If you’re not already showering in the A.M., you’ll want to switch, stat.
Stepping into a warm shower is a pleasant experience for almost everyone, but if you have rheumatoid arthritis, this daily routine can be part of your treatment.
“Usually patients who have rheumatoid arthritis will say, ‘If I wake up in the morning and I’m stiff, I take a hot shower, and the warm water from the shower will help to loosen my joints and make them feel better,’” says Ashira Blazer, MD, a rheumatologist at NYU Langone Medical Center.
It’s not just in your head: The warm water really does help. It’s coined “warm water therapy” by the Arthritis Foundation (AF), and it plays a big role in managing symptoms of rheumatoid arthritis (RA).
How Warm Water Helps Rheumatoid Arthritis Pain
Most people associate arthritis pain with aging joints, but RA is different. It’s an autoimmune disease in which the immune system turns against the body and attacks the joints. Learn more about what rheumatoid arthritis is here.
Inside the joints, you have something called synovial fluid. (This is what makes the popping sound when you crack your knuckles.) The synovial fluid “helps protect and lubricate the joints,” says Dr. Blazer. This way, your bones don’t grind together when you bend your elbows, knees, and fingers.
However, if you have RA, this synovial sac can become a site of pain-causing inflammation. The synovial fluid “starts to get filled with inflammatory cells and inflammatory proteins,” says Dr. Blazer. “If you’re not moving your joints, those inflammatory proteins sort of settle out.”
To cut down on the inflammation, you basically need to “churn” the synovial fluid that has become thickened with inflammation.
Warm water gets blood flow moving throughout stiffened muscles and joints, according to the Arthritis Foundation. This helps loosen up the synovial fluid and get the joints moving more comfortably, which in turn helps shake out the inflammation.
Tips for Using Warm Water Therapy for RA Pain
Warm water is just one part of the equation for loosening up joints in the morning. Since you need to “churn” the synovial fluid to decrease inflammation, adding movement to your routine may reduce joint pain and stiffness in the morning.
That’s why many patients say that the more they use their joints in the morning, the better they feel, according to Dr. Blazer. The movement helps cut down on the presence of inflammatory cells in the synovial sac.
Some patients find it beneficial to combine the two tasks by swimming or doing other types of water aerobics. Not only is this a low-impact workout, but you may be able to find heated pools that can help soothe your joint pain. A study of the effectiveness of water exercises found that 87 percent of RA patients doing water exercises had fewer symptoms (compared to 47.5 percent of patients using land-based exercise).
If you don’t have time for a full workout, the Arthritis Foundation suggests doing some gentle stretches during a warm bath—emphasis on warm. Very hot water can be bad for both the heart and the skin, so warm water is best.
Need more tips for managing RA?
Dr. Blazer is a rheumatologist and instructor in the department of medicine at NYU Langone Health.
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Usually patients who have
rheumatoid arthritis will say,
00:00:05,530 --> 00:00:09,560
if I wake up in the morning and I'm stiff,
I take a hot shower and the warm
00:00:09,560 --> 00:00:13,350
water from the shower will help to loosen
my joints and make them feel better.
00:00:16,840 --> 00:00:21,760
Every joint has synovial fluid, so in
rheumatoid arthritis, the synovial fluid,
00:00:21,760 --> 00:00:24,060
which helps protect and
lubricate the joints,
00:00:24,060 --> 00:00:28,680
starts to get filled with inflammatory
cells and inflammatory proteins.
00:00:28,680 --> 00:00:33,230
So if you're not moving your joints,
those inflammatory proteins settle out and
00:00:33,230 --> 00:00:36,550
you almost have to churn it to
get the synovial fluid moving.
00:00:36,550 --> 00:00:40,840
So when you use hot water, what it
does is helps to loosen that fluid and
00:00:40,840 --> 00:00:43,830
helps to allow the joints
to move more comfortably.
00:00:43,830 --> 00:00:46,470
So, hot water, hot showers,
things like that
00:00:46,470 --> 00:00:50,760
will help to loosen this fluid that has
been thickened with active inflammation.
00:00:50,760 --> 00:00:54,440
And then also, patients who have
rheumatoid arthritis will say
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they are using their joints more and the
more I use my joints, the better I feel.
00:00:59,060 --> 00:01:02,530
So, usually those patients will
have a lot of stiffness, and
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it improves with movement, and
it improves with warm water,
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which is much different than
mechanical types of arthritis.
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Eversden L, Maggs F, Nightingale P, Jobanputra P. A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis. BMC Musculoskeletal Disorders. 2007;8(23).
Warm water works wonders on pain. Atlanta, GA: Arthritis Foundation. (Accessed on June 14, 2018 at https://www.arthritis.org/living-with-arthritis/pain-management/tips/warm-water-therapy.php.)
Water walking 101. Atlanta, GA: Arthritis Foundation. (Accessed on June 14, 2018 at https://www.arthritis.org/living-with-arthritis/exercise/workouts/simple-routines/water-walking.php.)