What about Weather Changes?

By James N. Dillard, M.D.

Why do your joints ache when the weather changes? Were you ever reluctant to say this to a doctor for fear that he might think you were crazy? Well, you certainly may be crazy, but perhaps for other reasons, not this one. Bones and joints do get painful with the change of seasons.

Since the time of Hippocrates, doctors have observed the worsening of arthritis pain with cold, damp weather. In Chinese medicine, the diagnosis for arthritis and rheumatism is called feng shi bi or wind-damp-cold disease. The symbol for feng shi bi also means rheumatism in several Asian languages.

The ancient observation that joints ache with weather changes is backed up by modern research. Tiny gas cysts in abnormal arthritic bone and cartilage tissue can sense changes in air pressure, such as the drop in barometric pressure of an approaching storm front. Distortion of these tiny air pockets will produce pain. Arthritis is the most common chronic medical condition in the United States.

There are two basic types of arthritis, common wear-and-tear osteoarthritis and inflammatory arthritis. In inflammatory arthritis, the immune system attacks your own tissues, damaging the joints. Inflammatory arthritis includes such diseases as rheumatoid arthritis, lupus, gout, psoriatic arthritis, and others. The more common reason for painful joints is garden-variety osteoarthritis, also called degenerative joint disease. In this condition, the cartilage that cushions the moving surfaces in the joint wears down with time, causing stiffness, pain, and decreased movement.

Although almost everyone over 40 years old has some evidence of osteoarthritis, it doesn’t usually cause pain. If you X-ray 100 people in their 50s who have no joint pain at all, virtually every one of them will show arthritic changes in their shoulders, knees, hips, fingers, or spine. In other words, common arthritis does not have to be painful. And if you do have pain from arthritis, it can be quieted down, even without drugs.

According to the Centers for Disease Control and Prevention, one in five Americans carries a diagnosis of arthritis, but this goes up to one in two people over age 65. Osteoarthritis, or OA, is more common in those who put stress on their joints, such as football players, manual laborers, and the obese.

Most regular doctors will give analgesic medicines of the aspirin class, such as ibuprofen, Naprosyn, Celebrex, Mobic, or others, for symptomatic OA. Previously, there was an effort to avoid these widely-prescribed anti-inflammatory medicines and just give Tylenol, as OA was thought not to be inflammatory. More recent research has shown the presence of chronic low-level inflammation in the tissues lining osteoarthritic joints. Still, it’s best to stay away from long-term use of these aspirin-like drugs, as they can injure the stomach and the kidneys.

Quality physical therapy, weight loss, muscle stretching, exercise, and gentle joint mobilizations are the hallmarks of effective conservative therapy for OA. If the ligaments and tendons that hold joints together are excessively tight or weak, they can cause wear and stress on the joint cartilage, further degrading the joint.

Swimming and yoga are two of the best things you can do for spinal and large-joint arthritis. These tend to be low weight-bearing activities, and lend flexibility to the muscles and joints. The Arthritis Foundation has more terrific self-care information at arthritis.org. For those who don’t use the Internet, you can call 800-283-7800 for information and free brochures.

In recent years, there has been increasing research evidence for the use of acupuncture for arthritis pain. Dr. Robert Kelly of the Cleveland Clinic has a nice review of the science in the September 2009 issue of American Family Physician. Acupuncture is certainly worth trying, especially if you don’t like taking drugs.

The anti-inflammatory version of the Mediterranean diet will quell low-grade inflammation, helping with achy joints. Adequate omega-3 fatty acids from deep-water fish are important as well. Cooking with plenty of ginger, turmeric, garlic, rosemary, walnuts, virgin olive oil, flax seeds, and other anti-inflammatory foods can allow you to dine on your medicines rather than swallow them from a pill bottle.

Many people respond to 1,500 milligrams of glucosamine and 1,200 milligrams of chondroitin taken each day in a combined supplement. Allow at least two to three months for it to work. There is solid research for OA pain relief with a new more absorbable form of the traditional Indian medicinal herb curcumin combined with black pepper. Consult with a nutritionally-trained practitioner who is current on this data for a specific program.

On the medical side, orthopedists and pain doctors can inject arthritic joints with local anesthetic and cortisone, which often gives months of relief. If the joint loses more cartilage and approaches the bone-on-bone stage, joint replacement should be considered. These surgeries are usually quite successful, giving back a good quality of life.

Arthritis is just one of those things you’re likely to get if you live long enough. In the words of Jack Benny, “I don’t deserve this award, but I have arthritis and I don’t deserve that either.” The good news is that with excellent care, exercise, and nutrition you can have well-deserved pain-free movement and an active life.