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Why does the cold make us hurt more? - (2/18/2020)

By Dr. Ron Gasbarro

An icy wind blew into the pharmacy as Fred walked in. “It’s painfully cold outside,” he exclaimed. “It always seems like the colder it gets, the more I hurt!” The pharmacist knew that Fred has a serious arm injury a few years before. The places where the right arm was broken appeared to be the main source of Fred’s pain. But why does the cold weather make certain parts of our body actually hurt more?

Many people complain that their once-injured backs hurt during cold weather. Back tenderness can occur because the muscles, tendons, and ligaments that support the spine tighten. This constriction puts a strain on the spinal column and yanks on the sensitive nerves that exit the spine. Joint pain can worsen if the joints are already inflamed because of arthritis. A drop in barometric pressure, as would occur in a blizzard or snow and rain event, can add to the swelling and discomfort of the joints. 

Research shows that a correlation exists between low temperatures and pain. A large 2012 Swedish study assessed 135,000 construction workers who spend several hours a day in frigid temperatures. The study investigators found that the outdoor workers, compared to people who spent most of their workdays inside, reported more occurrences of back and neck pain. A 2018 study show revealed that people who work the night shift are more sensitive to the cold and experience more pain than those who work daytime hours. The researchers explained this phenomenon as a shift in the perception of cold. A person who leaves his factory at 7 AM and walks into a 50-degree morning may feel colder and achier than does a person leaving the same factory at 3 PM and walking into a 50-degree afternoon.  

When our warm-blooded bodies confront the wintriness of the outdoors, a process called vasoconstriction takes place, during which the blood vessels narrow in the extremities to keep the body core – and the vital organs it houses – as close to 98.6 degrees as possible. The extra blood that the body conserves is diverted to the brain, heart, and lungs, to keep them warm and functioning. One can lose a finger and a couple of toes due to frostbite, but the warmed heart keeps beating steadily.

Scientific studies have revealed that the cold, dark days of winter contribute to a condition known as seasonal affective disorder (SAD) that can aggravate or outright trigger old injuries. SAD is a type of depression associated with late autumn and winter that researchers believe is caused by a lack of sunlight. The person may not sleep well, which amplifies existing minor pains. A person with typical aches and soreness brought on by cold temperatures can feel better after a hot shower and a steaming bowl of soup. However, the SAD person is trickier to treat. 

Melatonin, an herbal remedy found in many pharmacies and health food stores, may help the person sleep better. Ask the pharmacist for dosing instructions. The person who gets SAD every year may benefit from taking the prescription antidepressant, bupropion. Because this drug takes a few weeks to work, starting daily therapy in early November may cover the person from the first snow to the first sign of spring. Research demonstrates that light therapy can perk up people in throes of their winter malaise. These “happy lamps” mimic the sunlight that the body craves throughout the coldest season. 

Certainly, over-the-counter analgesics may alleviate some of the pains heighten by the cold. The trick is to stay active, eat lots of fruits and vegetables, stay hydrated, and find the warmest spot you can. 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com.

 


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