Pain two years after hip replacement

[missrat]

Do oher people find that they have pain when they sit - al;most as if they have insufficient buttock muscles? Also I'm having pain in my right buttock a lot - as I did before - possibly piriformis syndrome. Do other people find that their pain is related to the weather?

[mike7748]

Dear Missrat

Thanks for your question. I have tried to answer by way of an article we had published some while ago.

My grandmother swore her bones were better weather forecasters than the weatherman – and she didn’t mean throwing them. ‘When I start aching, cold and rain are on their way,’ she’d quip. And she’s not alone. Professionals working with arthritic pain report countless sufferers associate a change in weather with a worsening of their condition.

‘Many of our members say they feel something,’ says Mike Body, CEO of the Arthritis Foundation of South Africa (AFSA). ‘But there’s been little research to support it.’ Cape Town rheumatologist Dr Cathy Spargo agrees. ‘Some patients detect weather changes before we do, but it varies from patient to patient,’ she says. ‘And there’s little to substantiate it medically.’

EXPLORATIONS

Johns Hopkins University in the US reports only two significant studies. In one, arthritis sufferers in a warm part of Argentina kept a journal for a year, recording changes in weather conditions (temperature, barometric pressure, relative humidity) and in their pain levels. This showed they experienced more pain when the temperature was low. In addition, those with rheumatoid arthritis were affected by high humidity and high pressure, those with osteoarthritis by high humidity, and those with fibromyalgia by high pressure. But the results were not strong enough for pain to predict weather, or vice versa.

In the second study, arthritis sufferers in sunny Florida reported their pain scores for two years, then researchers matched these with daily weather conditions. No ‘significant associations’ were detected except a ‘slight’ one between rising barometric pressure and hand pain in women.

Johns Hopkins’ concluded that ‘although some evidence exists that people living in warmer, drier climates experience fewer episodes of arthritis pain, climate does not affect the course of the disease.’

EXPLANATIONS

The most popular theory is that as air pressure drops ahead of cold, rainy weather, tissues in the body expand to fill the space, and tissue that is already inflamed swells more, increasing arthritic pain. According to the Chicago Centre for Orthopedics at Weiss, studies in cadavers found barometric pressure affects pressure inside joints. In one experiment when pressure in hip joints was equated with atmospheric pressure, the ball of the hip joint was thrown almost a centimeter out of line.

‘Members often say their pain is worse in winter, but I think that’s just because it’s cold and you’re uncomfortable and a bit miserable, so you feel it more,’ says Mike’s wife Judy Body, national secretary of the AFSA, who has had arthritis since she was two. ‘In fact, I prefer winter! For me and quite a few others, the pain is worse in summer, possibly because joints swell with heat and cause flare-ups.’

SOLUTIONS

Judy has been on pain medication all her life. She’s had bilateral hip, knee and shoulder replacements, and fractures repaired, and last year a titanium tibia implant grew infected and her leg was amputated below the knee.

‘But you learn to manage pain,’ she says. ‘When there’s a change in pressure and I have a flare up, I tell my doctor, and she just increases my medication a bit until it settles.’

Another reason some people experience more pain in certain seasons may be that they exercise less then – discouraged from walking or other outdoor activity by extreme cold or rain, or uncomfortable heat and humidity.

Getting exercise is vital for easing arthritic pain, say authorities from the AFSA to the Mayo clinic in the US. It strengthens the muscles around joints, helps maintain bone strength, gives you more energy to get through the day, makes it easer to get a good night’s rest, helps control weight, and improves your body image and sense of well-being. Without it, your joints become stiffer and more painful.

Whatever the weather, ask your doctor about an exercise plan and keep to it – any movement, however small, can help, says Mike Body. Just start gently and don’t overdo it.

Bottom line? While the symptoms of some arthritis suffers may be affected by changes in the weather, it’s neither conclusive nor true for all. ‘Every patient is different and should be treated individually,’ concludes Spargo.

Perhaps keep a symptom diary, and see if you and your doctor can anticipate the onset of symptoms. Then take steps to prevent them or curb their severity.

BOX

COLD COMFORT

Certain rheumatic conditions that can be associated with arthritis are clearly affected by weather conditions:

Muscle cramps: Risk of these rises when you don’t warm up properly, especially in cold weather.

Solution: Do warm–up stretches before getting active.

Lupus: This can cause inflammation of internal organs and joints, and involves photosensitivity (sensitivity to sunlight).

Solution: Use clothing and sunscreens to cover up.

Raynaud’s Phenomenon: This is associated with arthritic conditions such as rheumatoid arthritis and Lupus. Exposure to heat or cold causes abnormal spasm in blood vessels, limiting blood supply so fingers and toes turn white then blue from lack of oxygen.

Solution: Avoid exposure to temperature extremes, especially cold.

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hi missrat,

I totally understand how you feel. my arthritis feels the worst in humid, cooler weather. i tend to feel the best in the summer time. i guess the vitamin d is a factor too!