Dr. Raheesh Ravindran, MBBS, PGCC (Rheumatology), DNB (General Medicine), Mumbai.
Winter is fast approaching and as you guys are reading this blog Northern India must be already reeling under very cold weather. Winter season is especially very difficult for patients with rheumatic diseases. Many of my patients who were doing well until recently suddenly start complaining of increase in pain as the weather becomes cooler. Patients with rheumatoid arthritis, ankylosis spondylitis, systemic sclerosis and MCTD find the winter months very difficult to bear. So I decided to write a blog to give some tips to patients so that they can endure these winter months with ease.
During winter our muscles and and joints become stiff hence we find it difficult to move our joints, and it’s because of this stiffness that we start experiencing pain. Due to exposure to cold climate the blood vessels undergo spasm (decrease in size/calibre), blood circulation to our extremities reduces and hence they become cooler and the stiffness increases. Patients with Raynaud’s (bluish discolouration of fingers) find their symptoms worsening due to decreased circulation in their fingertips.
Now how do we tackle this problem?
It is advisable that during winter months patients should keep themselves warm by surrounding themselves in a warm environment, wearing appropriate warm clothes at all time. Instead of wearing one warm garment it is advisable to wear layered warm clothes which gives better insulation from the outside cold. I strongly advise my patients to increase the exercises to twice a-day, half an hour in the morning and half an hour in the evening so that the joints are kept warm and blood circulation is better in the muscles so that they do not become stiff. Some of my patients have suggested that when they apply certain oils they feel that the joints are warm and they feel much better. So if you are using any such oil for external application you can continue to do so if it gives you symptomatic relief.
Patients with Systemic sclerosis and MCDT who are suffering from Raynaud’s need to be very careful during these winter months. Exposure to extreme cold can lead to blockage in blood circulation in their extremities which can lead to gangrene and painful fingertip ulcers. Such patients should be wearing woollen gloves at all times except while doing household work. Once they finish their work they should make their hands dry and warm their hands and use woollen gloves and socks to protect them from cold. Keeping their hands in warm water especially in the mornings and late evenings during winter may help to improve the blood circulation and thus prevent gangrene or fingertip ulcers. I advise all my patients to use copious amounts of moisturising cream on their extremities so that the skin is moist and supple and doesn’t become dry.
During the winter season we are exposed to less sunlight hence the vitamin D levels are usually low during the winter months so it is advisable to make sure that your vitamin D levels are maintained by taking supplements in consultation with your Rheumatologist. It is also advisable that you increase the intake of nuts during the Winter months especially almonds and walnuts and other food items like flax seeds, avocado, fish as they are rich in omega 3 fatty acid which are known to be good anti inflammatory agents. Keep yourself well hydrated throughout the day. Eating a healthy diet, taking adequate rest, doing regular exercises, using appropriate woollen clothes will help you to tide over the winter months with ease.
Seasonal flu is very common during these winter months which may worsen your complaints. So take adequate steam inhalation, drink warm water, stay away from people who are coughing or sneezing. Make sure you have taken your vaccinations as advised by your Rheumatologist.
However in spite of all these measures if your symptoms are not getting relieved you should immediately consult your Rheumatologist and try to adjust your medications as per his advice.
Winter is fast approaching and as you guys are reading this blog Northern India must be already reeling under very cold weather. Winter season is especially very difficult for patients with rheumatic diseases. Many of my patients who were doing well until recently suddenly start complaining of increase in pain as the weather becomes cooler. Patients with rheumatoid arthritis, ankylosis spondylitis, systemic sclerosis and MCTD find the winter months very difficult to bear. So I decided to write a blog to give some tips to patients so that they can endure these winter months with ease.
During winter our muscles and and joints become stiff hence we find it difficult to move our joints, and it’s because of this stiffness that we start experiencing pain. Due to exposure to cold climate the blood vessels undergo spasm (decrease in size/calibre), blood circulation to our extremities reduces and hence they become cooler and the stiffness increases. Patients with Raynaud’s (bluish discolouration of fingers) find their symptoms worsening due to decreased circulation in their fingertips.
Now how do we tackle this problem?
It is advisable that during winter months patients should keep themselves warm by surrounding themselves in a warm environment, wearing appropriate warm clothes at all time. Instead of wearing one warm garment it is advisable to wear layered warm clothes which gives better insulation from the outside cold. I strongly advise my patients to increase the exercises to twice a-day, half an hour in the morning and half an hour in the evening so that the joints are kept warm and blood circulation is better in the muscles so that they do not become stiff. Some of my patients have suggested that when they apply certain oils they feel that the joints are warm and they feel much better. So if you are using any such oil for external application you can continue to do so if it gives you symptomatic relief.
Patients with Systemic sclerosis and MCDT who are suffering from Raynaud’s need to be very careful during these winter months. Exposure to extreme cold can lead to blockage in blood circulation in their extremities which can lead to gangrene and painful fingertip ulcers. Such patients should be wearing woollen gloves at all times except while doing household work. Once they finish their work they should make their hands dry and warm their hands and use woollen gloves and socks to protect them from cold. Keeping their hands in warm water especially in the mornings and late evenings during winter may help to improve the blood circulation and thus prevent gangrene or fingertip ulcers. I advise all my patients to use copious amounts of moisturising cream on their extremities so that the skin is moist and supple and doesn’t become dry.
During the winter season we are exposed to less sunlight hence the vitamin D levels are usually low during the winter months so it is advisable to make sure that your vitamin D levels are maintained by taking supplements in consultation with your Rheumatologist. It is also advisable that you increase the intake of nuts during the Winter months especially almonds and walnuts and other food items like flax seeds, avocado, fish as they are rich in omega 3 fatty acid which are known to be good anti inflammatory agents. Keep yourself well hydrated throughout the day. Eating a healthy diet, taking adequate rest, doing regular exercises, using appropriate woollen clothes will help you to tide over the winter months with ease.
Seasonal flu is very common during these winter months which may worsen your complaints. So take adequate steam inhalation, drink warm water, stay away from people who are coughing or sneezing. Make sure you have taken your vaccinations as advised by your Rheumatologist.
However in spite of all these measures if your symptoms are not getting relieved you should immediately consult your Rheumatologist and try to adjust your medications as per his advice.