Study reports prolonged morning stiffness in patients with hand osteoarthritis

Although it has a limited ability to discriminate, prolonged morning stiffness (>60 min) is thought to be a symptom of inflammatory arthritis. There is a shortage of information regarding morning stiffness in patients with hand osteoarthritis (OA). According to research published in Osteoarthritis and Cartilage, morning stiffness lasting longer than 60 minutes is common in subjects with hand OA and is associated with increased pain, poorer function, and a lower quality of life.

Van de Stadt and his associates examined the prevalence of morning stiffness in a cohort of 538 patients with hand OA. A majority of patients (87%) experienced some stiffness in the morning, with 17% expressing stiffness that persisted for more than 60 minutes. Long-lasting morning stiffness (>60 minutes) was linked to higher levels of discomfort, worse levels of function, and lower levels of quality of life. Patients who experience these symptoms generally report more pain and have a lower quality of life than patients who do not. Long-lasting morning stiffness does not rule out a hand OA diagnosis.

A 2015 study has distinguished OA by pain that worsens with exercise and is only occasionally accompanied by morning stiffness, whereas rheumatoid arthritis frequently results in morning stiffness that lasts longer than an hour. Hand OA symptoms may include pain with exertion, slight morning stiffness, or stiffness after inactivity. Experts reported that one or more joints may be affected at once, and this may be intermittent. Based on the existence of common symptoms and clinical findings, hand OA can be diagnosed. If there is any clinical uncertainty, a hand X-ray can be used. The study reported that prolonged morning stiffness is frequently considered a characteristic of inflammatory arthritis and is less consistent with OA. 

The current study offers proof that a subset of people with hand OA can have persistent morning stiffness with a low likelihood of developing inflammatory arthritis in the future. This finding highlights the importance of differentiating between morning stiffness in hand OA and morning stiffness associated with inflammatory arthritis. It suggests that prolonged morning stiffness in hand OA should not automatically raise concerns about the development of inflammatory arthritis in all cases.


  1. van de Stadt LA, Haugen IK, Felson D, Kloppenburg M. Prolonged morning stiffness is common in hand OA and does not preclude a diagnosis of hand osteoarthritis. Osteoarthritis and Cartilage. 2023 Apr 1;31(4):529-33.
  2. Hawkins T, Barr A. Osteoarthritis: pathophysiology and diagnosis. Rheumatology. 2015 Apr 24.