Managing Joint pains during the winter

Joints are made up of strong and flexible connective tissues that bind a muscle to a bone (tendon) or one bone to another (ligament). Certain connective tissues serve as soft padding between bones (cartilage). Depending on a person’s age, their body will have an estimated 250–350 joints. As a general rule, joints provide stability and support to the internal skeleton and help people move.

Any problems in bones, muscle or connective tissues can lead to discomfort, pain, swelling, redness, stifness or reduction in movement.”

Typically, musculoskeletal pain can be felt in any part of the body. People often term the joint pain as arthritis, which is the soreness or pain or swelling of one or more joints. Some of the most common arthritis types include osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, gout, and lupus.

• Osteoarthritis is the persistent pain in the knee, hips from wear and tear of the joints in these parts due to weight transfer on the limbs. however, this can sometimes happen even in the upper limb.
• Rheumatoid arthritis is an acute inflammatory disorder usually affecting both hands, both knees, or both ankles. This condition could also affect the heart, blood vessels, eyes, lungs and bone marrow.
• Psoriatic arthritis is characterised by psoriasis (itchy scaly patches on the skin of the knees, elbows, scalp, navel as well as genital and anal skin) as well as arthritis (joint pain in these areas).
• Gout, another kind of arthritis, is a sudden and severe pain in the big toe and sometimes in other parts of the foot caused by the depositing of tiny uric acid crystals in these joints.
• Lupus causes inflammation and pain in different parts of the body.

Apart from the arthritic types, infections, injuries, age, incorrect posture at work, and being overweight are some of the leading causes of joint pain. Overuse and injuries could potentially inflame tendons (tendinitis) in the elbows, heels, and shoulders, over time. Bursitis, another painful swelling of the hip, knee, elbow, or shoulder joints, is also the result of overuse. This condition causes accumulation of fluid in thin sacs, and sometimes it may get inflamed.

Winter and joint pain — The connection

Cold weather seems to exacerbate joint pain for many reasons. For one, people tend to be less active physically during the colder months of the year. Prolonged sitting and lack of sufficient mobility might reduce blood flow to the bones and organs. Decreased blood circulation to the bones is a key cause of weakness, numbness, or pain in the joints during winter. Poor blood circulation also slows down the delivery of oxygen, nutrients, and hormones to muscles, thus curbing the growth and regeneration of muscular cells. This leads to a lack of strength in the muscles and random sharp pains in the muscular tissues.

Historically, grandmoms and grandads have predicted the approach of a cold storm or chill from an uptick in the soreness in their knees. However, scientific studies are yet to establish any straight-line connection between arthritis flare ups (or joint inflammations) and cold weather. One plausible (though by no means conclusive) explanation is that low temperature causes the lubricating fluid in the joints to thicken and the spongy cushions of the cartilage to dry, so the joints feel stiff and sore.

Since cold air is denser than warm air, atmospheric pressure (weight of the air) exerted on the body is higher in winter than in summer. The consequent expansion of connective tissues, muscles, and scar tissue might intensify joint pains in people with joint disorders. Certain studies suggest cold weather, in conjunction with low humidity (moisture in the air), amplifies joint pain.

Another issue that is common in our population and can be coexistent with arthritis is Osteoporosis. Well, osteoporosis (which literally means “porous bone”) — leaves people with bones that are porous on the inside due to the loss of calcium and phosphate. The bones are weak in easily breakable. Patients with this condition are at increased risk of fractures. Individuals with porotic bone can get fractures even with trivial falls at home.

Vitamin D is believed to be able to check the buildup of psoriatic scales on the skin surface and contain inflammation. Reduced exposure to the sunlight, which is the most natural and convenient way to get vitamin D, and low humidity during the cold months, might be responsible for the spike in psoriatic and other arthritic cases. Studies linking joint pains with temperature drops are inconclusive, so far, but the fact remains that a drop in mercury is almost always accompanied by an upward trend in bone and joint pain cases at most hospitals.

Regarding lupus, experts think more studies are required to prove its connection with cold weather. These apart, winter is marked by longer nights and shorter days, limited access to sunlight, and the need to be mostly indoors. These scenarios might have a negative effect on the nervous system and moods of people with arthritis and acute pain. As a result, body pains often seem far more distressing and magnified than they really are.

Reducing the risk of joint pains in winter

Wear warm clothes
It is important that people with joint pains stay warm at all times. Areas further from the trunk (i.e., head, neck, ears, fingers, forearm, hand, ankles, feet, toes) are more prone to heat loss because of their thinner skin and more blood flow. Keep these areas warm behind multiple-layers of clothing. Apply heating pads and hot water bottles to the aching joints from time to time.

Exercise
The right amount of exercise can build muscle strength and reduce joint pain and stiffness. Exercise generates heat that relaxes joints and muscles. Low-impact weight training, aerobics, yoga, and other physical activities are highly recommended. Simple stretches can help loosen stiff joints. Consult a medical professional before starting.

Eat healthy/p>

Stick to a natural and organic diet that includes nuts and seeds, fish rich in omega-3 fatty acids, fish oil supplements, fruits and vegetables loaded with vitamins C and K (e.g., orange, strawberry, cabbage), beans, and wholegrains. These can help reduce joint swelling, pain, and stiffness and help maintain healthy joints. Some of these foods are also good sources of protein that muscles badly need while others reduce blood levels of C-reactive protein level (CRP), which is a sign of bodily inflammation.

Such a diet, in tandem with low-impact physical activities, can help people with joint aches maintain a healthy weight and ease body pain. So much as a 1 kg reduction in body weight can potentially reduce the weight brought to bear on the knee by as much as 40 kg.

When to see a doctor/p>

Persistent swelling, joint pain, stiffness, weakness, fatigue, and/or any unusual symptoms demand a doctor’s attention.

Doctors and non-physician specialists at the Department of Rheumatology and Orthopaedics at P.D. Hinduja Hospital and Medical Research Centre, Khar, Mumbai have intensive experience in diagnosing and treating pain, swellings, and stiffness of the joints, bones, muscles, tendons, and ligaments. We have cured or provided relief to a significant number of patients with various types of whole-body (fibromyalgia) and localised inflammations. These include inflammations of the skin (scleroderma); spine (ankylosing spondylitis); shoulder/hip/thigh muscles (polymyositis /dermatomyositis); as well as of the immune cells in the neck, armpit, chest, belly, and groin and lungs (sarcoidosis).