KATHMANDU, Oct 26: Although daytime temperatures remain relatively warm, mornings and evenings have become colder as winter gradually sets in. With the onset of cold weather, more patients with respiratory problems and rheumatic diseases, particularly those experiencing joint pain, are seeking treatment at hospitals.
Compared with summer, more patients with rheumatic diseases seek treatment during winter. According to the National Center for Rheumatic Diseases, the number of patients visiting the center with pain-related complaints increased by 20 percent toward the end of October compared with summer.
The center receives an average of 150 patients daily during summer. Since the onset of winter, the daily average has risen to around 250. Historical data show that the number can reach 300 patients a day during December and January, about 50 percent higher than in summer.
The body's immune system protects it against diseases. Two important types of immune cells, known as T cells and B cells, help identify and fight viruses, bacteria and other harmful pathogens.
When the immune system malfunctions, however, it may fail to distinguish between harmful pathogens and healthy cells in the body. It may mistakenly attack healthy tissues, leading to autoimmune diseases, including certain types of rheumatic diseases.
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Rheumatic diseases can affect various parts of the body. Although joint pain is a common symptom, some conditions can also cause serious complications, including kidney damage and eye inflammation.
Dr Sudhir Karmacharya, a rheumatology specialist at the National Center for Rheumatic Diseases, said joint pain can worsen in winter as cold temperatures affect joint movement and increase sensitivity to pain.
Nerves responsible for transmitting pain signals may become more sensitive in cold conditions. As a result, even minor injuries or movements may cause greater discomfort in the joints. Lower temperatures may also make people more sensitive to existing joint pain.
Changes in barometric pressure may also contribute to weather-related joint discomfort in some people. Fluctuations in atmospheric pressure may affect the tissues surrounding joints, potentially increasing discomfort. However, the extent to which these changes directly cause joint pain is not fully understood.
Reduced physical activity during winter is another factor that can aggravate joint pain. People tend to exercise less and remain seated for longer periods in cold weather. Reduced movement can increase joint stiffness and make everyday activities more difficult for people with rheumatic diseases. Regular physical activity, by contrast, helps maintain joint mobility and flexibility.
Doctors also point to vitamin D deficiency as a possible contributing factor. People may receive less sunlight during winter, reducing the body's production of vitamin D, which plays a role in bone health and immune function. People with certain rheumatic diseases may also be more vulnerable to infections, including influenza and pneumonia.
Cold weather may also affect the viscosity of the fluid inside joints, potentially contributing to stiffness and discomfort. When joints become stiff, movements such as making a fist or bending the knees may become more difficult. The precise relationship between temperature, joint fluid and pain can vary depending on the underlying condition.
A study conducted by the National Center for Rheumatic Diseases across 27 districts found that 27 percent of Nepal's population showed symptoms of rheumatic and related diseases. Based on this finding, the center estimates that around seven million people in Nepal may be affected.
Doctors say people with rheumatic diseases can reduce discomfort and maintain their daily routines during winter by taking a few precautions.
Wearing warm clothing that covers the body and applying heat to painful joints with a hot-water bag or warm compress may help ease stiffness. Applying warmth can provide temporary relief and make movement more comfortable.
People are advised to remain physically active indoors when outdoor temperatures are low. Simple exercises, including moving the fingers, rotating the wrists and exercising the knees and back, can help maintain joint mobility and reduce stiffness. Regular, gentle exercise is preferable to remaining in one position for long periods.
Doctors also recommend appropriate vaccinations against influenza and pneumococcal disease to reduce the risk of respiratory infections. Avoiding smoking and exposure to smoke can further help protect health during winter. People experiencing persistent or worsening joint pain should consult a healthcare professional and continue prescribed treatment rather than stopping medication on their own.
