Bill Ownbey OTR/L, CHT
Occupational Therapist, Certified Hand Therapist
Marcus Daly Rehabilitation
With the certain return of winter, we must deal with the cold weather,
wind and ice. However, there are some people that have more problems in
the cold. People with arthritis, Raynaud's phenomena and circulatory
diseases typically do not like the cold weather. These common conditions
will benefit from special attention during the winter months. Our hands
are extremely susceptible to pain and injury in the cold but with some
planning and maybe some special equipment one can enjoy outdoor activities
even with these conditions.
Arthritis can be especially painful in the cold. Some arthritis sufferers
claim that their joints let them know when it is going to storm. Although
there is sparse research on the effect temperature and barometric pressure
has on joint pain, one study from the Arthritis Foundation is a 2007 research
project from Tufts University in Boston which indicated that joint pain
increased with every 10 degree drop in temperature in arthritis subjects.
The same joint pain increase was observed with barometric pressure changes.
So there seems to be a correlation between arthritic joint pain and barometric
pressure changes and cold weather.
Raynaud's disease or as it is better described, Raynaud's phenomena
is a condition that can be very painful and limiting. People with this
condition often find that cold weather causes their fingers to turn blue
and then white but as the digits warm up they become red and swollen and
very painful and the pain can last for several hours. The condition is
called a phenomenon because it can also be brought on by stress or by
getting frozen food out of the freezer or even by just drinking cold beverages.
In cold weather what happens to our fingers is blood flow is restricted
as the body attempts to regulate the blood flow away from your extremities
and direct it to the core of your body. This regulation of blood flow
is important in that it helps the vital organs retain their appropriate
blood flow and body heat when it is cold outside but in Raynaud's
it is hypersensitive to the cold response. This cold response is when
the thermoregulatory receptors located in our fingers are stimulated by
the cold and the decrease in blood flow causes increased sensitivity in
the fingers.
Since our fingers have very densely packed nerves and they are close to
the skin, changes in temperature past a certain threshold are perceived
as pain. This is why our hands and fingers can hurt when they are exposed
to the cold.
Because of this cold response anyone with circulatory problems or peripheral
nerve conditions typically doesn't like the cold. But what can we
do to help our hands to enjoy the cold weather and not exceed the threshold
of the cold response that will cause pain? The obvious answer is to wear
gloves. It is true that keeping the hand and fingers warm is the most
effective way to avoid cold hands but the really helpful strategy is to
keep our core warm too. Layering using insulated base layers, vests, pants
and coats will keep the core warm so that our fingers thermoreceptors
do not have to regulate blood flow so much. Clothing, including gloves,
should also provide wind protection and moisture wicking because the wind
chill effect that can make even a mild day cold!
Mittens are often warmer than gloves and many people prefer to use both,
a light glove with a heavier mitten over it; this is layering for the
hands! The materials that these gloves are made of make a huge difference
in their effectiveness, so look for quality fabrics. One of the best resources
for warming products is the Raynaud's website,
http://www.raynauds.org/featured-products/
October is Raynaud's awareness month and the Raynaud's Association
is always searching for products to help people with the condition enjoy
outdoor activities but the products the association endorses are appropriate
for anyone suffering from hand pain due to the cold. Some examples include;
Verseo heated gloves, they are thin and supple, and when fully charged
will last up to 5 hours of continuous use and have a max setting of 95
degrees. Winter Leash is a product developed by Mike McMahon, a military
veteran and avid dog owner, for walking your dog in the cold; it is an
oversized mitt with two large handles inside for control. There is also
a pocket integrated in to the mitt to keep keys, hand warmers or anything
else "on hand"... like a poop bag. One new product is a cream
called Warm Skin that insulates the skin against cold and extreme weather
conditions. It is designed to be used before going outdoors and contains
higher concentrations of lanolin and other lotions to help form a protective
barrier for the skin. This product was tested on Mount Everest and several
NFL players have endorsed it. Warm Skin can be purchased at Target stores
or thru their website. For extreme heat needs the G-Tech Hand Warmer is
a pouch that is worn around your waist like those quarterbacks (think
Bears and Packers playing in minus 20 degrees). But the G-Tech pouch is
an instant hand warmer that can be turned on and off and the temperature
varied as needed. The rechargeable lithium battery is small and is integrate
into the pouch.
Whether we are outdoors hunting, watching a football game, playing in
the snow or just out walking dog, we need to be caring for our hands.
Questions and or comments regarding this week's health column please
contact, Bill Ownbey OTR/L, CHT at Marcus Daly Rehabilitation Center and
Services, a service of Marcus Daly Memorial Hospital, 1200 Westwood Drive,
Hamilton, MT 59840. Working together to build a healthier community!