Cold Weather and Arthritis

Many of you might notice with the cold weather increased aching and stiffness in your joints, often times this specifically occurs in the small joints of the hands. Though the cold exacerbates symptoms, it is probably the effect of osteoarthritis or degenerative joint disease, more commonly referred to as just “arthritis." Arthritis means “joint inflammation” and is caused by the breakdown of joint cartilage causing bone on bone contact, in turn causing pain. The exact cause of arthritis is unknown, but factors that are known to contribute include obesity, the natural aging process, joint injury or stress, heredity, muscle weakness, and repetitive use. Rheumatoid arthritis is another very prevalent form of arthritis and should not be confused with osteoarthritis. Unlike degenerative joint disease, rheumatoid arthritis is an inflammatory condition caused by your body’s immune system attacking the tissue that lines your joints called synovium. From this point forward in this article, "arthritis" will be in reference to osteoarthritis rather than rheumatoid.

The signs and symptoms of arthritis tend to develop slowly over time. You may experience pain in your joints before or after activity, or during periods of inactivity. You may note swelling or stiffness, boney lumps or loss of joint flexibility. And, as mentioned previously, the cold may set any or all of the above into full gear.

In the hands you may notice bony knobs called “nodes” develop, which enlarge the fingers and create a gnarled appearance. The nodes tend to be painful and affect joint mobility. Nodes tend to run in families and are more common in women than men. Arthritis often times strikes in the joint at the base of the thumb, called the basal joint. Basal joint arthritis is most common in women over 40, but anyone can get it. Many times, both thumbs are involved and you may feel pain whenever you lift something with you thumb and fingers.

Unfortunately there is no cure for arthritis. However, there are numerous ways to minimize the symptoms and to prevent further deformity. Several medications are available to help manage the inflammation and pain, including both oral and injectable. Talk to your doctor to see if there may be one appropriate for you. There are surgical interventions that range from joint replacement to debridement (cleaning out the joint) to fusing of the joint. Surgical intervention is obviously the most invasive and usually left as a last resort when all conservative measures have been exhausted. Wearing splints can minimize pain and prevent further deterioration by providing support to the inflicted joints. Using moist heat and a gentle exercise program may also be helpful in decreasing pain and increasing or maintaining joint flexibility.

If you haven't been plagued by stiff, achy joints of the hand yet, be aware that it could happen at anytime. Therefore, it is important for everyone to take precautions to prevent joint deterioration. By following some very simple rules we can prevent injury and disease. Education in prevention is a very important part of an arthritis treatment program. Conserving energy, modifying activities, and decreasing stress on the joints can be incorporated into daily activities to improve comfort, energy level, and overall function of the hands and decrease the deformities caused by arthritis. As a whole this concept is referred to as joint protection principles and there are eight basic “rules” that apply.

  1. Respect Pain
    Discomfort typically disappears when the joint is rested. Pain persists for several hours after an activity or exercise is stopped. Perform exercises for short periods throughout the day and avoid excess pain and fatigue. Exercise joints to a “comfortable stretch” and discontinue if pain occurs.
  2. Maintain Muscle Strength and Joint Range of Motion
    Regularly perform range of motion exercises to maintain functional use of the hand. Maintaining muscle strength is necessary for efficient joint movement. A physical or occupational therapist can guide you on appropriate range of motion and strengthening exercises that are safe for you to do.
  3. Avoid Positions of Deformity of the Hand (and other joints)
    Over time, poor posture and stressful activities may result in muscle or joint deformities that can lead to pain, loss of strength, and decreased ability to perform everyday activities. For example, resting your head on a fisted hand or sleeping with your wrists bent.
  4. Use the Largest Joint Available for the Job
    When possible use your wrist, elbow or shoulders which are bigger and stronger, instead of your fingers which are smaller, weaker joints. For example, carry your purse over your shoulder or forearm rather than gripping with your fingers.
  5. Use Good Body Mechanics
    Use two hands to lift and carry heavy or large objects, using forearms and hands underneath or around the object rather than gripping with your fingers. Hold the object close to your body to relieve stress on the smaller joints. For example, ask for paper grocery bags that you can “hug” to your body with both hands rather than plastic which cinch down on gripping fingers.
  6. Avoid Holding One Position for Extended Periods
    Muscles tire more quickly in a static or maintained position due to a buildup of waste products, resulting in increased tension and vulnerability to injury. Dynamic activity allows reciprocal movements of muscles, allowing one set of muscles to work while the others relax.
  7. Conserve Your Energy
    Simplifying work and working more efficiently, reduces strain on your body minimizing fatigue and helps your energy go further. Some examples of conserving energy include eliminating unnecessary tasks (i.e., letting dishes air dry rather than hand drying), delegate work to other family members, organize your work and schedule rest breaks, avoid unnecessary carrying, lifting, and holding (i.e., plan ahead, use a cart on wheels rather than carrying loads, slide objects rather than lift them when possible, use grip aides), and use both hands.
  8. Avoid Starting an Activity that cannot be Stopped Immediately if Too Stressful.
    Plan ahead, schedule rest breaks, and obtain help from someone else as needed. Prolonged stress to a joint may result in injury.

It's never too late to start taking precautions to prevent deterioration of our bodies. By making small lifestyle changes we can make big differences in the functionability of our joints. For more information regarding arthritis and prevention go to www.arthritis.com or talk to your local health care provider.

Jamie Harrison is an occupational therapist that practices at Montana Orthopedics & Sports Medicine. She has special interest in the hand, bracing and injury prevention.