Managing Pain in Cold Weather

As winter approaches, the physicians of the American Society of Interventional Pain Physicians (ASIPP) find that there is an increase in the reporting of pain by many chronic pain patients, many of whom will request additional pain medications.

It is no news to anyone in the northern states who has endured a winter or five, the seeping bitter cold makes hands and feet freeze up and ears feel as if they will fall off if not adequately bundled up.

According to Dr. David S. Kloth, spokesperson and Board member for ASIPP and a practicing interventional pain management physician, “Pain is often exacerbated during the cold winter months.”

January and February are two brutal months of dark, short days and icy cold nights. This can increase levels of depression, creating a vicious cycle that Dr. Kloth refers to as the “Winter Blues.”

Dr. Kloth, added, “Increasing pain medications is not the best answer for seasonal changes in pain level; you can’t chase pain with pills, it simply doesn’t work. Prescription pain pills are merely one tool and should not be relied on as the sole source of pain relief for most pain conditions. Patients should explore alternative treatment options with their physicians and discuss sensible lifestyle changes before requesting/accepting an increased dose of opioids.”

Dr. Francis Riegler, an interventional pain management physician and ASIPP Board member agrees that “this is a widespread problem in the winter, with too many doctors simply acquiescing to their patients’ requests for additional prescription drugs”. ASIPP believes that providing patients with education about what they can do to combat their pain prior to resorting to additional medications is essential.

Doctors Kloth and Riegler offer our readers the following basic tips for those suffering from chronic pain conditions this winter:

· Adjust your expectations: If you live in a cold weather climate, recognize that your pain is more than likely to increase in the winter. This is in part due to the cold and the associated muscle spasm that can frequently occur, and also from the more frequent barometric pressure changes that accompany major weather systems in the fall and winter.

· Avoid increasing pain medication dosages for seasonal pain pattern changes: You may be accomplishing little by increasing your pain medication except worsening long term tolerance problems. This will likely only provide temporary relief and few patients are willing to wean when the weather improves. Pain varies day-to-day, depending on a variety of factors, many of which are not under one’s control.

· Stay warm: Keep the affected body area warm, especially when you are exposed to the cold. Keeping your neck and your back warm throughout the winter months can be very helpful if you experience chronic back or neck pain. Long underwear, scarves, and layering of clothes are all important. Once the area goes into spasm from the cold, it may be hard to get the area to calm down. These flares can last days to weeks.

· Protect yourself from falls and jarring moves: Wear shoes with good traction especially with snow and ice to avoid unnecessary slips and falls which can cause or exacerbate painful conditions. Remember that your balance may not be what it used to be, and this may be compounded by your underlying condition.

· Shovel snow with care: Try to avoid shoveling if you have a chronic neck or back injury, especially with heavy snow. If you find that you must shovel snow to clear a driveway or walkway, do so in small increments, every couple of inches before the snow

accumulates. Your best bet is to get assistance or hire someone to help. Unfortunately finding that neighborhood kid to shovel the driveway isn’t as easy as it used to be.

· Talk to your physician: Flares of specific conditions can also be quieted by various interventional therapies. For example those with a flare of joint pain (arthritis pain) may benefit from an injection to the region. Speaking with your doctor about alternative therapies to opioids, including the various interventional pain therapies (epidurals, trigger point and facet injections,) which may help alleviate pain in both the short and long term.

About the American Society of Interventional Pain Physicians ASIPP promotes the development and practice of safe, high-quality, cost-effective interventional pain management techniques for the diagnosis and treatment of pain and related disorders, and to ensure patient access to these interventions. For more information, visit or call 270.554.9412. Ext. 215