‘Winter worsens bone problems’: Experts share ways to maintain bone health

According to the fifth National Family Health Survey (NFHS), the reported prevalent deficiency of Vitamin D3 deficiency is about 50-70 percent in India, one of the major reasons why bone conditions like osteopenia and osteoporosis and others is common among Indian adults. Vitamin D and its supplement Vitamin D3 are important to controlling Calcium and Phosphate levels in the body, which determine one's bone health.

Dr. Vaibhav Bagaria, director, orthopedics, Sir HN Reliance Foundation Hospital Mumbai, explains that during the winter season, conditions like arthritis and osteoporosis become a cause of concern as it may affect day-to-day activities of adults. Mainly associated with bone strength and health, the National Health Portal of India defines osteoporosis as a medical condition that affects the bones, causing them to become weak and fragile and more likely to break (fracture). Similarly, Dr Aneesa Kapadia, consultant rheumatologist at Masina Hospital states that the season often leads to an increase in joint pain in people suffering from prior bone problems.

"Arthritis is also known to worsen during winter days. It is usually of two types. One is age related osteoarthritis. The other one is what is called inflammatory arthritis. For inflammatory arthritis, it's often the rheumatologist who prescribes appropriate medications and with seasonal changes they may need to be treated. On the other hand, the age-related osteoarthritis is something that is best managed with physiotherapy, dietary modification, and occasionally supplements," explains Bagaria.

Experts Bagaria and Kapadia explain the season's impact on bone health and ways in which adults can prevent major issues:

How does the winter season affect one's bone health?

Kapadia: Winter season often leads to an increase in joint pains in people suffering from arthritis. In winter as the temperature drops patients experience flares of inflammatory arthritis and even degenerative conditions such as osteoarthritis. Cold weather and drop in atmospheric pressures cause muscle spasms and poor blood flow. Poor circulation leads to flare-ups of certain conditions such as lupus and systemic sclerosis.

Raynaud's phenomenon is another condition in which hands and feet turn blue in cold weather due to poor blood flow precipitated by the cold weather. This happens in arthritis conditions such as lupus and systemic sclerosis, it can also happen to normal people. If untreated, it can be dangerous with development of ulceration over the fingertips. Besides this, lack of sunlight leads to vitamin deficiency and worsening osteoporosis and osteomalacia (softening of bones due to lack of Vitamin D).

What are the challenges specific to women?

Kapadia: In winter many women often remain indoors. This leads to lack of sunlight as well as paucity of exercise. Vitamin D deficiency can aggravate and cause joint pains in patients with Arthritis and Osteoporosis. Further, lack of sufficient physical activity leads to worsening of joint pain and swelling.

Arthritis comprises a number of different diseases and certain types of arthritis such as rheumatoid arthritis is common among Indian women and the cases rise during winter. In fact, the ratio of females and males suffering from arthritis is double, two is to one, or even more than that. But on the other hand, certain diseases such as ankylosing spondylitis are common among men.

A majority of Indian women, mainly those engaged in domestic work at home and outside suffer from arthritis. What must they be cautious of during the winter season?

Kapadia: Certain arthritis such as osteoarthritis may be aggravated by physical exercise. Domestic work if physically exerted can cause worsening joint pains.

Domestic work can be considered a good way of keeping your joints active and can be continued. The domestic work does not interfere with patients with arthritis. The only thing women can be careful about is that if domestic work involves sitting on the floor or bending your knees, especially those who suffer from knee arthritis or osteoarthritis, it can cause a problem.

If possible, one should avoid that instead of using the traditional method of wiping the floor with a cloth by bending the knees instead they can use a standing mop, which can make a world of a difference. Sitting on a stool or a chair to do the work will also make a difference. So these are the small changes one must adopt.

What are the ways in which individuals can take care of their bone health during winter?

Bagaria: There are many ways in which these things can be managed better, and it is important to take care of our bone and muscle health seriously. The first one being dietary habits, it's important that we take care of the fact that as we age, our bone strength and our bone mass, particularly of calcium, starts waning off. Foods like dairy products such as milk and cheese, dry fruits, broccoli, and those who are non-vegetarian, salmon fish are a good source of calcium.

The recommended dose for calcium in elderly females is 1200 mg every day. One can sit under the sun during winters for natural intake of vitamin D. But, in most cases, it's important that vitamin D supplements are taken on a regular basis. If you're vitamin D deficient as proven by blood tests, you may be prescribed a weekly dose of vitamin D. But if you're nearing a normal range, it is good to supplement it with a once a month dose. These supplements are available over the counter and can be prescribed by the general practitioners.

It is also important to ensure that you exercise regularly like walking, cycling, swimming, yoga or even normal stretching to reduce the stiffness associated with lack of any physical activity. Those suffering from any heart ailments should take care that they do not go into an exercise program without consulting their cardiologist.

To conclude we must assert that it's important for us to take care of our bone and joint health, especially those who are elderly, taking into account the seasonal changes, simple measures, like exercises, dietary modifications, appropriate investigations, and supplements can go a long way in ensuring healthy bone and healthy muscle or a longer active life.

Also read: World Pneumonia Day: How to take care and avoid the respiratory disease this winter