in layers. "Start with the simple, safe things: heat and cold, gentle movement, and pacing your activities," she says. These are a few pain-relieving tips to try:

• Strengthen the muscles around the joint. This is one of the most durable forms of pain relief, even though it takes several weeks of exercise before you will start to notice a difference.
• Weight loss. Where relevant, shedding excess pounds directly reduces pain.
• Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs). These have a role for many, but they aren't for everyone, so check with your doctor.
• Prescription injections. When pain is persistent or the joint is clearly inflamed, see your doctor. There are medications for inflammatory arthritis that address the root cause, not just the symptoms.

Heat Therapy for Stiffness

Heat is a vasodilator, bringing nutrient-rich blood to the joints that are inflamed or stiff, says Diamos. "Imagine throwing taffy in the microwave. It comes out warm, pliant, and stretchy," she says. "That's essentially what heat does to your body, warming the tissue and helping it move more easily." Stiffness and pain usually respond well to heat because it relaxes the muscles and soft tissue, allowing for easier movement and even a little more available range once the tension is diminished, she adds.

Cold Therapy for Swelling and Inflammation

Cold is especially useful after an arthritis flare, says Diamos, but it cuts both ways: "If you've overdone it and have visible swelling, cold can help calm things down," she notes. "But cold also constricts blood vessels and can increase stiffness, and not everyone tolerates it well."

Bottom line, she says, is that both heat and cold are viable options for easing pain depending on the person, the situation, and what your tolerance is for either approach.

Physical Therapy and Occupational Therapy

After you've addressed immediate pain relief, it's time to look at a long-term plan for ensuring arthritis stiffness and inflammation remain in check. A physical therapist can check your range of motion, strength, stability, and control, and consider how those are affecting your level of pain. "Once we understand where you're doing well and where things are falling short, we build a program around you rather than a one-size-fits-all approach," says Diamos. "We create an exercise program specific to what your body actually requires."

An occupational therapist is similar to a physical therapist, but rather than creating an exercise routine around general strength or motion range, an occupational therapist focuses on movements related to your everyday life. For instance, if arthritis stiffness has made climbing stairs difficult, or rendered it nearly impossible to open a jar due to grip weakness, an occupational therapist will develop a set of exercises for the specific problem.

On a high level, the two types of therapy overlap: they both help with daily pain management and assist with tools and strategies for joint protection and independent living.

Medication for Pain Relief

Common pain relief medications for arthritis include over-the-counter analgesics like acetaminophen (Tylenol), which may be used because it doesn't have the same risk for heart attack, stroke, or stomach bleed as NSAIDs, per the Arthritis Foundation. But analgesics don't target joint inflammation with arthritis, so your doctor may still prescribe NSAIDs to tackle that issue, such as naproxen (Aleve), aspirin, and ibuprofen (Advil, Motrin).

In addition, "topical treatments applied right over a painful joint help many people with fewer side effects than pills," says Dr. Girnita. Topical meds for arthritis include diclofenac sodium (Voltarol, Voltaren), capsaicin creams, and menthol or salicylate rubs.

Mobility Aids Can Reduce Joint Strain

A wide range of mobility aids can help with arthritis joint pain and stiffness. For milder cases of arthritis, "a properly fitted cane is the simplest option," says Dr. Girnita. "When held in the hand opposite the painful hip or knee, it offloads a surprising amount of weight from that joint."

People with moderate to severe arthritis symptoms may benefit from a walker. Dr. Girnita recommends the four-wheeled version with a seat, known as a rollator, to give more support and let you rest when you need to.

Walking support doesn't end there: Electric wheelchairs provide further options depending on what joints are affected and whether you want support indoors or outdoors. "The theme across all of these devices is the same: Shift the load off the sore joint and onto something else," Dr. Girnita explains.

Other mobility support options for arthritis include:

• Braces or supports. "These can stabilize a specific joint during activity," says Dr. Girnita.
• Cushioned, supportive footwear. The right footwear acts as a shock absorber for the knees and hips and can be used with shoe inserts for additional support.
• Grab bars and raised toilet seats. Raised toilet seats reduce the strain of getting up and down, and grab bars prevent falls if you should lose your balance going from standing to sitting.
• Tools with thick, cushioned grips. "Built-up utensils, jar openers, and key turners dramatically cut the strain of everyday tasks on arthritic hands," says Dr. Girnita.

When to Talk to a Doctor About Arthritis Pain or Mobility Problems

Managing arthritis is not something you have to do alone. Keeping your health care team involved can help you stay ahead of changes in your symptoms, protect your mobility, and find the right combination of treatments and support.

Contact your doctor if your pain is getting worse, your mobility declines suddenly, you begin falling more frequently, or everyday activities become harder to manage independently. These changes may mean your arthritis treatment needs to be adjusted or that you could benefit from physical therapy, occupational therapy, or a mobility aid. The sooner you speak up, the sooner your care team can help you move more comfortably, safely, and confidently.