As the temperature drops sharply, bones become more fragile. Especially for the elderly and some middle-aged women who originally suffered from joint and bone diseases, bone health problems have become a “worry” in winter. There are a lot more outpatients than usual, and many osteoarthritis patients complain of recurrence or worsening of joint pain, which can be compared to the “weather forecast” of walking.
Although cold stimulation is not a causative factor of osteoarthritis, it can induce or aggravate joint pain and stiffness. This is mainly due to the fact that the joints are superficial and have less subcutaneous fat. They are particularly susceptible to cold stimulation, which causes the blood vessels around the joints to constrict, causing poor blood circulation, thereby reducing the supply of oxygen and nutrients around the joints, making the joints more susceptible to damage and pain. Low temperature and poor blood circulation will also cause inflammatory mediators and pain-causing substances to be unable to be metabolized in time and accumulate around joints. These substances can trigger inflammatory reactions and aggravate joint pain and swelling. Muscle tension in the cold winter is also one of the factors causing joint pain. Cold temperatures make muscles more likely to tense and contract. Tight muscles put extra pressure on joints, increasing the burden on them and causing more pain and discomfort.
How can we protect our joints this winter?
First of all, pay attention to keeping warm and try to avoid prolonged exposure to wet and cold environments. In particular, protect joints such as hands, feet, ankles, knees, and elbows. Using a hot water bottle or electric blanket to provide localized warmth is a good method, but care should be taken that the temperature should not be too high. Soak your feet in warm water for 15 to 20 minutes before going to bed, and gently massage your feet at the same time, which can help relax muscles and improve blood circulation. Wearing protective gear is also a good idea. Joint braces can provide extra support and stability, taking the load off your joints. However, you should pay attention to the following points: avoid wearing them continuously for a long time to prevent muscle atrophy and joint stiffness; the protective gear should be close to the skin but not too tight to avoid affecting blood circulation; the skin should be checked regularly for rashes or irritations.
Followed by moderate aerobic exercise. It is a mistake to remain inactive for long periods of time out of fear of pain. Rest cannot delay joint aging, but will aggravate aging due to disuse. Moderate aerobic exercise can not only help enhance muscle support, keep joints flexible, reduce stiffness, and improve blood circulation; it can also enhance cardiopulmonary function. You can choose gentle exercise, such as walking, jogging, cycling, Tai Chi, water sports and swimming (in a heated pool), but sports such as mountain climbing and stair climbing are not suitable for patients with osteoarthritis. What should be noted here is that proper warm-up and stretching should be carried out before and after exercise to help the joints adapt to the movement state.
When exercising, you should listen to your body’s signals. The amount of activity should be comfortable and slightly sweaty. Avoid strenuous or long-term exercise to prevent excessive burden on the joints. It is recommended to choose low-intensity exercise at the beginning and gradually increase the intensity and time of exercise according to individual conditions. If you feel severe pain or discomfort while exercising, stop immediately and rest.
Functional exercises are also very important, especially muscle strength and joint range of motion training. Because weakness of muscles and ligaments around joints is one of the important factors that aggravates the progression of osteoarthritis, especially patients with knee osteoarthritis, they should exercise the strength of the front thigh muscles (quadriceps), including isotonic strength training and isometric strength. train. For example, the key points of quadriceps isotonic training (straight leg raising method) are to lie flat, straighten the affected limb, raise it 30 degrees, maintain it for 5 to 10 seconds, relax and rest for 5 to 10 seconds, 10 to 15 times per group. 3~6 groups/day. The key point of quadriceps isometric training is to lie flat and straighten your lower limbs, tighten your thighs so that the back of your knees are close to the bed, hold for 10 seconds and then relax, 10 times/group, 2 to 3 groups/day. Proper joint movement can improve blood circulation and maintain normal joint range of motion. Active or assisted joint activities should be carried out within a range that does not cause obvious pain, such as lower limb activities in a sitting or lying position.
The third is good living and eating habits. In winter, you should ensure adequate sleep and avoid overexertion. Try to avoid going up and down stairs, standing for long periods of time, sitting for long periods of time, squatting for long periods of time, and lifting heavy objects to avoid increasing the burden on the joints and aggravating the condition. Women should try to avoid wearing high heels and wear comfortable and elastic soft-soled shoes to reduce the impact on joints. For older adults, appropriate assistive devices such as crutches or walkers can provide additional support and reduce strain on joints. Chronic pain can lead to anxiety and depression. Maintaining a positive attitude and maintaining good communication with family and friends can help reduce the psychological stress caused by pain.
It’s important to eat a balanced diet that includes enough vegetables, fruits, whole grains, protein and healthy fats to help provide the nutrients your joints need. There is also adequate calcium and vitamin D intake to maintain bone health; food sources include dairy products, fish and egg yolks. The intake of anti-inflammatory foods is also necessary. Some foods have anti-inflammatory properties that can help reduce the symptoms of arthritis. These foods include fish (such as salmon, cod), olive oil, nuts, fruits (such as blueberries, strawberries), etc. Maintaining proper fluid intake helps lubricate joints. You should also pay attention to weight control in winter. Excessive weight will increase the burden on the joints and accelerate the wear and tear of articular cartilage, especially the knee joints. Losing weight can help reduce joint pain. It’s important to note that being too thin or too heavy can have a negative impact on bone health, and maintaining a stable weight, rather than repeatedly losing and regaining it, can help maintain bone density.
Once osteoarthritis develops, it must be treated promptly to avoid worsening of the condition. In addition to the above methods, symptoms can also be relieved through physical therapy, medication, etc. Physical therapy includes techniques such as massage, heat, cold, electrical stimulation, and ultrasound, which can be used to reduce pain and improve joint function. Oral anti-inflammatory analgesics such as celecoxib can relieve pain and reduce inflammation, but they have side effects such as gastrointestinal tract. Patients with gastritis, gastric ulcer, and gastric bleeding should use the medication with caution. External medications such as loxoprofen sodium gel patch have fewer systemic side effects, but attention should be paid to skin allergies. Winter is crucial for joint health in older adults. Cold weather can exacerbate joint problems, causing pain and discomfort. Therefore, special attention should be paid to the above measures to protect the joints; work with your doctor to obtain a personalized management plan.
Finally, I would like to remind you that bone health is not something that happens overnight, but is the result of long-term persistence of “nutrition + exercise + healthy lifestyle”. Especially in the cold winter, you should try to maintain moderate exercise and sufficient sun exposure.
(Authors: Shan Haojie and Yu Xiaowei are resident physicians and chief physicians respectively at the National Orthopedic Medical Center, Shanghai Sixth People’s Hospital)