Cold Weather Joint Support

Joint Anatomy

Although there are multiple types of joints in the body, it is the synovial joints that are commonly susceptible to weather-related discomfort. A synovial joint has two bone ends covered by articular cartilage that is smooth and reduces friction during movement. Surrounding the bones is a joint capsule consisting of an outer fibrous layer that provides stability and an inner layer known as the synovial membrane that secretes synovial fluid to lubricate the joint. Discomfort in the joint may arise from numerous factors including those affecting articular cartilage, subchondral bone, the joint capsule, and swelling and immune reactions in the synovial membrane. Joint discomfort is mediated by receptors (nociceptors), which are nerve fibers that can be excited by various stimuli including pressure, stretch, temperature, or chemical mediators associated with swelling or damage. Modulation of these factors can alter the perception of discomfort.

Weather, Temperature, and Joint Health

Many individuals with transient seasonal joint discomfort attribute changes in weather or temperature as contributing factors. Although researchers debate this topic in the literature, several studies report that certain meteorological changes influence common joint aches.

An interesting study evaluated weather patterns and joint comfort. In this study, 53 subjects completed a daily questionnaire regarding hip symptoms for one month. Data was collected from the nearest weather station regarding precipitation, atmospheric pressure and temperature. The results indicated that reported hip discomfort correlated to absolute change in atmospheric pressure from one day to the next.¹ A similar study evaluated weather variables and knee discomfort in 200 subjects with an average age of 60 years over 3 months. Weather values were collected daily from the weather station closest to each subject including temperature, barometric pressure, dew point, precipitation, and relative humidity. The study showed a consistent association between both ambient temperature and pressure changes with the extent of the knee discomfort.²

In another study, 70 subjects with an average age of 43 years completed a questionnaire regarding symptoms and weather changes. The questionnaire showed that the subjects could reliably identify which meteorologic variables influenced their discomfort. Temperature was reported by 87 percent of subjects and humidity was reported by 77 percent of subjects as the meteorologic variables, which most frequently affect their discomfort. Eighty-two percent of the subjects reported joint aches and 79 percent reported muscle aches as the symptoms associated with weather variables.³ An additional study showed that subjects reported increased joint discomfort the day after the advent of a cold wave, and reported more discomfort in the first 2 months during the cold wave period than in the next 2 months when the cold wave period had ended. The study authors suggest that dramatic weather changes such as a sudden cold wave might influence the experience of joint discomfort.⁴ In addition, this time of year has fewer hours of sunlight. Research indicates that increasing number of sunlight hours is associated with decreasing proportion of individuals with joint discomfort.⁵

In another study, investigators evaluated the association between working in a cold environment, such as a cold storeroom, and low back discomfort. The subjects included 122 male storeroom workers between 20-45 years of age. The subjects were assessed for the presence of low back discomfort over the previous 12 months. The study showed that the males who worked in a cold environment had 3 times the likelihood of having low back discomfort and nearly 5 times the likelihood of having low back discomfort while at work, compared to the subjects who worked at room temperature.⁶

The mechanism for this relationship between atmospheric pressure and temperature with joint discomfort is unknown. Several theories exist to explain this association. One theory suggests that because fluid viscosity is reduced at lower temperatures, the fluid flow within the joint is decreased. Another theory proposes that stress relaxation of polymeric molecules such as those of the extracellular matrix is faster at higher temperatures, thus at lower temperatures there are changes to the matrix mechanisms affecting cartilage viscoelasticity.⁷ A third model suggests that nerve fibers within the joint are more sensitive at lower temperatures. Animal models indicate that experimentally induced inflammatory response and swelling in the joints results in increased firing of specific nerve fibers when the temperature was reduced compared to rats without swelling in the joints at low temperatures or rats with swelling of the joints at room temperature. The researchers concluded that cold hypersensitivity causes increased firing of afferent nerves with chronic joint swelling.⁸

Joint Health Support

Numerous studies support the use of botanicals and other natural products to support joint health. Turmeric (Curcuma longa) and Indian Frankincense (Boswellia serrata) (as found in EnFlex™) help ease occasional inflammatory discomfort by modulating the inflammatory response. A randomized, double-blind, placebo-controlled trial with Boswellia showed enhanced joint comfort and knee range of motion among other benefits for helping maintain knee health.⁹ A similar study demonstrated that turmeric supplementation offers similar benefits.¹⁰ Animal models indicate that turmeric promotes a healthy inflammatory response and may help protect the structural integrity of bones and joints.¹¹ EnFlex also contains DL-phenylalanine and the proteolytic enzyme nattokinase. Proteolytic enzymes influence the natural inflammatory response, minimize swelling, and directly affect nociceptors.¹² DL-phenylalanine also modulates the inflammatory response as well as inhibits enkephalinase, the enzyme that breaks down enkephalins, which are the body’s natural opioid modulators of nociceptors.¹³

Overall joint health can be supported with glucosamine sulfate, chondroitin sulfate, methylsulfonylmethane (MSM), Type II collagen including hyaluronic acid, plus vitamins and minerals such as folic acid, vitamin B12, molybdenum, potassium and silica (all found in Joint Support Formula).

Glucosamine is a precursor in the synthesis of glycosaminoglycans and proteoglycans in the cartilage matrix of joints, and stimulates the production of hyaluronic acid by synovial tissue.¹⁴ Chondroitin is a glycosaminoglycan that is part of the proteoglycan structural component in the joint cartilage, and provides much of its resistance to compression. In one clinical trial, subjects received 500 mg of glucosamine sulfate 3 times daily for 12 weeks. Over 70 percent of the subjects showed overall enhanced knee comfort, and 74 percent of subjects reported enhanced joint health.¹⁵ A similar study found joint support benefits after 12 weeks of glucosamine sulfate supplementation in 77 percent of the subjects while 69 percent reported enhanced physical function.¹⁶ Another study evaluated the effect of 800 mg chondroitin sulfate daily or placebo on knee health. The study showed enhanced comfort and enhanced functional ability in the chondroitin sulfate group compared to the placebo group.¹⁷ Both glucosamine and chondroitin sulfate have been shown to offer protection for joint tissue maintenance.^18-19

Methylsulfonylmethane (MSM) has also been studied in knee health. MSM was supplemented at a dose of 1.125 grams 3 times daily for 12 weeks. Compared to placebo, MSM supplementation appeared to promote normal physical function and comfort.²⁰ Research has also shown that the combination of MSM and glucosamine is more efficacious with a more rapid onset at enhancing comfort and improving the functional ability of joints than placebo or either supplement alone.²¹ Type II collagen was also evaluated in a 90-day supplementation trial. The subjects receiving Type II collagen reported significantly better knee comfort and enhancement in daily activities.²²

Another effective tool to support joint comfort is Incredisocks and Incredibraces, which can help ease common, everyday aches. These products are made with a blend of bamboo charcoal and germanium, which work by increasing blood flow, thereby improving oxygen supply to tissues, which results in improved comfort and reduced swelling.²³ The increase in blood flow also allows the body to regulate temperature much easier, enhancing the ability to stay warm in cool weather. Thermographic images show significant improvement in circulation after use of the socks and braces, with increased blood flow by 50 percent.²³ Additionally, thermographic imaging comparing Incredisocks to regular socks showed maximum area temperature of the non-Incredisock foot was 29 degrees while the Incredisock foot was 32.6 degrees.^24-25 Incredisocks can also help keep the feet warm in the winter.

Conclusion

It is not uncommon to experience minor joint discomforts due to changes in atmospheric pressure and decreasing temperature. Several natural products can help enhance comfort and optimize joint function, such as EnFlex, Joint Support Formula, and Incredisocks and Incredibraces.

References

1. Brennan SA, Harney T, Queally JM, et al. Influence of weather variables on pain severity in end-stage osteoarthritis. Int Orthop. 2011 Jun 29. Published Online Ahead of Print.

2. McAlindon T, Formica M, Schmid CH, et al. Changes in barometric pressure and ambient temperature influence osteoarthritis pain. Am J Med. 2007 May;120(5):429-34.

3. Shutty MS Jr, Cundiff G, DeGood DE. Pain complaint and the weather: weather sensitivity and symptom complaints in chronic pain patients. Pain. 1992 May;49(2):199-204.

4. Tsai WS, Yang YH, Wang LC, et al. Abrupt temperature change triggers arthralgia in patients with juvenile rheumatoid arthritis. J Microbiol Immunol Infect. 2006 Dec;39(6):465-70.

5. Tokumori K, Wang DH, Takigawa T, et al. The relationship between joint pain and climate conditions in Japan. Acta Med Okayama. 2011 Feb;65(1):41-8.

6. Dovrat E, Katz-Leurer M. Cold exposure and low back pain in store workers in Israel. Am J Ind Med. 2007 Aug;50(8):626-31.

7. June RK, Fyhrie DP. Temperature effects in articular cartilage biomechanics. J Exp Biol. 2010 Nov 15;213(Pt 22):3934-40.

8. Takahashi K, Sato J, Mizumura K. Responses of C-fiber low threshold mechanoreceptors and nociceptors to cold were facilitated in rats persistently inflamed and hypersensitive to cold. Neurosci Res. 2003 Dec;47(4):409-19.

9. Kimmatkar N, Thawani V, Hingorani L, et al. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee–a randomized double blind placebo controlled trial. Phytomedicine. 2003 Jan;10(1):3-7.

10. Kuptniratsaikul V, Thanakhumtorn S, Chinswangwatanakul P, et al. Efficacy and safety of Curcuma domestica extracts in patients with knee osteoarthritis. J Altern Complement Med. 2009 Aug;15(8):891-7.

11. Taty Anna K, Elvy Suhana MR, Das S, et al. Anti-inflammatory effect of Curcuma longa (turmeric) on collagen-induced arthritis: an anatomico-radiological study. Clin Ter. 2011 May-Jun;162(3):201-7.

12. Klein G, Kullich W. Reducing pain by oral enzyme therapy in rheumatic diseases. Wien Med Wochenschr. 1999;149(21-22):577-80.

13. Ehrenpreis S. Pharmacology of enkephalinase inhibitors: animal and human studies. Acupunct Electrother Res. 1985;10(3):203-8.

14. Uitterlinden EJ, Koevoet JL, Verkoelen CF, et al. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants. BMC Musculoskelet Disord. 2008 Sep 11;9:120.

15. Dudek A, Raczkiewicz-Papierska A, Tłustochowicz W. Efficacy of glucosamine sulfate treatment in patients with osteoarthritis. Pol Merkur Lekarski. 2007 Mar;22(129):204-7.

16. Bennett AN, Crossley KM, Brukner PD, et al. Predictors of symptomatic response to glucosamine in knee osteoarthritis: an exploratory study. Br J Sports Med. 2007 Jul;41(7):415-9.

17. Uebelhart D, Malaise M, Marcolongo R, et al. Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a one-year, randomized, double-blind, multicenter study versus placebo. Osteoarthritis Cartilage. 2004 Apr;12(4):269-76.

18. Bruyere O, Pavelka K, Rovati LC, et al. Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies. Menopause. 2004 Mar-Apr;11(2):138-43.

19. Hochberg MC. Structure-modifying effects of chondroitin sulfate in knee osteoarthritis: an updated meta-analysis of randomized placebo-controlled trials of 2-year duration. Osteoarthritis Cartilage. 2010 Jun;18 Suppl 1:S28-31.

20. Debbi EM, Agar G, Fichman G, et al. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complement Altern Med. 2011 Jun 27;11:50.

21. Usha PR, Naidu MU. Randomised, Double-Blind, Parallel, Placebo-Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination in Osteoarthritis. Clin Drug Investig. 2004;24(6):353-63.

22. Crowley DC, Lau FC, Sharma P, et al. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int J Med Sci. 2009 Oct 9;6(6):312-21.

23. The test of acceleration in blood circulation by Taiwan Textile Research Institute tells that the speed of blood flowing increases above 50 percent. <The authentication No: FK991116-00.IMG, TFF4G123, TFF4K288>.

24. The test of fabrics about deodorizer, antibacterial and anti mildew by Taiwan Textile Research Institute. <The authentication No: TFF3J353>.

25. Tested 4/22/2010 Thermal Imaging Consultants LLC, Reno Nevada <Taiwan Textile Research Authentication: Fk99116-00, TFF4G123, TFF4K288)>.