There are an estimated 10 million people in the UK living with osteoarthritis, and many more experiencing chronic joint pain due to conditions such as rheumatoid arthritis, ankylosing spondylitis, fibromyalgia and bursitis.
For many of them, the onset of winter comes with the knowledge that those familiar aches and pains will soon become unbearable.
According to research, around three quarters of people living with chronic pain claim the weather negatively affects their condition – and most doctors would agree. “In cold weather, joint pain often flares up, and the reasons go beyond just stiffness from the chill,” says Dr Snieguole Geige from It’s Me & You Clinic.
“For those prone to joint issues, joint inflammation and sensitivity can be keenly felt as a type of internal weather forecast, predicting cold fronts before they arrive.”
While the issue remains controversial – with mixed scientific evidence failing to provide concrete proof that joint pain is worse in cold weather – one 2007 study of patients with osteoporosis in their knees reported that their pain increased with every 10-degree drop in temperature.
More recent research also backs up this finding, with a mass study led by University of Manchester-based researchers demonstrating the links between pain and certain weather conditions. It tracked over 15 months more than 13,000 UK residents who suffer from chronic pain and asked them to record the daily intensity of their pain on a smartphone app.
The GPS location of their phone then linked their findings to the weather data and showed that on the days that most people reported high levels of pain, the humidity and rain levels were higher and winds were stronger.
The findings are no surprise to osteoarthritis sufferer Raija Piispanen, 65, from London. “As winter approaches, I know exactly when the temperature is going to drop because the osteoarthritis in my hands is so painful,” she says.
“The joints in my fingers feel as though they are burning and the dull ache often wakes me up in the night. On bad days, my fingers are so stiff that even simple tasks like opening a jar or doing up buttons are impossible,” says the retired childmin- der who has lived with the condition since her late 40s. “I tend to drop things too. To combat the pain, I always make sure I wear gloves when I go outside and try to stay as warm as possible.
“I sit under a heated blanket at home which helps and take a collagen supplement and use painkillers when I really need to. But, without doubt, the thing that helps the most is when summer comes back around again.”
Why does cold weather impact joint pain?
Joint pain is anecdotally worse in the cold and in damp, wintery conditions. It is certainly a burden for many of my patients,” says Dr Jonathan Rajan, pain management consultant at OrthTeam Centre. “There are many postulated reasons for this but the research is conflicting and inconclusive.”
Dr Wendy Holden, medical adviser to Arthritis Action and consultant rheumatologist at Curaleaf Clinic adds: “While the exact reasons aren’t fully understood, several factors likely play a role. When atmospheric pressure drops, it can cause tissues around the joints to expand slightly, leading to discomfort. Cold weather also makes muscles and tendons contract, which can increase joint stiffness, especially in those with arthritis. Reduced movement during colder months may also contribute, as this can cause the lubricating fluid in joints to thicken, making stiffness more noticeable.”
Some research suggests increased pain could be linked to a tendency to experience lower moods in winter as depression is linked to joint, limb and back pain. “Inclement conditions often lead to adverse effects on mood, which can also affect the perception of pain,” says Dr Rajan. “Everyone tends to feel more positive on warm sunny days.”
Menopausal women may also find they experience more aches and pains in winter. Dr Elise Dallas, women’s health GP at The London General Practice, says: “Oestrogen is anti-inflammatory, therefore the decline in oestrogen levels during menopause leads to increased inflammation in the body. Colder temperatures in winter can exacerbate this inflammation, making joint pain more pronounced.
“Cold temperatures can also constrict blood vessels, reducing blood flow to the joints and causing stiffness.”
We also exercise less in winter, which is not good for joints. “When it is cold outside, we tend to move around or exercise less, which can lead to a loss of muscle strength and flexibility and, therefore, more joint pain,” says physiotherapist Clara Kervyn.
How to manage joint pain in winter
Wrap up: Try wearing lots of thin layers to avoid getting cold and help lessen the shock to your joints. “As with many conditions that are worsened by cold weather, it is important to wrap up warm if heading outside,” says Dr Holden. “By keeping muscles and joints warm this helps muscles to stay relaxed and prevent the contraction that contributes to stiffness. As our hands are typically the most exposed to the elements and susceptible to the cold, those with arthritis in the hands or wrists may therefore particularly benefit from wearing gloves or the use of hand warmers.”
Keep moving: When you’re in pain, it can sometimes feel counterintuitive to exercise and consequently many people avoid it as they feel that activities such as running or HIT classes put extra strain on their joints. But Dr Holden suggests trying less intensive forms of exercise instead.
“Activities like yoga or swimming can help keep joints flexible and support circulation,” she says. “These are particularly good exercises as they typically place less pressure on knees and hips. The most important exercise, however, is one you can enjoy and can maintain long-term as exercise is an important part of managing arthritis year-round.
“Although many people may experience some pain and discomfort when they first take up an activity, regular exercise helps to strengthen local muscles and improve fitness. This has been shown to reduce pain and improve daily function, leading to a higher quality of life.” Have a stretch: It’s not just exercise that will make a difference to aching joints. Stretching will also help to stop them seizing up and is easy to do even when you are in pain.
“Try stretching for a few minutes at various points throughout the day,” says Clara Kervyn. “Stretch first thing in the morning and when you go to bed. Regular small stretches can help warm up muscles and joints and can help you stay mobile.”
Totally topical: “There are a number of over-the-counter medicines you can access for topical pain relief products including anti-inflammatory gels,” advises Claire Nevinson, Superintendent Pharmacist at Boots. “These can be applied directly to the affected area which allow the active ingredient to target the pain and inflammation where it is needed.”
For example, Deep Relief Anti-inflammatory Gel (£4.99; Boots) contains two painkilling ingredients – Ibuprofen and Levomenthol. Or if you prefer a patch, the Deep Relief Actiflex Patch (£7.99) can be worn under clothing for up to 12 hours.
Feel the heat: “Hot and cold therapy is another effective option for managing joint pain and can help to relax muscles and ease swelling. Heat therapy can be useful for stiff or painful joints which might feel cramped or tight,” says Claire. “It should be applied for 15 to 30 minutes and can be reapplied every two hours.
“Similarly, icing the painful area for up to 20 minutes every two to three hours can also help to relieve pain.”
Watch your weight: Being overweight puts excess pressure on joints, which can lead to increased pain. One study published in Arthritis and Rheumatism that monitored overweight and obese adults with osteoarthritis in their knees showed losing one pound resulted in four pounds of pressure removed from their knees.
“Healthy eating and weight management are also important in the long term, both of which are hard in the colder months and with joint pain,” says Dr Rajan.
Take your sunshine pill: In winter our vitamin D levels drop, especially in the UK where we get minimum exposure to the sun during the colder months. But research has shown a deficiency can lead to joint pain and swelling, and one study showed a lack of vitamin D led to increased severity of rheumatoid arthritis.
“Vitamin D is essential to maintain healthy bones and muscles,” says Clara Kervyn. “Be sure to take the government recommended dose of 10 micrograms daily.”
Don’t be afraid of painkillers: While some people are reticent about taking pills regularly, if you’re struggling with chronic joint pain do speak to your GP or a pharmacist about the medications available to you.
“Oral pain relief such as ibuprofen or paracetamol can also help relieve pain,” says pharmacist Claire Nevinson. “If you aren’t sure which pain relief is suitable for you, a pharmacist can help answer questions and give you advice on what can help.
“Or visit the Pain Management page and try the pain relief selector tool on Boots Health Hub for more information and advice. If symptoms do not ease, or worsen, you should book an appointment with your local GP.”
Some sufferers are also turning to medical cannabis for joint pain relief. “For those open to alternatives, medical cannabis is also gaining interest for its potential in managing pain and inflammation, especially in cases where other treatments may have fallen short,” says Dr Holden.