Friday, November 11, 2011

Joints Under the Weather??

Ahhhh. The leaves are turning, the gym junkies are getting back outdoors to exercise and the weather is, well, unpredictable! And so are the joints!! This is the time of year where your foot and ankle specialists here at FAANT are seeing an jump in the number of patients who cannot keep their joints from aching! Good and bad days are here again!

So is it true that weather affects the joints? Surprisingly, there is not a lot of research on this subject. We have to look back at a study performed in 1961 by arthritis specialist Dr. J Hollander. He tested 12 patients in a climate chamber he built and discovered that low barometric pressure and high humidity caused an increase in pain and stiffness in joints. Each weather change individually, however, did not. This study had a very small number of patients, but it is true that there seems to be a certain number of people with arthritis whose symptoms are influenced by these climate changes. Is one of them you? How can we help?

While it is easy to tell you to control your symptoms with anti-inflammatories and rest, little is said about controlling your environment!

We can treat weather in the same way we treat environmental allergies. Many people stay indoors whenever there is a high count to whatever they are allergic to.
The same can be helpful when your weather trigger is present. Remember, individual environmental changes are not have as much infulence as the combination of the weather changes (ie: pressure and temperature). If you can identify what combo affect you, you will know when to limit outdoor time in these environments. I have many patients purchase a temperature gauge that also shows pressure and humidity to help find what their trigger is. Just as many of them have changed the humidity and temperature in their homes during certain times of the year when they consistently show flare ups. It does make a difference!

For others, it is more of a muscle cramp or spasm that worsens an arthritic joint. If you fall into this group, know that when the temperature drops, you need to properly warm up your muscles with stretches and slowly progress into the exercise. In other words, if you like to jog, start off with a brisk walk before you start jogging.

Weather also plays a role in joint pain with systemic conditions such as Raynaud’s phenomenon and Lupus.

Raynaud’s phenomenon in particular can be seen in a number of arthritic conditions such as polymyositis, scleroderma, systemic lupus erythematosus, rheumatoid arthritis and mixed connective tissue disease. When the weather turns cold, the small blood vessels in the extremities constrict, causing not only the digits to temporarily lose some circulation, but can in turn cause the joints to become stiff and painful as a result! Avoiding drastic changes in climate can make a big difference in this group of people. Though it cannot be said for all arthritic patients, if you have this condition, and it is severe, you may actually benefit by moving to a warmer climate.

Systemic Lupus Erythematosus without Raynauds could benefit from cooler climates. These patients are very sensitive to sun exposure. Exposure to ultraviolet light can trigger inflammation to internal organs, including the joints. If you fall into this group, limit sun exposure and protect with sunscreen and clothing.

If your feet or ankles are feeling “under the weather”, visit with your podiatrist and let them evaluate you! You may just end up discussing the weather!!

Tuesday, November 1, 2011

Snap, Crackle, Pop....My Ankle Hurts!

Snap, Crackle, Pop. Ankles are not supposed to make that noise.

It softball season and you just attempted to slide into second base and you managed to twist your ankle. You have done this before but this time it was followed by an audible snap you have not heard before. Oh yeah, and don’t mention that strange lump at the ankle you did not have this morning. You treat it like you have treated your previous ankle sprains, icing, elevation and trying to walk a little more gingerly, but it has not gotten better after several days, and any pressure to your foot is excruciating and unstable.

You may have an ankle fracture. Ankle fractures can typically occur during a violent injury like a car accident, fall from a height, or twisting motion of the ankle. The ankle consists of three bones that are bound to each other tightly by ligaments and allow motion of the foot up and down to allow for normal running in walking. When a fracture occurs the normal alignment of the bones of the ankle is lost as well as ligament integrity and instability, and pain ensues.

Ankle fractures need to be diagnosed and treated as soon as possible in order to provide the most appropriate treatment. Minor fractures can sometimes be treated with a period of immobilization while more major unstable fractures require surgery. If an ankle fracture is left untreated it can lead to chronic instability of the foot and ankle as well as chronic pain from arthritis.

Typical recovery from fracture to a normal shoe is around three months, so if you don’t want to miss next year’s softball season or possibly every softball season in the future, see a podiatrist immediately after any ankle injury.