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January 2009
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When the Weather Gets Cold
Winter Health Problems

 Cartoon of a woman sitting at a table with a hot drink

Bright blue skies, blankets of snow, crisp days and cozy nights by a crackling fire. For many people, winter is a welcome time of year. But for people with certain diseases like arthritis, it can be a pain—literally. While cold weather doesn’t cause arthritis or most other conditions that get worse when temperatures drop, it can cause problems for people who have them. If you’ve got one of these conditions, here’s what you need to know to survive winter’s chill.

“Weather affects different people differently,” Dr. Mark Gourley of NIH says. “Some people actually prefer cold weather, but many people with rheumatoid arthritis or lupus will be more stiff in the morning. It can take them longer to get up and loosen their joints and get going.”

There’s very little research showing that cold weather directly causes arthritis or alters its course. So why does the cold seem to make arthritis feel worse?

As the weather changes, so can the pressure in your joints. If you think of the tissues surrounding the joint as a balloon, Gourley explains, the balloon around the joint will expand a little when air pressure is low. The expanding tissues put pressure on the joint. People can actually feel changes in air pressure in their joints, which is why some people say they can predict the weather by the pain in their joints.

“Do what you can to keep warm,” Gourley says. “Bundle up from head to toe in several layers, preheat the car before getting into it and make sure your home or apartment is kept warm.” Other suggestions: Sleep under an electric blanket, warm clothing in the dryer before dressing and drink warm or hot drinks, such as coffee, tea or hot chocolate.

It’s also important to keep moving, Gourley says. Try exercising the affected joints before going out in the cold weather. It also helps to maintain a regular exercise program year round. Exercise will not only loosen stiff joints, but will help prevent winter weight gain that puts more stress on painful joints.

Joint stiffness isn’t the only problem low temperatures can cause. Raynaud’s disease is a condition in which the blood vessels quickly narrow, reducing the flow of blood and causing the skin on the fingers, toes and even the nose to temporarily turn white, then bluish. As blood flow returns, the skin turns red and becomes painful. In rare severe cases, Raynaud’s can cause skin sores or tissue death (gangrene) at the tips of the fingers and toes.

As with arthritis, the best advice for people with Raynaud’s is to keep warm. “Wear mittens as opposed to gloves,” Gourley advises. That way, the fingers can help keep each other warm. See the article in last month’s issue for more about Raynaud’s.

Sjögren’s syndrome is another condition that can get worse in colder weather. In Sjögren’s syndrome, the immune system attacks the body’s moisture-producing glands, leading to dryness of the eyes, mouth and other tissues. Cool, dry weather can exacerbate the situation.

People with Sjögren’s syndrome need to add moisture back into the environment when the air is dry. Run a humidifier to raise the humidity level in your home and use lotions after bathing to keep skin moist. Use artificial tears for dry eyes and keep a water bottle on hand to sip to relieve dry mouth. Be careful about using mouthwashes with alcohol or over-the-counter cold remedies, either of which can worsen dryness.

Many prescription medications, including antidepressants and high blood pressure medications, can also cause dry mouth. If you’re taking these medications and having trouble with dry tissues, ask your doctor about the possibility of changing your medication or combating dryness with other treatments. In more severe cases, your doctor may prescribe a medication to increase saliva flow or recommend a simple medical procedure to block the drainage of tears out of your eyes, leaving more natural tears in the eyes to moisten and lubricate them.

Osteoporosis—in which the bones become porous and prone to fracture—may not itself worsen with cold. However, icy steps and walkways in the wintertime can present a particular danger to people whose bones are fragile. Slipping and falling can cause painful fractures that can be slow to heal and even disabling.

If you have osteoporosis, in addition to following the treatment plan your doctor prescribes, it’s important to take measures to reduce your risk of falling. Make sure you have handrails on your porch, keep sidewalks free of snow and ice, and avoid wearing shoes with slippery soles. If you take medications that affect your balance or stability, ask your doctor about the possibility of changing medications, or at least the timing of medications so that they’re less likely to interfere with daytime activities.

Cold weather may also affect people with certain lung diseases. For example, asthma can be triggered in some people by physical activity in cold weather. Rheumatoid lung disease, caused by the same immune response that affects the joints of people with rheumatoid arthritis, is characterized by shortness of breath, cough, chest pain and fever. For people with rheumatoid lung disease, winter air can aggravate problems breathing.

“If you have marginal breathing capacity and you compromise that in any way,” Gourley says, “cold winter air can make breathing worse.”

If you have difficulty breathing, try a face mask when you need to go out in the cold. Such masks, which can be found at many outdoor and sporting goods stores, cover your mouth and use the heat from your own breathing to warm the air before it enters your lungs.

If you have symptoms brought on by cold weather, be sure to mention them to your doctor.

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Definitions iconDefinitions

A chronic lung disease that causes wheezing, coughing, chest tightness and trouble breathing.

Immune System
The system that protects your body from invading viruses, bacteria and other microscopic threats.

A disease in which your immune system mistakenly attacks healthy cells and tissues. It can affect many parts of the body.

Rheumatoid arthritis
A disease in which your immune system mistakenly attacks your joints, causing pain, swelling, stiffness and loss of function.

Wise Choices iconWise Choices
Chilly Problems

If you have a health problem that gets worse in the cold, talk to your doctor about what to do. Here are some ideas for keeping warm, comfortable and safe:

  • Bundle up from head to toe in several layers.
  • Use a face mask that warms the air you breathe.
  • Preheat the car before getting into it.
  • Keep your home warm.
  • Sleep with an electric blanket.
  • Warm clothing in the dryer before dressing.
  • Drink warm or hot drinks, such as coffee, hot tea or hot chocolate.
  • Run a humidifier to raise the humidity level in your home.
  • Use lotions on your skin.
  • Keep physically active.
  • Avoid falls. Use handrails, keep sidewalks free of snow and ice, and wear shoes with a good grip.

Links iconWeb Sites

Rheumatoid Arthritis


Cold Fingers and Toes? It Might Be Raynaud’s

What is Asthma?

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