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Why Do My Joints Feel Stiff in the Morning?

Waking up with stiff fingers or achy joints is a common experience, especially for those recovering from hand injuries or living with conditions like arthritis. But why exactly do your joints feel stiff after a night's rest?

Understanding Joint Stiffness

Between each of your joints lies a substance called synovial fluid. This fluid acts as a natural lubricant, allowing your joints to move smoothly and pain-free throughout the day.

However, during the night while you sleep, your body remains mostly still. This lack of movement slows down circulation and causes the synovial fluid to settle, rather than flow freely through your joints. When you wake up in the morning, it may take a bit of time and movement for everything to get going again.

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Ulnar Neuropathy

Ulnar neuropathy is inflammation or compression of the ulnar nerve – if there are sensations of pins and needles, numbness with or without tingling along the ring and little fingers, there could be an element of ulnar neuropathy.

The ulnar nerve is one of the three main nerves of the forearm. It originates from the neck, passes through the axilla, goes around the medial epicondyle/ “funny bone” of the elbow, and travels towards the ring and little fingers. 

This nerve gives sensations to inner half of the hand, as well as muscle power to half of the forearm, part of the thumb, ring and little fingers.  When the ulnar nerve is irritated or compressed, it is called ulnar neuropathy. The most common point of ulnar nerve compression is at the elbow and this condition is called Cubital Tunnel Syndrome.

Causes of Ulnar Neuropathy

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Lost the ability to straighten the tip of your finger.... could it be a Mallet injury?

What is a mallet finger?

A mallet finger is when the terminal extensor tendon comes away from the distal phalanx with or without a piece of bone, resulting in an inability to straighten the tip of the finger.

A mallet injury can be classified as the following:

A bony mallet - when the tendon comes off attached to a bony fragment called an avulsion fracture.

A tendinous mallet - where the tendon pulls off its point of bony insertion.

What are the symptoms?

Inability to straighten the tip of the finger (the distal interphalangeal joint – DIPJ)

If you straighten the fingertip up but cannot manage to keep it straight, then it is likely that you have sustained a mallet injury.

There can be subsequent swelling to the injured finger, most commonly overlying the DIPJ.

A mallet injury can be painful to touch and when moving or using your hand

You will still be able to bend (flex) the joint as the flexor tendon is not interrupted in a mallet finger injury.

What Causes a mallet finger?

Mallet finger injuries usually occur when the tip of the finger is forced to bend, and most commonly occurs during impact and ball sports. Some individuals with connective tissue disorders will be at higher risk of tendinous mallet injuries.

How is a mallet finger treated?

For both types of mallet injuries, patients are placed into a splint that holds the fingertip straight or in slight hyperextension. The splint is worn strictly full time for 6 to 8 weeks. Following this period of immobilisation, the bone and tendon will be assessed for stability and healing and will then be weaned accordingly.

Mallet splints can come in a range of designs and materials and depending on your functional needs and lifestyle - your hand therapist will discuss and recommend the most appropriate splinting design for you and fabricate a custom-made splint to wear. Your hand therapist will provide exercises for the uninvolved joints, monitor the skin and oedema whilst ensuring that the splint remains a good fit to ensure optimal positioning while healing. Better outcomes are associated with early referral. If you suspect a mallet finger, see your family doctor for an x-ray and book an appointment with a hand therapist promptly.

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