When cold weather hurts

Published: January 2010

Cold winter weather can be especially hazardous for people who work outside or even for those who just like to spend lots of time outside. Cold-exposure injuries, including frostbite, have increased over the past 20 years. But sometimes the cold can cause other ailments, too.

A 40-year-old chef was still wearing woolen gloves when she sat down in my office last winter. She said her symptoms—hand pain and numbness—worsened when she was outdoors or reached into the freezer. When her fingers got cold, they turned shades of red, white, and blue. Several fingertips were ashen and one had a small ulcer. She had a severe case of Raynaud's phenomenon, caused by spasm of the arteries of the digits or a nerve sensitivity to cold, which affects 3 to 5 percent of people.

Attacks usually last from a few minutes to several hours. Aside from avoiding the cold and not smoking, treatment is generally not warranted. In more serious cases, calcium-channel blockers such as nifedipine (Procardia and generic) may prevent and reduce episodes. In advanced cases, ulcers can develop on the fingers and may necessitate amputation.

Frostbite is another concern. While it affects feet or hands in 90 percent of cases, it can also involve the face and ears. At first, most people experience a cold numbness, and the body part feels icy to the touch. Go to the emergency room immediately if you are affected, to be warmed (a whirlpool is ideal) and to take steps to avoid infection and gangrene. Two to three days later, the blood supply re-establishes, causing a throbbing pain that can last weeks or months.

Added risks

Other cold-weather ailments include hypothermia—when the body's temperature plummets below 95º F (35º C)—and cold-induced asthma and heart attacks. People with hypothermia first feel cold, shiver, and seem socially withdrawn. As the condition worsens, victims can become confused and sleepy and slur their speech. In the most severe stage, the heart can slow down dangerously.

The risk of hypothermia is highest when people are not prepared for it—when they're at a sporting event on a cold, rainy day, for example, or swimming in a cold lake on a hot spring day.

Exercise-induced cold stress, which can be caused by working outdoors in the winter, can raise blood pressure. Activities involving the upper body seem to be most dangerous, particularly for people with coronary artery disease, who may be susceptible to angina and heart attacks. That is why people with coronary disease shouldn't shovel snow.

My patient was lucky. She responded well to medication and her skin ulcer healed. She has asked her sous-chef to handle the freezer and is thinking of moving to Florida.

To prevent frostbite:

Wear layered, loose-fitting, heat-retaining clothing and avoid constrictive garments, including tight boots.

Wear mittens instead of gloves, and consider a balaclava, a cap that can also cover the ears, nose, and lips.

Stay dry and out of the wind, cold rain, and snow.

Avoid alcohol, which, besides impairing judgment, causes heat loss by dilating the blood vessels and contributes to dehydration, another risk factor.

Orly Avitzur, M.D.

Medical Adviser

E-mail Newsletters

FREE e-mail Newsletters!
Choose from cars, safety, health, and more!
Already signed-up?
Manage your newsletters here too.

Latest From Consumer Reports

Four built-in refrigerators that are worth the moneyVideo These coolers start at $7,600 but fared very good in our performance tests.
Evenflo car seat uses tech to fight child heatstroke risk The Advanced Embrace DLX warns if a child unbuckles the harness, too.
Save big: 5 products on deep discount in AugustVideo Look for seasonal deals air conditioners, dehumidifiers, and more.
Special report: How your hospital can make you sickVideo Find out which hospitals avoid MRSA, C.diff, and other infections.
Car insurance
Investigation: The truth about car insurance revealed We studied 2 billion price quotes to understand the factors that raise rates.
You're paying too much on cable-box rental fees Pay-TV companies rake in nearly $20 billion annually on the boxes.
Consumer Reports
Interested in joining the Consumer Reports Board Get details on applying for service on our board of directors.


and safety with
subscribers and fans

Follow us on:


Cars Build & Buy Car Buying Service
Save thousands off MSRP with upfront dealer pricing information and a transparent car buying experience.

See your savings


Mobile Get Ratings on the go and compare
while you shop

Learn more