I can relate to what you are experiencing.

For the year or so before I started with Humira being only on Methotrexate, I would experience the same thing. I would not have any specific joints hurting really bad when I went to bed only to be hit a couple hours after I went to sleep. I mean the type of pain in a joint all of a sudden where you sit upright in bed all of a sudden. Then as you say, it makes for a long night trying to get comfortable enough to sleep.

Since I need to know the "why" of everything happening to me with this RA, I tried to find a reason. All I came up with is that when we lay down and go to sleep, our muscles/tendons etc. start to relax. As our joints start to relax, they are assuming a slight different position than they did during our waking hours. Also we are horizontal instead of vertical which is shifting the joints into a slightly different position than they were during the day.

Whenever I would get one of these nasty flares at night, I also tried to think back during the previous day to find where I might have stressed that joint that is giving me fits now. Most of the time I would find something that I did, however slight, that could have promoted the pain in the joint.

So I think this is par for the course for us. Sleep is such a wonderful thing, and when it is interrupted it makes for a tough night and the day following. I have noticed since my Humira has kicked in within the past 6 weeks that I get very few of these zingers in the middle of the night. So this tells me that my cocktail of meds is working in the right direction.

Hi Lori, sorry you had a bad night and are having uncomfortable nights. I go through that phase as well. Sometimes things are magnified at night. I am woken up at night in pain and that is sometimes due to weather. It is damp, temp drops, or is raining like last night.. I get up and take something right away especially if it is not too close to time I have to get up and go work.. If early in am I can only do Motrin and just grit my teeth. I had a bad night last night and had to take pain meds around the clock yesterday an last night. I am off from work so I can take the pain meds as needed. For me when the weather is bad the RA pain increases. I just ordered another heated mattress pad cover because the old one stopped working. That helps to warm the body from beneath you. It helps me immensely. Hope you get some sleep and are feeling better soon.

Lori,
I have experienced similar things as you described and haven't been able to figure out a pattern for me. I usually can get to sleep fine and may wake up briefly and feel lousy, worse if I switch to the recliner and go into a deep sleep. I may only be asleep for half hour to an hour and wake up in such pain. By then it is too late to take pain medication because I'll be too groggy at work. I would love to find an answer to this myself as this has affected me for years.

Thanks for your responses! At least I know I am not crazy. Sorry, we all have to be in this nasty boat.

Coaltrain, I do the same as you so far as wanting answers and doing research. Sometimes I link my pain to something I may have done earlier in the day or the day before. The hip thing last night, I can't think of a thing.

Right now my working theory is that someone, who does not like me, has a voodoo doll and a really long needle!

Lori

Very fristraiting ..for myself ..im exhausted early in teh evening and ready for bed ..but if i lie there for too many hours it seems to do more damage then good .The mornings are super tough to get out of bed then ...it takes long time to be flexable and move , just a few steps to the bathroom is agony at times ..wishing you a better night and a better tomorrow .

I've been getting the "zingers" -- sharp bolts of pain. Usually this happens after I fall asleep. They move around somewhat. But often it is my left ankle and right wrist joint. Sometimes I can wiggle my foot and hand and it stops and I get back to sleep.

Other times I have to get up, walk around, take some tramadol and hope it helps.

Lately I've been getting a cramp in my left calf muscle. I'm wondering if this is related to methotrexate.

Nancy

maybe it's because RA only ran me over like a train this past January....maybe i'm just a glass-half-full newby....maybe because i'm still on the lowest level of RA medicine inhibitors, maybe. i have taken absolutely no anti inflammatory medicines (including over the counter) since July. None, zip, zero. I don't have the pain jolts at night, i have no pain any time of the day as long as I stay strict to a no night shades diet. they are in so many things, as preservatives, as gluten's from potato starch. go night shade free (google it) and see if that doesn't help. it's not easy, a radical change to your diet. this is my second post on this forum...when i began my first i popped an Altoids mint into my mouth which unbeknownst to me has some ingredient in it containing a night shade....in the past fifteen minutes my shoulders have begun popping when i roll them and i can suddenly crack my knuckles. I'll eat no more of those mints.

I experience increased pain in the evening. I personally believe it's bc humidity rises in the evening. Also, when I've had a busy day my body is ready to rest. If the pain gets too high, I can't sleep. I take 2 tramadol and 2 Tylenol at night and also a clonzapam and tizinadine. That helps me relax and sleep. If i do not get good rest there is no way i can get to work the next day. I also started going to the gym and get in a dry sauna for at least an hour. This really reduces my pain. I also do yoga at night. That helps me too. But in spite of all i do, sometimes the pain is horrible. Thank God for IcyHot and heating pads. Lol

last night i had four splints on and my wrists sideways resting on pillows. my ankles one thrown over the other. my wrists still kept waking me up. when i fall asleep i move them the wrong way. i should be duct taped in one position. and the anti inflammatory didn't work. i was trying to choose between it and the muscle relaxant. i went with the stupid nsaid and it did crap. now i am at work and feel like more crap. this is my whining hour. ignore me.

Ros

I'm sorry you had a rough night and day, Ros! I hope you are able to rest tinight.

I am lucky in that I know pretty quickly when I get into bed. That way I can get up and take Tramadol and wait for it to kick in so I can get to sleep. I also worry that al my jumping, tossing and turning will keep my husbad up so I get up pretty quickly so he can sleep in peace.

I am not sure why the pain is worse at night. Last night was just awful for me. My hip and both knees were just incredibly painful. I think when I lay down at night the lack of movement allows the joints to swell more than when I am moving around. Yesterday was a long day for me at work and I went grocery shopping afterwards. Pretty sure I over did it and paid the price later on.

Sorry that you had a bad night. Hope that there aren't too many more.

I too have this--have had this for years. Some nights I'm OK (!) , doesn't seem to be any rhyme or reason as to the cause. Sometimes at night I'm sitting watching TV or on my laptop and it starts---this allover pain with pain in different joints, both feet, both knees, a shoulder or elbow. That kind of pain that you can't get away from! I get up and walk, or go take a warm shower, rub Aspercreme on my feet or ankles, plug in the heating pad. And definitely take a pain pill! Sometimes, I feel like I could just scream! And so then I'll take my flexeril (muscle relaxer) and go to bed, usually laying there rolling around in the bed trying to get a comfortable position. And then I start to pray a litney of prayers over and over till I finally go to sleep. At that point I'm usually done with the pain, only occasionally do I have to get up during the night and start the whole process over (thank God)!!!

i have to be careful on my judicious and occasional use of narcotics. i get up very early for work ( o dark thirty) and i have a long commute. i either have to get home from work early or not have work the next day. i don't like being groggy or mind compromised at all to drive. i need a chauffeur :)

Ros

I read on another forum ONE possible explanation for why the pain often increases at night: lack of distraction. During the day we are usually busy and hence distracted. At night we come to rest and are able to concentrate more on our body. And the pain.

That's a very good point calibanshour.

My wife has been suffering with a permanently damaged sciatic nerve for many years which is terribly painful 24/7. She doesn't like to take much pain medication so over the years she has found other ways to cope. She says that some form of distraction works the best. For her that is crochet - the simple repetitive action along with counting.

As you say, when we lay down to go do sleep any distraction is gone.