Cold Hands and How to Care for Them

This year’s winter has been cold, wet and rainy, leading to many questions about the relationship between weather and pain. In honor of National Women’s Physician Day, we spoke with Hoag Orthopedic Institute (HOI) hand and wrist surgeon, Joanne Zhang, MD, MBA, to get her expertise on cold hands and how to care for them in the chilly weather.

It has been colder than usual in Southern California and many folks complain of more soreness in their hands or finger joints during cold, wet weather. What does the weather do to our joints?

Unfortunately, we do not yet fully understand why different types of weather seem to affect joint pain. Our joints are lubricated with synovial fluid, which is produced by a type of tissue called synovium that lines the inside of our joints. Some research suggests that cold weather or drops in barometric pressure in the atmosphere may increase synovial fluid viscosity and thus increase pressure in your joints, leading to increased joint pain. Synovium tissue is also highly vascularized, and these blood vessels can constrict during cold weather and may be unable to deliver pain-modulating signals from the body.

Many older adults experience pain in their fingers and hands. How to you tell the difference between arthritis symptoms and just plain soreness?

Arthritis is typically accompanied by joint swelling, stiffness with prolonged rest, gradual loss of motion or increased stiffness over time, and sometimes sensations of clicking or catching in the joint with motion. Finger arthritis may also show up as small bumps and increasingly knobby appearance of the joints and knuckles, sometimes with cyst formations over the tops of those joints.

What about cold hands or fingers? Some experience coldness or numbness in their fingertips especially. Anything to take notice of or self-treatment tips?

As we age, we commonly have less effective blood circulation to our fingertips. Coldness or numbness in your fingertips in cold weather is typically due to poor circulation. Wearing weather appropriate gloves or using electronic handwarmers can typically help combat these symptoms. If you have cold fingers and your fingers turn blue or white when exposed to cold temperatures, you may have either Raynaud’s syndrome or Raynaud’s phenomenon. In this case you should talk to your doctor about whether further tests are needed to make sure nothing more serious is going on. Numbness in your fingertips that does not go away once your fingers warm up may be an underlying nerve issue and should also be something to discuss with your doctor.

What are some common misconceptions about our hands as we grow older? Is strengthening the hands with simple exercises a good thing for all of us?

Just like with the rest of our bodies, our hands will not always look the same as we age. We all may lose some level of strength in our hands as we age, but increasing clumsiness, hand numbness, and feeling like you are dropping things or unable to do typical daily tasks like buttoning up your shirt or putting on your necklace are typically not part of the normal aging process and should be looked into with your doctor.

Are there any new medications or methods of treatment for arthritis of the hands that you use or have taken notice of?

Arthritis pain in the hands is still first treated with non-steroidal anti-inflammatory medications (NSAIDs). These range from over-the-counter options like ibuprofen and naproxen, to prescription options like meloxicam and celecoxib. Steroid injections, also known as cortisone shots, can also help with pain control in the setting of arthritis. The jury is still out on hyaluronic acid and platelet-rich-plasma (PRP) injections for the treatment of arthritis in hands – some research supports this, but they are still relatively new techniques. The field of hand surgery for arthritis treatment has been changing very quickly. With new types of implants and minimally invasive surgical options to treat arthritis in the wrist, hand, and fingers – which have come out in recent years - we are beginning to see more and more options for patients.