It's that time of year! The weather is cold and rainy, and everyone likes to have a hot drink and sit in front of the fireplace and relax. However, people suffering with arthritis can’t help but notice that their pain is far worse, and that they are much stiffer than before. Dr Prabhu Gandhimani, Pain Management Specialist at New Victoria Hospital, often hears in his clinic that every winter there is a flare up of the arthritis and that his patients pain improves when they go on a summer holiday to warm weather, and some go a step further and ask whether he can prescribe a holiday. Ever wonder why it happens?

What Conditions Get Worse In Winter?

Often elders and people who suffer from chronic pain and autoimmune pathologies are more likely to experience worsening symptoms with cold temperatures.

Conditions that could get worse in winter are:

• Osteo arthritis: The most common type of arthritis also called “wear and tear” arthritis is caused by wearing of the cushioning cartilages in the joint. The cartilages gradually wear away with aging leading onto bone rubbing on bone that results in crunching noises and severe pain.
• Rheumatoid arthritis: This is a form of autoimmune disease where the body’s own immune system attacks the cells lining in the joint, making the joints swollen, inflamed and painful. Rheumatoid arthritis can cause severe early morning stiffness, general tiredness and can attack other organs like the lungs. If left untreated Rheumatoid arthritis can damage your body further so it is recommended to see a doctor for this condition.
• Back and Neck pain: Back and Neck pain can be from muscles, ligaments, joints in the back, or from trapped nerves. The back muscles are the largest in the body and they can become stiff in the cold weather. Anxiety, lack of sleep, bad posture at work, especially when sitting at your desk, and stress that occurs in winter can aggravate back and neck pain. Regular stretching, changing position frequently, avoiding sitting for too long, and taking a short walk after 30 minutes of sitting can help to reduce your pain. Physical activity and physiotherapy are also a great way to strengthen your muscles and improve your posture.
• Raynaud’s disease:  This is a disease affecting your blood circulation where the blood vessels in your hands and feet become sensitive to cold causing them to spasm and reduce blood supply. This causes severe pain and a pins and needles sensation and often there is change in colour from white, blue to deep red when blood flow resumes. Prevention is better than a cure in Raynaud’s and warm clothing and appropriate socks and gloves can prevent an attack. Stopping smoking and reducing caffeinated drinks like coffee, tea, and cola also helps to reduce the frequency of attacks.
• Sports injuries and old injuries: These injuries are often more painful in cold weather.
• Migraines: Some people with migraines are more sensitive to sudden temperature changes and cold weather may trigger an attack by causing an imbalance in brain chemicals. Exercising regularly, staying hydrated, good sleeping habits and managing stress will reduce the frequency of these attacks.

Why Does This Happen?

Despite the common perception that cold weather increases some types of pain, when scientists in Australia and America undertook formal research to establish a link, they couldn’t find one, and concluded that there is no definitive link between cold weather and increased pain.

There are some plausible theories as to why pain increases in cold weather:

      1. Change in barometric pressure

Our joints are supported by muscles, tendons and ligaments, and a change in barometric pressure as happens during a drop in temperature may cause these tissues to expand and produce stiffness.

Moreover, during cold weather the atmospheric pressure drops and the lubricant fluids in joints and minute gas bubbles which are normally present inside joints may expand and thus stretch the sensitive joint capsules, producing pain and stiffness.

      2. Stretching of fascia

Lower temperatures cause various tissue to contract differently, and this stretches the sensitive muscle fascia that surrounds them. Stretching of fascias can cause pain and stiffness. The resultant muscle spasms can even put pressure on nerves going between muscles. This is especially true in neck pain and headaches (occipital neuralgia).

      3. Lack of physical activity

During cold weather people try to stay inside and become less active, and this reduced activity causes more pain and stiffness. Resting instead of using muscles over long periods of time will cause them to weaken. Muscles start to break down when they are not used to their full capacity and stiffness is the result of muscles shortening and becoming knotted. Stretching and exercise will provide your muscles with oxygenated blood that will alleviate tightness.

      4. Restricted blood flow

When our body becomes exposed to cold weather, the body restricts the blood flow to extremities like hands and feet to conserve heat and this make the soft tissue around joints less pliable, causing stiffness and pain.

Top Tips To Prevent Pain And Aches This Winter

• Maintain a healthy weight and an active lifestyle is probably the first advice a pain management specialist can give. Unhealthy weight puts too much load on the joints accelerating the wear and tear changes. An active lifestyle maintains bone strength and keeps muscles strong. Exercises helps with physical and mental wellbeing and improves sleep as well.
• Wear appropriate clothing when going outside; this keeps the muscles warm and pliable, reducing stiffness and keeping them ready for action. By wearing several layers of clothing like soft breathable cotton close to your body and wool or a fleece on top will trap the air and keep your body warm. Compression socks and gloves also help to retain heat and maintain blood flow in your hands and feet, this is especially important for Raynaud’s sufferers. The ears are sensitive to cold so make sure you cover them appropriately too.
• Warming up before exercise prepares the muscles for the exercise and therefore reduces injury. This is especially important during winter as muscles are stiff to begin with.
•  Indoor exercises like yoga, Pilates, treadmill, indoor cycling, or a gym can be handy during rainy days. One could consider joining group exercise classes, a lot are on offer these days and can be done remotely through Zoom in the comfort of your home.
• Keep your bedroom temperature above 18 degree at night. Having a warm meal at least once a day and a warm drink throughout the day will also help you to cope with the cold weather.
• Taking vitamin D supplements might also help. Low sunlight can cause low vitamin D and a study revealed that vitamin D levels were sub optimal in 80% of the British population during winter. Eggs, dairy, cheese, and oily fish are all rich sources of Vitamin D. Vitamin D plays an important role in bone growth, immunity, and metabolism.
• Tumeric is a naturally occurring anti-inflammatory and helps to reduce stiffness. It can be obtained from healthy food shops.
• Last but not least, it is important to realise that pain is a physical and emotional sensation. Being in constant pain affects the mind and can amplify the pain you are feeling. As well as good sleep and regular exercise, mindfulness and allocating time to do things that you enjoy, along with talking therapies should all have a positive effect on your wellbeing.

If you are struggling with joint, bone, or muscle pain this winter or if you would like to speak about your therapy with a specialist, you can book an appointment with one of our Pain Management Consultants by calling us on 020 8949 9020 or you can fill in our online form.