Why is the Cold Weather Hard on Your Joints? An Expert Weighs In

Do your achy joints make it hard to get out of bed in the winter? You're not alone. There is some scientific evidence that shows that joint pain feels worse in the winter.

When it comes to winter weather and achy joints, the theory is that when it is cold outside, nerves and blood vessels constrict in the arms and legs, decreasing blood flow and circulation to keep our inner core (heart and organs) warmer. "This causes our joints to become more stiff and painful. A drop in barometric pressure may also lead to increased joint pain for some. Also, when it is cold outside, people move around or exercise less, which can lead to a loss of muscle strength and flexibility and, therefore, more joint pain,” explains Maria Salgado, MD, Assistant Professor of Medicine in the Division of Rheumatology at CUIMC.

Achy Joints or Arthritis?

Everyone associates joint pain with arthritis, but is there a difference between the two?

Arthritis is more common than many people realize. More than 58 million Americans are living with some type of arthritis, according to the CDC. Osteoarthritis is the most common type, in which tissue around joints degenerates and causes inflammation. Rheumatoid arthritis is less common—it’s an auto-immune disease that causes your body to attack its own joints.

Whether you have inflammatory arthritis or not (osteoarthritis), cooler temperatures may increase the thickness of the synovial or joint fluid, causing the joints to become stiffer and have less mobility.

“Arthritis can cause stiffness and a decreased range of motion in the body’s joints. Combined with colder temperatures, individuals with arthritis may experience increased pain during the winter months,” according to Dr. Salgado.

Joint pain is often caused by arthritis, but not always. If your joints are consistently sore or painful, you should see a doctor to determine the root cause.

How to Help Your Joints Survive the Cold

The cold weather may make your arthritis or joint pain feel worse, but there are some things you can do that can help.

• Dress warmly: Layer clothing to stay warm and reduce exposure to the cold. Choose coats with Velcro or large zippers to make it easier to get on and off. Insulated treaded footwear will help with slippery streets.
• Stay active: Exercise to maintain joint flexibility and muscle strength. Hot showers in the morning will help you get moving earlier in the day. Treadmills are a good option for moving indoors; gentle yoga, heated swimming pools, or walking around indoor malls can be a good source of exercise.
• Use heat therapy: Applying heat to affected joints can help alleviate pain and stiffness. Paraffin baths are an option. It is a small machine that melts paraffin wax. You dip your hands in, and they absorb the heat, which may soothe achy joints. The use of heating pads on sore joints may also help. 
• Maintain a healthy lifestyle: A balanced diet, regular exercise, and stress management can all contribute to managing arthritis symptoms.

Medications Are an Option, Too

If bundling up and staying active doesn’t help your joint pain or arthritis, it might be worth talking to your doctor about medications. Your choices will likely depend on the root cause of your joint pain.

“There is no cure for most rheumatic diseases such as rheumatoid arthritis, therefore, the goal of treatment is to put the disease into remission. Drugs having some ability to do this are known as disease-modifying antirheumatic drugs (DMARDs). Early treatment would improve physical function, decrease inflammation, and slow or prevent structural joint damage,” says Dr. Salgado.

There are three general classes of DMARDs used in rheumatology:

• Conventional synthetic DMARDs, which include hydroxychloroquine or sulfasalazine monotherapy commonly used for mild rheumatoid arthritis. Methotrexate is one of the most effective DMARDs for moderate to severe rheumatoid arthritis and the anchor drug for all combination therapies.
• Target synthetic DMARDs such as JAK inhibitors (Xeljanz or Rinvoq) which are oral medications mainly used in patients with severe disease or in cases of inadequate response to methotrexate. JAK inhibitors can be used alone or in combination with methotrexate.
• Biologic DMARDs target specific pathways of the immune system to calm down inflammation and reduce joint damage. These drugs include Enbrel, Humira, Remicade, Actembra, Rituximab, etc.

Non-steroidal anti-inflammatories (NSAID) or corticosteroids may help bring down during “flare-ups.” NSAIDs are commonly used to alleviate symptoms in patients with non-inflammatory joint diseases such as osteoarthritis. However, all NSAIDs should be used with caution in patients with underlying renal or cardiovascular disease. Using the smallest effective dose and intermittent dosing is advised. Topical NSAIDs or duloxetine are other effective options for patients with osteoarthritis.

The risk of hepatitis B reactivation and mycobacteria infection are increased in patients on biologics therefore, screening for these diseases is important before starting biologic therapy. Rheumatic diseases and immunosuppressive medication used to treat them place patients at higher risk of vaccine-preventable infections and infections serious complications. Pneumococcal, flu, and shingles vaccines are encouraged. A vaccination strategy should always be shared with your rheumatologist.

Dr. Salgado advises, “If you find that cold weather significantly impacts your arthritis symptoms, speak with your healthcare provider. It's important to speak to a rheumatologist for a proper diagnosis and to develop a personalized treatment plan. Early intervention is crucial as it can help improve your long-term outlook and keep you moving longer.”