Morning stiffness is the “signal light” of rheumatoid arthritis

After getting up in the morning, some people feel that their fingers are tight, stiff, or even unable to make a fist. They gradually relieved after a period of activity. What is going on?

This symptom is called morning stiffness. Morning stiffness is a typical manifestation of rheumatoid arthritis. It means that the joints that rise in the morning appear stiff for a long time after being still, the hands are stiff, the fist is difficult to make, such as the feeling of glue, and it may be accompanied by cold extremities. Numbness and other phenomena can be gradually reduced after appropriate activities.

The reason for morning stiffness is that edema fluid accumulates in inflammatory tissues when sleep or exercise is reduced, causing the tissues around the joints to swell. After the patient moves, as the muscles contract, the edema fluid is absorbed by the lymphatic vessels and venules. The morning stiffness also eased. Therefore, joint stiffness can also occur during the day, in fact, it is the same thing as morning stiffness.

Patients with rheumatoid arthritis have morning stiffness in the acute or active phase, and the duration is directly proportional to the severity of synovitis.

The duration of morning stiffness should be counted from the time the patient starts to move after being awake. For patients with a clear diagnosis of rheumatoid arthritis, morning stiffness should be considered as morning stiffness if the joint stiffness lasts for more than 30 minutes.

In the acute stage of activity, standardized medication is the main treatment. The affected joints should rest, maintain the functional position of each joint, and minimize long-term excessive flexion of each joint to reduce pain and avoid deformity.

Patients in remission are mainly trained in passive or small-scale active joint exercises. Each joint is abducted, adducted, flexed, internally rotated, and externally rotated, such as finger exercises.

Finger exercises: wave hands up and down, wave hands left and right, finger each other, make a fist flat.

The first thing Tom heard on Friday morning was very pleasant news – Becky Thatcher had returned with her family the previous evening. Before this event, the Indian Joe and his sweetheart had to take a back seat, and Becky, the only Becky, took the boy’s whole interest. He saw her again, and the two of them spent a delightful day in the company of their schoolmates at ‘Blind Man’s’ and ‘Hiding’. In order to make the day’s happiness full, Becky had obtained permission from her mother to be allowed to hold the picnic that had been planned for a long time and was postponed again and again on the following day, which aroused enormous enthusiasm and cheers. Becky in particular was ecstatic, and Tom no less. The invitations were sent around before sunset, and the entire youthful population of the town was in a fever of expectation and diligent preparation. Tom’s excitement kept him awake until late at night, always waiting for Huck’s meow signal. How wonderful it would have been to astonish the company the following day with the treasure found! But this hope was deceptive – no signal disturbed the quiet of the night.

The morning finally met, and at ten or eleven o’clock[240] A noisy, blissfully drunk company gathered in front of the Thatcher family home. Everything was ready to go. Older people were in the habit of never disturbing picnics with their presence; the children were thought to be adequately protected under the wing of a few young women of eighteen and a few young men of about twenty-four years of age. The old steam ferry had been hired for the occasion, and the cheerful, colorful crowd, laden with promising storage baskets, began moving down the main street. Sid was unwell and had to renounce pleasure; Mary was left to him for comfort and company. The last thing Mrs. Thatcher said to Becky was:

“You’ll be back late, child, in the end you’d better stay for the night with one of your friends who live near the ferry landing.”

“Then I’ll stay with Suschen Harper, Mama.”

“Because of me; and do you hear that you are behaving nicely and are not a burden to anyone. ”

Then, as they trotted down the street together, Tom said to Becky:

‘You – watch what we want to do. Instead of going home with Joe Harper, we go up the mountain and stay the night with the widow Douglas. She certainly has something frozen – she always has some, heaps of it, and will be terribly happy when we come to her. ”

“Oh, that will be delicious!”

But then Becky thought about it for a moment and said:

“But what will my mom say about it?”

“How should she find out?”

Becky pondered again for a while and then said hesitantly:


“It’s not right – but -”

“But – nonsense! Your mother won’t find out, and what’s wrong with that! All she wants is for you to be safe for the night, and I’ll bet she would have sent you there if she’d only thought of it. I know that for sure! ”

Mrs. Douglas, who owned the largest and most beautiful house in town and whose brilliant hospitality was the delight of all who were ever allowed to enjoy it, proved to be all too tempting bait. This and Tom’s eloquence won out and it was decided not to let anyone announce anything about the program for the night.

Suddenly it occurred to Tom that at the end of the day Huck could come that same night to give him the agreed signal. The thought clouded his joyful expectations considerably, but he could not make up his mind to give up the plan with Mrs. Douglas. Why should he? He thought to himself that everything had remained quiet the night before, why should the signal go off that night? The sure pleasure he expected from the evening far outweighed the uncertain prospect of the treasure, and right like a boy he decided to give in to the stronger inclination and get rid of any thought of the money box for the rest of the day .

The ferry landed three miles below town in a cove surrounded by woods. The merry company swarmed from the boat, and soon the woods and rocky heights resounded with shouts and laughter. All the different methods of getting hot and tired were examined one after the other, until gradually one after the other of the swarming around the camp, armed with the necessary appetite, and now the extermination[242] the delicious things brought along could begin. After the meal there was a refreshing rest and chat in the shade of the broad-branched oaks, until someone called out:

“Who’s coming to the cave?”

Everyone was ready at once, whole bundles of candles were dug out and a general climb of the hill followed. The mouth of the cave was high up, a black, yawning opening shaped like the Latin letter A. The massive oak door stood wide open. Inside you first saw a narrow, small chamber, as cold as an ice cellar, surrounded by nature with solid limestone walls that exuded a lot of moisture. There was something romantically mysterious about looking into the sunlit, green land from this dark, cold place. But the magic that first held the spirits captive soon lost its charm and the frolicking began all over again. As soon as anyone tried to light a candle, everything rushed on and a fight against the brave defender ensued. The light was finally snatched from him, thrown to the ground and extinguished, followed by a new hunt with the same outcome. But since every thing has its end, so the procession gradually rearranged itself and moved cautiously down the steep descent of the main passage of the cave. With a gloomy, restless glow, the flickering row of lights illuminated the mighty rock walls on either side, almost up to the point where they collided at about sixty feet. This main aisle was no more than eight or ten feet wide. Every few steps other high-arched and even narrower crevices branched off on both sides, because the Mc. Douglas Cave was really just a monstrous labyrinth of winding corridors that ran into one another and again apart and had nowhere a goal or an end. It was said that one could spend days and nights almost up to the point where they collided at about sixty feet. This main aisle was no more than eight or ten feet wide. Every few steps other high-arched and even narrower crevices branched off on both sides, because the Mc. Douglas Cave was really just a monstrous labyrinth of winding corridors that ran into one another and again apart and had nowhere a goal or an end. It was said that one could spend days and nights almost up to the point where they collided at about sixty feet. This main aisle was no more than eight or ten feet wide. Every few steps other high-arched and even narrower crevices branched off on both sides, because the Mc. Douglas Cave was really just a monstrous labyrinth of winding corridors that ran into one another and again apart and had nowhere a goal or an end. It was said that one could spend days and nights that ran into each other and again apart and had nowhere a goal or an end. It was said that one could spend days and nights that ran into each other and again apart and had nowhere a goal or an end. It was said that one could spend days and nights[243] could wander through this curled, tangled tangle of crevices and crevices without ever finding an end of the cave; that one could go down and down, deeper and deeper and deeper into the heart of the earth and yet always find the same thing – labyrinth under labyrinth in endless succession. Nobody knew the cave completely, that was an impossibility. Most of the young people knew a part of it, and usually no one dared go beyond this common part. Tom Sawyer knew no more about the cave than any of the others.

The whole procession was still closed and moving along the main entrance, but gradually groups and couples began to separate and disappear into the side corridors. Here they flew silently through the eerie corridors, full of unacknowledged horror, and surprised and frightened others at points where the individual corridors intersected or[244] also ran together. You could avoid or find yourself for half an hour without ever leaving the known part of the cave.

Gradually one part of the company after the other returned to the mouth of the cave, breathless, happy, blissful, drizzled with sebum from head to toe, smeared with clay, but delighted, intoxicated by the enjoyment of the day. One was amazed that it was almost night out there by now. For almost half an hour, the ferry’s bell had been a shrill warning to return home. This end of the day’s adventures, however, was entirely in keeping with the spirit of the youthful society, which was used to sipping every cup of joy to the brim. When the ferry thrust out into the stream with its great cargo, only one person on board regretted the wasted time of the past hour, and that was the captain.

Huck was already on his nightly listening post when the lights of the ferry glided past the bank. He heard no noise on board, for the young people had become tame and quiet, as tame and quiet as one usually becomes when one has let off steam in pleasure and exuberance. Huck wondered what kind of boat this could be, and why it didn’t moor at the usual mooring; then his mind wandered on to focus fully on his plan. The night was cloudy and dark. Ten o’clock came, the noise of the cars ceased, individual lights began to go out, the pedestrians became fewer and fewer, the town prepared for nightly slumber and left the little eavesdropper to himself, to the surrounding silence and the spirits of darkness. Eleven o’clock approached the lights of the inn also went out, darkness everywhere. Huck waited and listened for a long, anxious time it seemed to him.[245] Nothing happened. His confidence began to falter. Was there any value in this patient endurance? Would it be of any use? Wouldn’t it be much better if he didn’t care about the matter at all?

A noise hit his ear. At the moment he was completely breathless attention. A door closed softly and gently. He jumped to the corner of the little alley, and almost simultaneously two dark figures flitted past him, one of which seemed to be carrying something heavy under her arm. That had to be the money box! So the treasure was dragged away! Should he call for Tom? That would have been insane, because for the time being the guys with the loot could disappear to God knows where – never to be seen again. Beware, he wanted to cling to her soles and follow her trail safely under cover of darkness. While he was coming to terms with himself in this way, he had glided nimbly after the men, cat-like, barefoot, leaving them just enough head start to be able to keep an eye on them.

They walked a distance along the river road and then turned into a side alley on the left. They followed them to where a footpath branched off to the Cardiff Mountains, which they were now taking, then they passed the Walliser’s house, higher and higher up the mountain. Fine, thought Huck, they’ll go to the quarry and bury their treasure there. No further, on and on, past the quarry, without stopping. Now the height of the mountain was reached. Now they penetrated the dense sumac grove on a narrow path and suddenly disappeared into the darkness. Huck followed quickly, shortening his distance, for a discovery was quite impossible here. So he trotted along for a while, only to then take slower steps again for fear of going too fast. Another[246] a few steps, then he stopped and listened – no sound, none, except for the beating of his own heart! The cry of an owl sounded up out of the valley – an ominous sound! But no kick, no crackling of the branches, no matter how faint! Great God, was all lost? He was about to rush forward at an accelerated pace when someone less than four feet away cleared their throat. His heart seemed to go into his throat, but he swallowed it again resolutely. There he stood, trembling like an aspen leaf, as if a dozen cold fevers had seized him at once and shook until he lost sight and hearing and thought he had to sink to the ground with fear and weakness. He knew where he was now. A few paces away must be the fence surrounding the property of the Widow Douglas. >All the better,

Now he heard a low voice, a very low voice that he recognized anyway, it was that of the Indian Joe.

“The hangman will fetch her, I’m sure he’ll have people with him again – I can still see lights, no matter how late it is!”

“I don’t see anything.”

It was that stranger’s voice – the stranger from the haunted house. Freezing cold shot through Huck’s heart. So that was that planned ‘act of revenge’. His first thought was escape. Then he thought of how kind the widow Douglas, the kind, beautiful lady, had been more than once to him, the poor rascal, and that these villains might have had in mind to murder her. Oh, if only he had the courage to warn her; but he didn’t dare to do that – the guys could come and catch him. All this and more shot through his brain in the one moment that passed between the comment of the stranger and the subsequent reply of the Indian Joe.


“Well, the bush is in your way, look out here – so – you see, now?”

“Yes, there will probably be people there – you’d better give up, I think.”

“Giving up, just when I want to turn my back on the damned country forever, to give up, maybe never to have a chance to revenge again? I’ll tell you again, like I said before, I don’t ask a chanterelle for your money – you can have that. But her husband was tough on me, not once, no, often and often, and above all he was the dog of a judge who kept sticking me in the hole for vagrancy. And that’s not all! Not everything a million times! By whipping he let me by whipping outside the prison as a dog or a nigger! The whole city could see it! Whipping through – do you understand that! He anticipated my vengeance and died – but she should pay for it! ”

“You don’t want to kill her, do you? You won’t do that, you pretty, stately woman, and she has a good heart for the poor too! ”

“Kill? Who is thinking of it? I would slaughter him if he were there – she wouldn’t! You don’t kill a woman if you want revenge – nonsense! It goes to the beloved grimace, her nostrils slit and her ears clipped! ”

“Lord God, this is -”

»Keep your opinion to yourself until you are asked, advise yourself in the best way, it will probably be the best for you. I tie her to her bed; if she bleeds to death afterward, it’s not my fault. I don’t cry after her! You, comrade, will help me – for my sake – that’s why I took you with me, because in the end I couldn’t do it alone. You try[248] you pinch out, so I’ll knock you down, remember that! And if I have to give you the rest, she’ll get one too, so that she forgets to get up, and then someone should find out who did the business. ”

“Well, if it has to be, that’s how it has to be, then go and do it! The faster the better – I’m already feeling cold! ”

»Turn now? – where are the people at? You, watch out, otherwise I won’t trust you anymore. Nothing there! – we wait until the lights are out, there is no hurry anyway! ”

Huck knew that a silence must now follow – a silence, more gruesome and dangerous than the most murderous speeches. So he held his breath and took a cautious and furtive step back, carefully and firmly putting his foot down, after balancing on one leg so that he almost lost his balance. One more step backwards with the same inconvenience, the same dangers, one and another! Now a branch cracked under his foot. He was almost unable to breathe, he listened. No sound – deepest silence! His gratitude was limitless. Now, silently and with the utmost caution, he turned and retraced his previous path through the tall sumac bushes. He glided quickly and carefully. When he emerged from the wood at the quarry, he felt secure. Now he lent his soles wings and flew down the mountain, further, further downhill, until he reached the house of the old Valaisan. He drummed on the door and immediately the old man and his two solid sons appeared at the window.

“What the hell is going on? Who is threshing at the door there? Hey, what do you want? ”

“Quick, open up – I’ll tell you everything!”


“Who am I?”

“Oh me, the Huckleberry Finn. Quick – for God’s sake open up! ”

“Look, the Huckleberry Finn! Is a name to which not many doors really open. Just let him in, boys, let’s hear what he has to say. ”

“For God’s sake don’t tell anyone that I told you,” were Huck’s first words when he stepped into the house, “please, please, don’t betray me, they would kill me, as sure as I stand here, – but the widow up there has often and often been good to me, and I will say so if you promise not to reveal that it was me! ”

“By God, something must have happened, or the boy didn’t act like that,” cried the old man, “come out with it, my son, and no one should ever hear a word of it.”

Three minutes later the old man and his sons, well armed, climbed the mountain and cautiously stepped into the wood on tiptoe, shotguns in hand. Huck did not go with them. He hid behind a large boulder and listened. At first there was an oppressive, fearful silence, which was then suddenly interrupted by several shots and a piercing scream. Huck did not feel compelled to find out more. He jumped up and on and flew down the mountain as fast as his feet could carry him.