By: Pam Ball, BSc OTReg(On)

Cold intolerance or cold sensitivity is a frequent complaint after a hand injury. It is an abnormal reaction to cold and an exaggerated response to what others interpret as a normal sensory stimulus. It is a common complication of all sorts of hand injuries.  While it is often seen with the nerve damage accompanying crush injuries and amputations, it can, occur even with more minor hand injuries.

Living in Canada, the winter months can make cold intolerance exceptionally difficult, but sometimes people complain of discomfort or pain with even minor exposure to cold, such as handling a cold drink or frozen foods or just “cooler” evenings. People describe feeling pain, stiffness, pins and needles, tingling or changes in skin colour.

Many patients experience problems with cold intolerance during the first winter following their hand injury. The estimated percentage of individuals who experience this varies in different studies. My personal experience, working with hand patients in Hamilton and Halton is that it is a relatively common complaint. It is important to realize that this is not an indication of something going wrong with the recovery of your hand. For some patients, it is only this first winter that presents a challenge, while others will continue to experience some or all symptoms for many winters to come.

Cold intolerance treatment

While there isn’t an “easy fix” or treatment, recognizing that this will be an issue, and being prepared will help you cope. Gloves and mitts are the most important consideration.  Fortunately, there is a wide variety of good quality handwear available.  Visit a sporting goods store that carries products for outdoor winter sports (ice fishing, hunting, skiing, snowboarding) and discuss your particular needs. There are numerous options available in the Hamilton and Halton area.  In general, mitts are warmer than gloves, and layers of clothing are warmer than a single product.  What will best for you is dependent upon your lifestyle.  You need to consider whether or not you require good dexterity, or moisture wicking properties.  You may need more than one solution for various situations.

For many, a good quality thin liner gloves, such as the silver-liner or silk-liner gloves or runner’s gloves is a good choice to be worn inside a larger thermal  insulating mitt. (These are designed to reduce heat loss or to wick moisture away from the skin, so knowing your needs will help with the selection). This way, if you need to take the mitt off for a short time for better dexterity (eg. manipulating your keys), your hand isn’t entirely exposed to the cold . Layers are often warmer as they trap warm air in. You can look online as well for gloves/mitts that meet your needs.  There are a number of products designed for workmen, sportsmen and winter enthusiasts which might be right for you. I ran across one site for dog sledders, with a number of options for the cold.  The investment in a good pair or two is well worth it!

There are also other products such as neosleeves – tubes made of neoprene (wetsuit material) and other products that are particularly good for individual digits. A hand therapist can help you find the right product; please feel free to contact me via the website for further information.

Other options include re-usable or disposable heat pads which can be worn inside gloves or mitts. These provide heat through chemical reactions for up to 10 hours.  Both styles are easy to use and the disposables are readily available, however, caution must be used to ensure that you don’t burn yourself.  Remember that the injured hand may have reduced circulation or sensation!

Similarly, there are gloves/mitts with battery-powered heat cells that can provide additional warmth. While effective, many have complained that these are bulky and costly, but new products are coming out with rechargeable and smaller battery packs. The same caution as above applies regarding the injured hand with reduced circulation and/or sensation.

Other things to consider regarding intolerance to cold:

  • Make sure you keep your body warm as well.  Even if you don’t feel the same associated pain from the cold, remember that wearing sufficient clothing to keep your body warm means your circulation will not need to divert the blood supply from your arms and hands to keep your core warm.  Similarly, some people find that warm wrist bands aid in keeping the hands warm.
  • Smoking and coffee: nicotine and caffeine are considered to be vasoconstrictors, therefore, your fingers will get colder, faster.  If you are going to smoke or have coffee, try to avoid doing so while exposed to the cold. With the anti-smoking regulations in Ontario, it’s common to see people standing outside, without proper clothing, with a cigarette in one hand and coffee in the other.  Unfortunately, this only worsens the problem.
  • Intolerance to cold can be a minor temporary  inconvenience or an ongoing serious problem after any sort of hand injury.

A bit of preparation and proper equipment can go a long way towards allowing you to continue to function in our “great white North”.

Has this article helped you? What is most difficult about cold intolerance and how do you cope?