Wednesday, January 16, 2019

Joint Pain during Winter




Hardly anyone really likes cold, wet, and windy weather – there’s only one word in the world that really describes this condition: usselig – a word from the language spoken in and around my hometown Cologne (the city with the cathedral, the Kölner Dom). But people with inflammatory rheumatic disease and also people with osteoarthritis suffer even more during this season. And actually it isn’t “Hello darkness, my old friend” – quite a lot of people get the blues during the darker months, which also affects pain and not only mood disorders. Besides the joint pain (arthralgia), these people also suffer from pain in the muscles (myalgia).

It isn’t the lower temperature alone; as inflamed and painful joints are very responsive to the application of local, dry cold packs (ice and cold water in a plastic bag are suited best for the purpose). Decisive for the increased pain is the humidity and some people think also the lower air pressure.

E.M. Savage and colleagues addressed the question: “Does rheumatoid arthritis disease activity correlate with weather conditions?” As the authors are based in Belfast, they have enough humid weather. They concluded: “In this study, rheumatoid arthritis disease activity (as measured by DAS-28) was significantly lower in both more sunny and less humid conditions.”

W.R. Patberg and J.J. Rasker looked at: “Weather effects in rheumatoid arthritis: from controversy to consensus. A review.” They came to the conclusion: “The classic opinion, "Cold and wet is bad, warm and dry is good for RA patients," seems to be true only as far as humidity is concerned.”

Muscles and joints receive less blood during winter as other organs are favored. And the restrictions on movement per se add to lower joint mobility; the synovial fluid loses its lubricity and then pain intensifies – a vicious circle to be broken. Therefore patients should be encouraged to put on warm clothes (not forgetting gloves, hats and scarves) and walk a lot in fresh air. During daytime and especially, when the sun comes out of hiding as this counteracts the blues. However, Vitamin D isn’t produced in large enough amounts during the winter half year (in latitudes like Germany or higher up).


Links:
E.M. Savage and colleagues: https://www.ncbi.nlm.nih.gov/pubmed/25342437
W.R. Patberg and J.J. Rasker: https://www.ncbi.nlm.nih.gov/pubmed/15229951


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