Q: My hands ache in the winter but are fine in the summer. Does this mean I have arthritis?
Rheumatoid arthritis and osteoarthritis are two common types of arthritis that can cause a dull, burning pain in the joints of our hands, but they are very different diseases. Rheumatoid arthritis is an autoimmune disease that happens when our immune system isn’t working properly and attacks the cushion of cartilage that rests between the bones in our joints. This causes pain and stiffness in the joint that feels worse in the morning, usually lasting more than an hour, and after periods of inactivity. Symptoms are generally equal in both hands and can sometimes be associated with fatigue, fever and a low appetite. With time, inflammation in the joints may cause the finger joints to start to curve away from the thumb.
Osteoarthritis occurs when the cartilage between our joints breaks down due to an injury or from daily wear and tear. As a result, the bones on either side of the cartilage start to touch and bone spurs start to grow in those areas. These growths cause pain and stiffness in the joint, making it difficult to fully open and close your fingers. You may even hear a grating or crackling sound when you try. Osteoarthritis affects single joints; therefore, symptoms are not necessarily the same in both hands and pain generally increases with prolonged use. With time, lumps may develop at the joint causing the joint to become swollen or deformed.
Cold winter weather doesn’t cause arthritis, but it can make your aches and pains feel worse. The cartilage and bones in our joints are surrounded by a lubricating fluid that keeps our joints moving freely just like oil on a hinge. Arthritic joints stiffen because the lubricating fluid reacts to the cold by becoming thick and making it harder for the joint to move, leading to pain and discomfort.
There are other reasons your hands may ache in winter weather that are not associated with having arthritis. Exposure to cold temperatures can cause the blood vessels in our hands to shrink which leads to decreased blood flow to our hands resulting in pain. Cold weather also makes it harder for the muscles, tendons and ligaments in our hands to fully extend as we move our hands and can trigger painful muscle spasms. Another reason is that the skin on our hands may become irritated or inflamed with exposure to cold temperatures and this can heighten our pain sensitivity where a minor injury can feel incredibly painful.
Having any of the above happen to you can have potentially dangerous side effects for your hands. Experiencing decreased hand movement and grip strength can put you at an increased risk of injury when performing tasks with your hands. If there is continued exposure to frigid temperatures, you increase your risk of developing frostbite. Pain, tingling, burning, numbness and aching are all signs from your body that you need to get inside and warm up.
Keeping your hands warm is the best way to avoid these things and to prevent an arthritis flare-up. You don’t have to wait for the ground to be covered in snow before you start protecting your hands. Once the temperature drops below 10°C it is time to start wearing light gloves, and as the temperature drops below -4°C change to lined mittens or gloves to keep your hands warm and prevent joint stiffness. On really cold days, or when you are outside for long periods of time, try putting hand warmers in your mittens to warm your hands faster and keep them warmer for longer.
If your hands ache while indoors, try to keep them moving because movement increases blood flow to your hands. Simple exercises like gripping a ball or rubbing your hands together are enough to get the blood circulating.
When warmth and movement are not enough to keep the pain away, you can speak to your pharmacist about trying herbal remedies such as turmeric or glucosamine. There are also pain-relieving creams such as those containing capsaicin or the anti-inflammatory diclofenac. They can also assess if pain relievers such as naproxen, ibuprofen or acetaminophen are right for you.
If your joints begin to change in shape and size or you experience persistent swelling, redness, numbness or the sensation of pins and needles it is time to book an appointment with your doctor or nurse practitioner for further investigation.
Erin Thompson (BSc, BScPharm) is a graduate of Dalhousie University and a community pharmacist practicing at Shoppers Drug Mart in Quispamsis N.B. Her opinions expressed in this column are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment.