Mr Joyti Saksena, Total Orthopaedics’ Hip, Knee and Sports specialist, discusses joint pain, the winter weather and what you can do to reduce the symptoms.
There is no concrete evidence that winter itself makes arthritis worse. However, it is widely reported by people suffering from arthritis that their joints cause more discomfort in colder weather. This may be because the muscles around the joint tend to contract when cold and thus joints tend to stiffen or ‘seize’ up.
In cold weather, it is best to keep your joints active – simple activities, such as walking, exercises and stretches, can help reduce joint pain. Particularly for the back but also other joints, yoga and Pilates can help maintain core muscle strength and support the joints maintaining movement and a degree of flexibility.
What sort of conditions can result from a lack of joint care? (i.e. ranging from stiffness to arthritis)
If joints are neglected or overworked, then it may lead to early degeneration of the articular cartilage (surface of the joint). This can often be a hazard of certain types of occupations or sports. The cartilage generally has a poor blood supply and thus even minor damage does not heal. Over time, this repetitive damage can lead to exposed bone. This is essentially early arthritis, which typically if left untreated may go on to degeneration of the joint. Patients often complain of symptoms such as pain, swelling and stiffness.
In which joints are these conditions most prevalent?
In osteoarthritis (commonest form of arthritis) it particularly affects the joints that bear weight, the hips and knees. However, other joints such as the hand, shoulders, foot and ankle can also be affected.
Does exercise help? If so what sort of exercise? Is it okay to exercise outside in winter or better to take it indoors?
Exercise is essential on many levels. Firstly, it strengthens the muscles around the joint and thus reduces the load through the joint. Secondly, it maintains movement of the joint which is often lost as arthritis progresses. Lastly, it helps all the other neighbouring joints and this helps to lessen the effects of arthritis in these joints too. Exercising outside in the winter is fine if one warms up beforehand and stretches down afterwards. There are also more hazards to be wary of in the winter such as wet roads/pavements, slippery grass and leaves etc.
Anything you should avoid?
If your joints are already starting to cause you havoc, then ideally high impact activities should be avoided as they can lead to more wear in the joints and more discomfort. This particularly affects the joints that I deal with namely the hip and knee joints. Similarly, sports that involve a significant amount of twisting and turning can cause joint damage. People may be better off switching to activities such as swimming, cross trainer or cycling.
How can your diet and supplements help to protect your joints?
Being overweight can put an additional strain on joints, in my practice I see this affecting the knee joint most commonly. I always tell my patients that although it can be hard to lose weight the benefits on your joints can be worthwhile. Some patients will complain that they can’t exercise to lose weight due to joint pain. This may be true however, it is about marginal gains and even losing a few kilos can make a significant difference to joint function.
Regarding joint supplements, there is mixed evidence in the medical literature. The NHS no longer supplies these on prescription. However, some patients have reported statistically significant benefit on supplements such as glucosamine, chondroitin, cod liver oil and even turmeric. My view is that they are probably worth trying as they are unlikely to cause any harm and may help with joint lubrication and reduce joint pain.
Is it ever too early or too late to start worrying about joint health?
Getting into good habits will always benefit joints, exercise, diet and maintaining a healthy body weight. Sometimes, joint damage occurs through our jobs or sports. Even if this happens obtaining good medical advice and occasionally early intervention therapy can help. In our group, Total Orthopaedics at Highgate Hospital, we are using biological agents to try and help with the symptoms of arthritis.
Lastly, if you think it is too late and your joint has worn out then replacement surgery can always be considered to provide long-term quality of life.
Is there anything else you can do to protect your joints that’s not been covered above?
If your occupation or sports that you play involve a lot of impact on your joints the best advice I can give in addition to that mentioned is to make sure you stretch, warm up or at least get your joints going before starting your activity. This nicely leads on to my last piece of advice – ‘always think about injury prevention’. This is just as important, probably more important than dealing with joints which are already damaged. We sometimes suggest using various splints or braces (functional bracing) for injury prevention or often for rehabilitation.