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On 09 Dec, 2023, Seniors Today hosted their weekly Health Live Webinar with Dr B S Murthy, Senior Orthopaedic and Joint Replacement Surgeon based in Delhi, who spoke on and answered questions about Winter Care for Joint Pain.
Dr. B S Murthy is Director and Senior Consultant, Orthopaedic and Joint Replacement at the Dharamshala Narayana Super speciality Hospital, Delhi which is a part of Narayana Health chain of hospitals. He has experience of over 3 decades, 32 years, to be precise, in joint replacement surgeries with thousands of knee and hip replacements to his credit. He does most of his primary replacement surgeries using minimally invasive surgery and a computer assisted navigation system. He’s in charge of high risk and critical cases such as major trauma, pelvic fractures and complex primary and revision joint replacement surgeries.
He has contributed to various national and international journals.
He is an MS in Orthopaedic Surgery from MKCG Medical College, Orissa. He is a fellow at the International College of Surgeons in the U.S. He is also a fellow in trauma in Germany and Australia. Fellowship in joint replacement and adult construction and reconstruction from Singapore. Visiting fellow, primary and revision joint replacement at Belgium. Visiting fellow in minimally invasive hip replacement surgery from Belgium. He has also completed his Fellowship from Association of Osteosynthesis, Switzerland.
He has worked with various hospitals such as Max Hospital, Fortis Hospital, RML, New Delhi, Central Institute of Orthopaedics, Sawdarjang.
He has also been the Registrar of Rehabilitation at AIIMS, New Delhi Registrar, Rehab, All India Institute of Medical Sciences, (A.I.I.M.S), New Delhi and Faculty for Joint Replacement in Various workshops in India & Abroad.
Nowadays, we not only have a lot of older patients but we are also getting a lot of younger patients for joint replacement. The younger population is using their joints too much leading to their damage at an earlier age. 16-17 year old kids going to the gym before their bones have matured, is part of the problem. Then going to the gym, trying to build their muscles by lifting and bearing weight puts pressure on the unformed/ soft bones.
Smoking, drinking, substance abuse, stress at a young age are also contributory factors.
These days we also get a lot of patients, young and old, with back pain and pain in the neck, this is due to excessive use of phones and other gadgets, sitting for long hours and usually with a bad posture.
In the winters there is a rise in breathing problems, cardiac issues, bone and joint problems. But it is the bone and joint issues which are often and easily ignored because they are not life threatening.
Factors aggravating joint and bone pain:
- Older age group
- Osteoporosis
- Osteoarthritis
- Individuals with pre existing comorbidities such as diabetes, hypertension- have a higher chance of developing bone and joint problems.
- Sedentary lifestyle and habits
- Working conditions which are stressful aggravate the chances of developing bone and joint pain and issues
- Low socioeconomic strata
Bone is not simply a stick but a living thing with cells,proteins, calcium, other minerals. It has nerves, blood supply.
Blood intact is made in the bones. It changes the whole blood in your body within 7 days.
2 bones meet each other to form a joint. They are surrounded by muscles and the bone ends are covered by a cartilaginous cap which does not have any blood supply, it gets its nutrients from the synovial fluid which is secreted by the capsular lining called synovium. The synovial fluid is a greasy and lubricating substance. The joint is stabilised and aligned with the help of ligaments, supported by the muscles and movement by contraction of the muscles signalled and contrived by the brain.
There are different types of joints, however they can be broadly classified into
- Weight bearing joints
- Non weight bearing joints
There are also different types of diseases of the joints, such as:
- Rheumatoid arthritis
- Gouty arthritis
- Skin conditions affecting arthritis
The end stage with all of these is osteoarthritis where the entire articular cartilage cap gets rubbed off, the bone gets exposed giving rise to pain. Thus, when the cartilage has completely worn out, the nerves on the bone are completely exposed giving rise to pain on movement.
This pain and joint stiffness aggravates during winters due to the following reasons:
- Cold temperature and surroundings makes the muscles tense. Tense muscles bring the bones closer together.
- Our skin is sensitive to cold and by extension so are our nerves due to reduced blood supply during cold temperatures, thereby causing the pain as the bone comes closer together and rubs the nerves.
Ways to prevent bone and joint pain and help alleviate the pain:
- Exercise- the more you work out/ maintain your movements, you will also be maintaining your muscle tone and adequate blood supply to the bone. Yoga and breathing exercises help in the movement of all your joints, breathing exercises help increase the oxygen flow.
- Studies have shown that receiving 1 hour of massage every 2 weeks during winters has a positive effect.
- Keep yourself warm indoors. Maintain the core temperature of your body between 24-25°C. Take warm water during winter seasons.
- Proper clothing should be worn during winters. And layering is advised
- A balanced diet is strongly advised. Protein and calcium are important in your diet for the health and nourishment of your bones. 60 g of daily protein intake is advised by the WHO for an individual of average height and built with the BMI of 20 kg/m2. 100 g of carbohydrates, 10 g of fat, minerals, vitamins is also recommended.
- Omega 3 fatty acids- present in walnuts, dry fruits, avocado, salmon fish- is a very important antioxidant which prevents ageing.
- Maintain your hydration.
- For patients already suffering from rheumatoid arthritis, gouty arthritis, etc. your medications do change in the winters if your issues and pain aggravate during winters.
- Patients who have to undergo knee and hip replacement surgeries often have a query as to whether they can get themselves operated during winters and the answer to that is – yes. Hip and knee replacement surgeries are not contraindicated during winters. However, if the temperatures are as low as 1-2°C, the surgery can be delayed since it is an elective surgery and can be done at a later date.
- Do not expose your joints to excessive cold or direct heat.
