Soothing Achy Knees and Hips When the Temperature Dips
We’ve had more than our share of bone-chilling days this winter. And if you suffer from arthritis (inflammation of the joints in your body), it may seem as though the frigid temperatures magnify your aches and pains. Is that just coincidence? Or does the cold affect arthritis symptoms? And what can you do to get relief?
UR Medicine orthopaedist Dr. Jonathan Gabel offers tips on weather-related flare-ups, supplements and current therapies. As you read this, please note that there are many types of arthritis. These tips focus on arthritis resulting from simple wear-and-tear, rather than from autoimmune disease or infection.
Health Matters: Many people believe their arthritis symptoms get worse in cold weather. Is this myth or fact?
Gabel: I believe there’s some truth to it. Over and over, patients report that changes in the weather make arthritis symptoms worse. This also applies to joint injuries and bone fractures. When it’s cold, our joints do get stiffer. Humidity and other dramatic swings in weather patterns seem to affect joints and mobility, as well. Snow-bird patients tell us that when they go to the Southwest or Florida in the winter their symptoms get better. Although no one knows exactly how this works, I think it makes sense that milder climates ease arthritis.
Health Matters: So, other than moving to the South, what lifestyle changes can upstate New Yorkers make, particularly if pain and stiffness is a daily struggle?
Gabel: You’ll feel better if you stay active. Winter is still a great time to exercise. You need to keep moving and keep your weight under control to keep arthritis symptoms in check. Regular activity also helps lubricate arthritic joints and diminish stiffness.
When you go outside, avoid spending prolonged periods in the cold. And don’t ignore your legs and hips when you’re dressing in layers. So often we think of wearing layers above the waist, but long underwear, socks, and heavier pants that protect your hips, knees, and ankles is equally important.
In terms of types of exercise, make sure it’s low-impact. Swimming is the best thing you can do if you suffer from arthritis. However, that’s not always convenient for people. The next best thing is an indoor exercise bike or elliptical machine. You can work up a good sweat with either one, and they’re gentler on the joints than a treadmill. I urge people with arthritis to avoid running, jumping jacks, squats, and lunges. I’ve heard of a trend where people with mild arthritis or joint discomfort do squats and lunges at exercise or Zumba classes—and suddenly they’ve got damage to the knees.
Health Matters: What about taking supplements for arthritis? Does science support certain over-the-counter remedies more than others?
Gabel: In general, the evidence supporting supplements for arthritis is weak. That said, I have patients who take glucosamine or omega 3s and firmly believe it helps. Neither of those supplements will harm you, so I don’t discourage it. Keep in mind, though, that the science is not very strong in this area. The NIH did a large clinical trial testing glucosamine and the results showed no significant benefit. The tricky thing about arthritis is that it’s such a variable disease. Some patients experience mild symptoms over the course of decades and others progress from almost nothing to severe joint destruction in a short period of time. Symptoms also come and go, from agonizing pain to almost no pain, so it’s difficult to know whether supplements actually help.
Health Matters: What about other medical interventions, short of surgery? Does anything really help?
Gabel: Cortisone injections can help in some acute situations, as do ice or cold packs. Heating pads are better for chronic pain. Massage can alleviate symptoms by lessening stiffness. You can’t really massage the hip joints, but for knees, ankles, and shoulders, it can bring some relief. Acupuncture is a pain treatment and it’s relatively harmless, but I haven’t had any rave reviews from my patients. Finally, a procedure called viscosupplementation, which is an injection of a lubricant similar to the native hyaluronic acid that is in joint fluid, may give relief of symptoms for several months.
Health Matters: Do alcohol and caffeine have a damaging impact? Should we be limiting or even eliminating mocha lattes or wine with dinner?
Gabel: Interesting topic, but there’s no convincing evidence to avoid alcohol or caffeine entirely. It’s okay in moderation, and obviously with alcohol it’s important to limit your intake. I recommend that for everyone. But having said that, consider the flip side: A compound called resveratrol found in grapes and wine is an anti-inflammatory. I’m not advocating drinking for those who don’t, but having some red wine with dinner or hors d’oeuvres won’t hurt and, who knows, it could help.
Health Matters: What types of treatment are available for arthritis sufferers who just want some relief?
Gabel: For osteoarthritis—which stems from wear on the joints—and not other forms (e.g., rheumatoid, psoriatic, etc.), I typically prescribe only over-the-counter pain relievers. In the past we worried about the effects of anti-inflammatory medications on the stomach, but more recent concerns focus on their ability to raise blood pressure and harm the kidneys. We tell patients to limit the use of these medications to a week or two, when they’re experiencing a severe flare-ups.
And again, staying active can make a significant impact on arthritis symptoms. Exercise—particularly range-of-motion and strengthening exercises—really is crucial for patients with arthritis. It increases strength and flexibility and reduces joint pain and fatigue. Painful joints may not make you want to be active but it helps to keep muscles and surrounding tissue strong, maintaining support for bones. Not exercising weakens those supporting muscles, creating more stress on your joints.
UR Medicine offers the most advanced arthritis care in the Rochester area. Jonathan C. Gabel, M.D., is accepting patients at office locations in Greece and at Strong West in Brockport.
Also, the UR Medicine Hip and Knee Clinic, coordinated by Jennifer H. Paul, M.D., and Mark H. Mirabelli, M.D., is another option for arthritis sufferers. Call the UR Medicine Orthopaedics appointment center at (585) 275-5321 for more information.