Health Feel good this Winter! Winter weather getting you down? Here’s how to make the best of the season, ease your joint pain and boost your spirits Words: Georgina Wintersgill no-one likes cold, damp, windy weather, but people with arthritis often dislike it more than most. A 2004 Australasian study found that 74 per cent of people with arthritis believed their symptoms were affected by the weather. But is there really a link between weather and joint pain? Despite lots of research, there’s still no scientific consensus. However, a 2019 University of Manchester study, called ‘Cloudy with a chance of pain’, found that people with long-term pain conditions were more likely to experience pain when there was an increase in relative humidity or wind speed, or a decrease in atmospheric pressure, usually associated with unsettled weather. Read on for advice on how to manage symptoms during the winter months. Stay warm As the weather gets colder, it’s important to keep cosy. Consultant rheumatologist Dr Stephanie Kaye-Barrett (drstephaniebarrett.com) says: “Warmth increases the blood supply to muscles. Things loosen up, you have less pain and can move a bit better.” Dress in light, loose layers that are easy to take on and off, avoiding heavy, cumbersome clothes and fiddly fasteners. Keep a lightweight blanket out in case you need an extra layer. Some people find arthritis gloves helpful – these provide warmth and compression to improve circulation. There are fingerless versions to wear indoors. Dr Kaye-Barrett recommends warm water to ease painful joints. “Hydrotherapy has always been used to help people with rheumatic diseases,” she says. “Exercising in a warm swimming pool can be really helpful. It’s less painful because you get some support from the water; some people find it easier than exercising on land. A warm bath can help, too.” Heat packs or pads can be very useful for acute pains and strains; however, they don’t suit everyone. “Some people prefer a cold pack,” Dr Kaye-Barrett says. “It’s about trying, and seeing what suits you.” Get active Physical activity is well known to relieve joint pain. A 2008 American study found that people with arthritis who did two low-impact exercise sessions a week for eight weeks experienced significant improvements in pain levels. Unfortunately, most people are a lot less active in winter. A 2011 American study on people with arthritis aged over 60, found that, during the months with fewer daylight hours, participants spent three hours more per day sitting down, compared with the months that have more daylight hours. So how can you make exercise part of your routine when the days are short and the weather’s poor? Dr Kaye-Barrett suggests buying a stationary exercise bike or trying a low- impact exercise such as yoga, Pilates or tai chi. “An exercise bike helps with joints, keeps muscles strong, and keeps the blood flowing to the joints, muscles and heart,” she says. “Pilates builds strength, doesn’t seem to put too much stress on joints, and stops people getting too stiff. Tai chi is great for balance and strength. It also seems to help with mindfulness, which decreases pain signals.” Dr Kaye-Barrett stresses the benefits of seeing a physiotherapist, particularly as we get older. “They can create proper exercise routines to improve strength and balance, and give advice on moving safely, reducing the risk of falls.” If pain prevents you from exercising, see your healthcare provider to discuss whether your medication can be adjusted. Watch your weight Spending more time indoors in the winter can lead to piling on the pounds – and that’s something to avoid. “Excess weight puts pressure on the joints and also has an inflammatory effect on the body – so if you’ve got an inflammatory joint disease, things could become a lot worse,” says Dr Kaye-Barrett. Losing excess weight is one of the most important things you can do to reduce arthritis symptoms. A 2018 study at the University of Surrey found that a calorie-restricted diet, combined with exercise, was effective in reducing pain in overweight people with osteoarthritis. “If you’ve got a problem with your weight, ban cakes and biscuits from the house and find healthy options to nibble on instead, such as carrot sticks or nuts,” says Dr Kaye-Barrett. “Eat fresh fruit and vegetables; don’t eat too many carbohydrates; keep sugary, refined carbs to a minimum; and avoid anything with trans fats.” Sugary, refined carbs include sweets, chocolate, desserts and sugary drinks. Trans fats are found in fast food, processed food and fried food, as well as pies, pastries, cakes and biscuits. Take a vitamin D supplement Vitamin D is essential for healthy bones and muscles, and has a role in reducing inflammation. It’s also thought to help support a healthy immune system. However, many people are deficient, which means they aren’t getting enough of this important vitamin. Sunlight is our main natural source of Vitamin D, but during autumn and winter in the UK, there isn’t enough to get what we need. Vitamin D is also found in certain foods, such as oily fish, but it’s difficult to get enough through food alone. Certain groups are at higher risk of deficiency, including older people, people with dark skin, and people who spend a lot of time inside. The Department of Health recommends that everyone over the age of five should consider taking a daily vitamin D supplement in autumn and winter, and that people at higher risk should consider taking one throughout the year. Dr Kaye-Barrett says: “I test every single patient for vitamin D levels, and find that most are deficient. A lot of my older patients are very low in vitamin D, which makes them more at risk of stress fractures. I put them on quite high-dose supplements to start with, then move them on to a maintenance dose.” If you’re unable to access a test, she recommends taking 1,000 IU (international units) a day: “Most people do well on that, providing they’re not deficient to start with.” A 2017 Brazilian study found that vitamin D supplements, plus good-quality sleep, could help manage pain in conditions including arthritis. Keep connected Many people feel a bit low in the winter, perhaps because of a lack of sunlight or not getting out as much. But did you know that your mood can affect how much pain you feel? The 2019 University of Manchester study found that mood was strongly associated with pain in people with long-term pain conditions, including arthritis. Dr Kaye-Barrett says: “Some people have seasonal affective disorder (SAD), a type of depression that’s usually more apparent in winter, and, for them, using a light box – a special lamp that simulates exposure to sunlight – in the winter would be helpful.” If you can’t get out to see friends or family in person, why not chat online or on the phone? “It makes a huge difference to mood,” says Dr Kaye-Barrett. She adds: “I’m very much in favour of community building for people with different conditions, such as rheumatoid arthritis or fibromyalgia. If you can talk to, or interact with, other individuals or a group that knows about it, that can be really helpful.” Exercising in a warm swimming pool can be really helpful. A warm bath can help, too If you’ve got a problem with your weight, ban cakes and biscuits from the house and find healthy options to nibble, such as carrot sticks or nuts istock.com / Andrey Shevchuk istock.com / tommaso79 Health no-one likes cold, damp, windy weather, but people with arthritis often dislike it more than most. A 2004 Australasian study found that 74 per cent of people with arthritis believed their symptoms were affected by the weather. But is there really a link between weather and joint pain? Despite lots of research, there’s still no scientific consensus. However, a 2019 University of Manchester study, called ‘Cloudy with a chance of pain’, found that people with long-term pain conditions were more likely to experience pain when there was an increase in relative humidity or wind speed, or a decrease in atmospheric pressure, usually associated with unsettled weather. Read on for advice on how to manage symptoms during the winter months. Stay warm As the weather gets colder, it’s important to keep cosy. Consultant rheumatologist Dr Stephanie Kaye-Barrett (drstephaniebarrett.com) says: “Warmth increases the blood supply to muscles. Things loosen up, you have less pain and can move a bit better.” Dress in light, loose layers that are easy to take on and off, avoiding heavy, cumbersome clothes and fiddly fasteners. Keep a lightweight blanket out in case you need an extra layer. Some people find arthritis gloves helpful – these provide warmth and compression to improve circulation. There are fingerless versions to wear indoors. Dr Kaye-Barrett recommends warm water to ease painful joints. “Hydrotherapy has always been used to help people with rheumatic diseases,” she says. “Exercising in a warm swimming pool can be really helpful. It’s less painful because you get some support from the water; some people find it easier than exercising on land. A warm bath can help, too.” Heat packs or pads can be very useful for acute pains and strains; however, they don’t suit everyone. “Some people prefer a cold pack,” Dr Kaye-Barrett says. “It’s about trying, and seeing what suits you.” Get active Physical activity is well known to relieve joint pain. A 2008 American study found that people with arthritis who did two low-impact exercise sessions a week for eight weeks experienced significant improvements in pain levels. Unfortunately, most people are a lot less active in winter. A 2011 American study on people with arthritis aged over 60, found that, during the months with fewer daylight hours, participants spent three hours more per day sitting down, compared with the months that have more daylight hours. So how can you make exercise part of your routine when the days are short and the weather’s poor? Dr Kaye-Barrett suggests buying a stationary exercise bike or trying a low- impact exercise such as yoga, Pilates or tai chi. “An exercise bike helps with joints, keeps muscles strong, and keeps the blood flowing to the joints, muscles and heart,” she says. “Pilates builds strength, doesn’t seem to put too much stress on joints, and stops people getting too stiff. Tai chi is great for balance and strength. It also seems to help with mindfulness, which decreases pain signals.” Dr Kaye-Barrett stresses the benefits of seeing a physiotherapist, particularly as we get older. “They can create proper exercise routines to improve strength and balance, and give advice on moving safely, reducing the risk of falls.” If pain prevents you from exercising, see your healthcare provider to discuss whether your medication can be adjusted. Watch your weight Spending more time indoors in the winter can lead to piling on the pounds – and that’s something to avoid. “Excess weight puts pressure on the joints and also has an inflammatory effect on the body – so if you’ve got an inflammatory joint disease, things could become a lot worse,” says Dr Kaye-Barrett. Losing excess weight is one of the most important things you can do to reduce arthritis symptoms. A 2018 study at the University of Surrey found that a calorie-restricted diet, combined with exercise, was effective in reducing pain in overweight people with osteoarthritis. “If you’ve got a problem with your weight, ban cakes and biscuits from the house and find healthy options to nibble on instead, such as carrot sticks or nuts,” says Dr Kaye-Barrett. “Eat fresh fruit and vegetables; don’t eat too many carbohydrates; keep sugary, refined carbs to a minimum; and avoid anything with trans fats.” Sugary, refined carbs include sweets, chocolate, desserts and sugary drinks. Trans fats are found in fast food, processed food and fried food, as well as pies, pastries, cakes and biscuits. Take a vitamin D supplement Vitamin D is essential for healthy bones and muscles, and has a role in reducing inflammation. It’s also thought to help support a healthy immune system. However, many people are deficient, which means they aren’t getting enough of this important vitamin. Sunlight is our main natural source of Vitamin D, but during autumn and winter in the UK, there isn’t enough to get what we need. Vitamin D is also found in certain foods, such as oily fish, but it’s difficult to get enough through food alone. Certain groups are at higher risk of deficiency, including older people, people with dark skin, and people who spend a lot of time inside. The Department of Health recommends that everyone over the age of five should consider taking a daily vitamin D supplement in autumn and winter, and that people at higher risk should consider taking one throughout the year. Dr Kaye-Barrett says: “I test every single patient for vitamin D levels, and find that most are deficient. A lot of my older patients are very low in vitamin D, which makes them more at risk of stress fractures. I put them on quite high-dose supplements to start with, then move them on to a maintenance dose.” If you’re unable to access a test, she recommends taking 1,000 IU (international units) a day: “Most people do well on that, providing they’re not deficient to start with.” A 2017 Brazilian study found that vitamin D supplements, plus good-quality sleep, could help manage pain in conditions including arthritis. Keep connected Many people feel a bit low in the winter, perhaps because of a lack of sunlight or not getting out as much. But did you know that your mood can affect how much pain you feel? The 2019 University of Manchester study found that mood was strongly associated with pain in people with long-term pain conditions, including arthritis. Dr Kaye-Barrett says: “Some people have seasonal affective disorder (SAD), a type of depression that’s usually more apparent in winter, and, for them, using a light box – a special lamp that simulates exposure to sunlight – in the winter would be helpful.” If you can’t get out to see friends or family in person, why not chat online or on the phone? “It makes a huge difference to mood,” says Dr Kaye-Barrett. She adds: “I’m very much in favour of community building for people with different conditions, such as rheumatoid arthritis or fibromyalgia. If you can talk to, or interact with, other individuals or a group that knows about it, that can be really helpful.” Exercising in a warm swimming pool can be really helpful. A warm bath can help, too If you’ve got a problem with your weight, ban cakes and biscuits from the house and find healthy options to nibble, such as carrot sticks or nuts istock.com / Andrey Shevchuk istock.com / tommaso79 Feel good this Winter! Winter weather getting you down? Here’s how to make the best of the season, ease your joint pain and boost your spirits Words: Georgina Wintersgill