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Does anyone know what could cause hand stiffness at night that is not arthritis?

I have sudden onset starting three months ago of night-time extremely stiff hands, with a low level of lingering discomfort during use.   I am a 56 year old female piano player and am in peri-menopause.  I know what osteoarthritis feels like because I have it slightly in my thumbs.  This is very different as it is equally dispersed more like it is all of my tendons across only the top on my hands, but equally all of them, not an injured tendon.

I have seen my regular doctor, a rheumatologist, an osteopath, and had X-Rays/bone density, AND spoke with my gyno to discuss possible hormonal causes. According to all blood work etc. I am very healthy, normal blood work, no inflammation problems, etc.  Only slightly low testosterone for my age and everything else is good.  Although my inflammation is normal, it is in the low end of normal.  No one can figure out what is happening.  This is EVERY night.  

This new thing is completely different than that. This is as if someone injected my hands with something while I was sleeping that stiffens them up all across the top.  I can gently get them moving full range pretty quickly (and always do because it is a distressing feeling when they are stiff like that, since piano is my lively-hood).  It is not Carpel Tunnel.  There is no tingling and it is across the top of my hand.  Also, my right knee is suddenly stiff at night also with a similar stiffness, not sure if that is related---)

Any insight on this would be so appreciated.  I don't expect a diagnosis.  Even a guess is fine!  I can't believe I am completely alone with this situation but not one person I have spoken with has experienced anything quite like this.  

Thank you!
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1081992 tn?1389903637
"Although my inflammation is normal..."
Hiya, as a thought provoking measure I'll suggest to you that there is no such thing as 'inflammation', in the sense of it being a single entity. E.g., you can test ESR and CRP, but what about IL-6 and TNF and IL-10 and on and on... for starters.

Or... inflammation can be very local in tissue and so the markers might not show up much in the blood anyway.

Overall, in your case what comes to mind is possibly Leukotriene B4 and neutrophils. An OTC anti-LTB4 is frankincense. (Yep, that same famous one.)

Btw, inflammation is usually worse in the morning. Have you had your morning cortisol (anti-inflammatory) peak measured?


"my right knee is suddenly stiff at night also with a similar stiffness, not sure if that is related"
It probably is. Any lung problems?

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Thank you for your response.  I have not had a morning Cortisol test.  I have to find a Dr. to ask since none offered.  I have a history of mild asthma but it has been almost nonexistent lately.  My skin is fine, it is strictly internal and I don't really use hand cream or have any pets.  I don't see any of the tests you mentioned here on my Rhumatologist test results.  What kind of Dr. would you recommend I see to get an order for them?  I know I am getting older and can accept that but I would like to be proactive preventing the preventable.  It is livable now but I worry about damage left untreated.  I will look into Leukotrine/B4.  
They tested:

Sjogren's Ab - SS-A/-SSB.  
RA Latex Turbid
CCP Antibodies
ANA Direct
Sedimentation Rate
C Reactive Protein
1081992 tn?1389903637
"only the top on my hands" is a feature that stands out, as if maybe there is something bad in contact. If not hand creme, then something maybe in/on a blanket? Or pet fur?


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1081992 tn?1389903637
Well, I don't mean to be recommending any of those tests at random. In response to you writing "no inflammation problems", I mean to be pointing out that inflammation has almost limitless complexity - way beyond just the ESR and CRP that you've had, along with the few antibody tests.

"a history of mild asthma but it has been almost nonexistent lately"
That concurrent absence is a clue, to something or other.

"It is livable now but I worry about damage left untreated."
Yes, you'd certainly want to prevent any fibrosis/remodeling (two more concepts to look up). I'd try experimenting overnight with topicals, one hand versus the other. Menthol, capsicum, aspirin. Turmeric is anti-TNF.
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3 Comments
So interesting.  I am a very healthy woman in my late 50's.  Mid September,  the exact same day,  I developed sausage finger (one finger,  my left index finger) the same exact time I developed a hacking, soupy cough.  I was put on antibiotics which seemed to cure both my soupy cough and my enlarged finger.  Once I was finished with the antibiotics,  both my soupy cough and my inflamed finger have returned.  I've been screened for tuberculosis and lung cancer.  

Any thoughts would be VERY welcome.  I fully believe my inflamed finger - ruled osteoarthritis although I'm thinking dactylitis,  is completely related to a bacterial infection in my lungs.  Thoughts?  Thank you so much.
KenPA:  I had tried Arhtritis Cream (trolamine salicylate 10%) on both hands, just one night though, and still woke up later with the same tightness but I will try again comparing two hands. (It does seem to help the sharp pain at the base of my thumb though pretty quickly on use).  I also have CryoDerm which is menthol, so I will start with that on one hand first tonight.  I looked up fibrosis/remodeling and see lung/heart covered but not hands.  Was that what you were referring to?

Qunol;  The Rheumatologist started me on Tumeric a few weeks ago and so far I haven't noticed any improvement but I just doubled the dose a couple of days ago to two 500mg tablets.  It doesn't say hydro-soluble though so I will have to grab some of that!  (it is standardized extract).    

One more detail I left out:  They are mainly only stiff on CLOSING the hand further the than the starting point.  When I try to sleep with curled fingers, it helps.  

Thanks!
Oops I am not sure where I should comment back----
Avatar universal
Yes, turmeric may be supportive for an overall healthy inflammation response. One thing to note is that forms that are hydro-soluble absorb better.
Helpful - 0
1081992 tn?1389903637
Hi, RockRose. What seems most likely goes like this:
- something(1) in your lungs makes the lungs susceptible to a bacteria infection
- your immune system over reacts to the bacterial lung infection, including production of lots and lots of pro-inflammatory signalling molecules  
- something(2) in that one finger makes it very responsive, and it over reacts to the signalling molecules that got there via the blood
- the Abx suppresses the lung infection, so then the reduction of blood-borne inflammatory molecules results in the finger inflammation going down
- when Abx stops, then maybe because of something(1) all reproduces as before... so didn't they give you more of the same Abx??

I'm guessing that you have some history of a hyperactive immune system. E.g., any unusual skin and/or gut problems?

As for something(1), since TB has been ruled out I'd keep in the back of my mind the possibility of sarcoidosis - not that it's likely.

As for something(2), are you left handed?


There's lots more to say, if you'd like to go back and forth for a while. Btw, I'd think of this as Reactive Dactylitis - though that term maybe doesn't exist (yet), so you can look up Reactive Arthritis.
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1081992 tn?1389903637
Anna:

"[salicylate/aspirin] does seem to help the sharp pain at the base of my thumb [but not otherwise]"
That tends to confirm what you say about the thumb-base arthritis being different than the back of the hands effects.

"I looked up fibrosis/remodeling and see lung/heart covered but not hands."
It's the same process wherever it occurs. E.g., in the liver it's cirrhosis. It is damaging.

"They are mainly only stiff on CLOSING the hand further the than the starting point."
Probably the swelling doesn't come so much into play when the fingers are extended.


Btw, does being cold come into play? Have you ever looked during the night and confirmed that the hands are not blotchy or all pale? If not, I'd set the alarm to see.
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