The Heat Is (Still) On For People In Pain
By: Joseph Pergolizzi, MD, Healthy Directions
The dog days of summer may have come to an end, but the heat of summer may still be taking a toll on many people dealing with arthritis and other conditions. Pain and heat don’t mix well and can make pain issues worse.
How Heat Affects Pain
The science behind how extreme weather changes can affect a person’s pain levels is not completely clear. However, we know from the medical literature that heat can trigger intense pain based on many documents by physicians who have treated patients who suffer more painful symptoms in hot weather.
One theory is that the increased humidity in the air can cause swelling and inflammation in the joints. Temperature sensitivity is common for people with chronic conditions such as fibromyalgia — some being sensitive to hot weather, while others are more sensitive to cooler weather.
Some patients with arthritis report that they can predict the weather based on how their joints feel. Some people notice their pain and stiffness flares up in the cold and wet winter months, while others find hot and humid summer weather can intensify their symptoms.
Scientists have identified that muscles, bones and tendons become larger and smaller in response to atmospheric changes, but exactly how and why barometric pressure changes affect the joints is still unclear. It could be related to the pressure of the fluid oiling the joints or increased nerve sensitivity. Each person’s response to heat may also depend on the type of arthritis they have.
While further study is needed to provide insight into how extreme heat affects pain, there are several strategies that we can access now to minimize heat induced pain.
Hydrate, Hydrate, Hydrate
We’ve all heard this advice before: you don’t want to wait until you are parched to start drinking water — continue to hydrate all day long even if you don’t feel thirsty.
The obvious advice is to drink water. The not-so-obvious advice is to drink food. Yes, the good news is that hydration can also come in the form of food since certain foods are high in water content. According to the Mayo Clinic, about 20% of our water consumption comes from foods – primarily fruits and veggies. So indulge in hydrating foods like: watermelon, cucumbers, zucchini, celery, carrots, radishes, kiwi, peaches, cantaloupe, eggplant, tomatoes, strawberries, iceberg lettuce, pineapple, grapefruit, apples and even potatoes, which contain about 80% water and are a good source of potassium, a key mineral in maintaining healthy blood pressure.
You may not want to hear this advice, but limiting alcohol and caffeine is key to staying hydrated. It’s not that you have to eliminate caffeine and alcoholic beverages, but try to alternate them between a large glass of water to keep your hydration in check.
Avoid Direct Sun
The sun may feel fantastic on your skin at first, but the heat is secretly doing it damage. Even staying hydrated and slathering on lotion and creams will not put back all the moisture that the sun drains away from it so quickly. Every moment spent in the shade allows your skin to repair itself and reduce the chances of sunburn, which can cause skin damage and intensify any existing aches and pains.
During the summer months, never leave home without a wide-brim hat and sunglasses. Some people even find an umbrella helpful so you are producing your own shade wherever you go. Whenever possible, move towards the shade and avoid walking or sitting in the direct sunlight.
Those who suffer from headaches should avoid bright sunlight as much as possible. While just being out in the heat stresses your body, direct sunlight can cause sunburn and intensify pain.
Mix Sunscreen With Pain Cream
We know the benefits of protecting the skin from being burnt by the sun by using sunscreen, but adding some pain cream to that sunscreen will also help mitigate painful muscle spasms, which can occur even if you have never had them before, and especially if the body gets too warm and can’t cool itself down fast enough. An effective pain relief cream can work much faster than oral pain medications, usually within a few minutes, and you are able to target the pain relief more precisely by putting the cream exactly where you are feeling the pain. Topical pain relief creams have been so effective for my patients, that I developed a formula called Instaflex Pain Relief Cream that can be applied directly on the affected joints or muscles, providing a first-line, instant pain defense for the body. This specific formula combines essential oxygenated oil with menthol to provide fast, targeted relief. Because it uses specially designed oils, less menthol is used, making it less harsh, but just as effective for pain.
Unlike pain pills, topical pain relief formulas do not adversely affect the gastrointestinal system or the heart or the brain. If you apply a pain relief cream to the shoulder, for example, it positively affects the joint and tendons and muscles around the shoulder to provide pain relief. You can also apply the pain relief cream more frequently than you can take an oral pain relief medication, where you would have to wait 6 to 8 hours between doses. Pills also take much longer to absorb in the body versus putting the pain relief cream directly on the affected joints or muscles, providing instant pain relief.
Dress To Protect
If you know you will be outside and exposed to heat for more than an hour, plan a wardrobe to protect accordingly. Choose to wear loose, breathable clothing. Avoid dark colored clothing and instead wear white or light-colored clothing to keep you cooler. Be mindful that UV light can still penetrate through the micro holes in the weaves of regular clothes or can even travel directly through a light-colored shirt. So add UPF (ultraviolet protection factor) clothing options to your summer wardrobe that will provide a more protective block from the sun.
While loose fitting clothing allows for airflow, choosing fabrics that allow sweat to evaporate more easily will feel even cooler. These fabrics include: cotton, linen, rayon, chambray, and bamboo, along with those that have been designed with moisture-wicking technology.
If you want to be fashionable and sun safe, don that hat. Luckily, many fashion hats are now embracing the fact that SPF is a key factor to design. The brim of your hat also matters so embrace your inner Audrey Hepburn and go for the wide brim look. The wider the brim, the more skin protection. The Skin Cancer Foundation recommends a three-inch brim circumference or at least a three-inch bill with a permanently attached drape covering the ears and neck. The key is to cover as much skin as possible. Be mindful that front-brimmed hats, like baseball caps and visors, only shade the eyes, not the skin.
Pain Or Not
Hot weather by itself can cause dizziness, lightheadedness, fatigue, and muscle cramps, even in people who do not normally have muscle pain so these heat reducing tips are good advice for everyone. Pain can easily sneak up on anyone so practicing these heat reducing techniques will create good habits that will protect your skin and minimize your pain in the long run. The key is to do your best to stay cool and pain-free while you enjoy one of the most pleasurable times of the year.
Biography: Joseph Pergolizzi, Jr., MD, is a leading pain physician who combines the latest medical advances and scientific breakthroughs with a profound professional compassion for patients facing painful, life-altering conditions. He earned his BS in physical chemistry from St. John’s University and an MD with the highest honors from Ross University School of Medicine. He completed his residency in anesthesia at Georgetown University School of Medicine and a clinical research fellowship in the Department of Medicine at Johns Hopkins University School of Medicine. Dr. Pergolizzi is currently a senior partner at Naples Anesthesia and Pain Associates, Inc. Additionally, he works with Healthy Directions as an adviser and educator on natural solutions for pain management. As a physician, inventor, research scientist, and advocate for pain patients, Dr. Pergolizzi has authored over 350 peer-reviewed articles, abstracts, platform presentations, and book chapters.