Dr Veena Patel, Consultant Rheumatologist at the Nuffield Health Leicester Hospital, talks about how cold weather can affect our joints and ways in which we can help manage the pain and discomfort in the comfort of our homes.
Here’s what Dr Patel had to say
As the winter starts, you may have started to notice that your joints are getting more achy and stiff. This is the case in a majority of people living with arthritis – be it osteoarthritis or inflammatory arthritis. Cold weather can make your joints painful and less easy to move.
A study done by the University of Manchester, involving more than 13,000 participants, reported more pain on days with higher humidity, stronger winds and low pressure. Scientists don’t yet understand the exact reasons why, but more research is being carried out to better understand the reasons for such attenuated pain perception during the colder months, so that it allows us to develop effective treatment to help those with arthritis.
The possible explanations may be related to the changes in the synovium (the soft tissues lining the joint that produces lubricating fluid) thickening leading to such symptoms. Another explanation may be the drop in the barometric pressure leading to expansion and swelling of the muscles and tendon. Others may believe that seasonal affective disorder commonly known as “winter depression” due to lack of sunlight, impacting the levels of melatonin and serotonin hormones, affects our mood and sleep resulting in a lack of energy and high pain perception.
It is also logical to think that during cold weather, the body conserves core temperature by sending less blood to its limbs and joints in an attempt to preserve the vital organs. Patients with underlying autoimmune conditions with Raynaud’s can have cold hands and exaggerated discomfort, sometimes leading to ulcers.
A few measures that can be taken to help reduce these symptoms in winter are:
The important tip is to keep yourself warm. NHS recommends home temperatures to be maintained at a minimum of 18 degrees. Vinyl flooring, wall insulation, double-glazed windows and drought-proofing are all ways to trap heat inside your home without raising the heating bills. Wearing appropriate winter clothing, such as loose thick clothes and gloves, and also using hand warmers and heated blankets can be incredibly useful.
It’s easy to be less motivated to remain active during cold weather. But exercise is the best thing to do, to keep the joints healthy. It, not only helps increase the blood supply to muscles, but also helps to ease off pain and boost energy levels. Stretching for 5 minutes before and after the exercise is important, especially during cold weather, to prevent muscle and joint injury. Exercise also releases the feel-good hormone, endorphin, which improves the mood and sense of well-being. Spreading your exercise plans throughout the week is better than cramming them as it reduces the sedentary episodes. More information on what types of exercises can be found on the NHS website (referenced below).
Vitamin D supplements
Vitamin D is sun-vitamin and is essential for the bone, teeth and muscle health, and is linked with many conditions like osteoporosis and hip fractures, autoimmune disease (such as rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease), chronic pain management, and respiratory tract infection. As the body produces Vitamin D on exposure to sunlight, many people will have lower levels, especially between October to early March. Therefore, it is vital to take supplements for it and consume food like oily fish (salmon, sardines, herring and mackerel), red meat, egg yolks and fortified foods (some fat spreads and breakfast cereals).
Reduce the falls risks
During winter months, footpaths will be wet and slippery, thus being cautious and using well-fitted, supportive footwear are useful. Simple adjustments in homes such as avoiding spillage on floors, replacing frayed carpets, and making sure rooms, passages and staircases are brightly lit will be helpful. Review from physiotherapist and occupational therapist on mobility aids and supports to reduce the risk of falling are encouraged.
Healthy eating, hydration and maintaining healthy body weight
In cold weather, it is natural that we crave comfort foods. The holiday season and celebrating with family and friends can influence us to indulge in alcoholic and high sugar-fat foods. Being conscious of this is important in order to stay hydrated and have a balanced diet. Sipping warm fluids, such as herbal teas or flavoured water all help in consuming more water. Eating plenty of fruits and vegetables also helps with hydration and essential nutrients. All of these contribute to maintaining a healthy weight, resulting in less pressure on the bones and tissues and therefore, fewer joint symptoms. More information on healthy diets and lifestyles can be found on the NHS website (referenced below).
Ensure you’ve had flu and COVID vaccines as per the GP advice
We know that during winter months, we stay more indoors allowing viruses to pass easily between us and thus increase the risk of cold, flu and other respiratory tract infections. This is more common among patients whose immune system is affected by treatment for auto-immune conditions. Along with the general respiratory hygiene measure, stopping smoking, it is important that you take the flu and COVID vaccine information from your GP and pharmacy.
When to see the doctor:
- Despite with the above measures, if your limbs become extremely cold especially below the knee along with changes in colour, it is advisable that you consult your doctor. This could be the initial symptoms of medical conditions affecting the blood supply to limbs i.e clot or stiffening of the blood vessels-peripheral artery disease).
- If you develop limb weakness, redness, soreness in the joints, along with excessive exhaustion or sweating, (especially among patients with inflammatory arthritis), it is advisable to see your rheumatologist.
- If you see any ulcers on the tips of your fingers or toes (especially among patients with severe Raynaud’s or long-standing diabetics), please visit your doctors for help early on to prevent infection.
- If you are feeling extremely low, sad, tearful, unable to sleep or function normally, it may be that you are developing seasonal affective disorder and your GP can help you with medication and counselling to help.
Dr Veena Patel is an experienced Rheumatologist, practising at the Nuffield Health Leicester Hospital. For more information on Dr Patel, click here or call the team on 0300 131 1416.