The cold winter months can be an extremely difficult time for the elderly. But as Jillian Watt explains, there is so much community pharmacists can do…


One older person dies every seven minutes in cold weather and there are another 5,000 deaths for every degree Celsius that the winter is colder than the 30-year average.

As the weather gets colder you will start hearing from your customers that their aches and pains feel worse in winter. And scientific studies suggest this is not all in the mind but lower barometric pressure, colder temperatures and higher humidity can lead to stiff or aching muscles and joints especially in people suffering from rheumatic diseases and osteoarthritis. However, further work is needed to discover exactly why this is the case.

The pharmacy is often the first port of call for older people needing advice perhaps because the patient does not want to bother the doctor or because GPs are under such pressure that it can be difficult to get an appointment quickly.

So as we move towards winter, make sure the pharmacy team is ready to help older customers with clear, practical advice on managing pain.

First, it is important for older people to stay active and keep moving. Our consumer research at Mentholatum tells us that when people are in pain, they may be reluctant, even frightened, to move because it hurts.

They remember that medical advice to people with joint or back pain used to be to stay in bed and take painkilling tablets but that advice has now been turned on its head.

The latest recommendation from the National Institute of health and Care Excellence (NICE) and the NHS is for back pain sufferers to keep moving and use topical pain relief products and NICE gives similar advice for osteoarthritis sufferers, highlighting exercise and weight loss and adding that “the use of local heat or cold should be considered as an adjunct to core treatments.”

Movement not only helps to keep people warm, it also benefits the joints. Activity encourages circulation of the synovial fluid which lubricates the joints as the heart pumps faster blood flow and increases and nourishes the synovial fluid and weight-bearing exercise helps nutrients reach the joints.

In addition, movement helps generate the body’s repair mechanism, removes cellular waste and strengthens the muscles, ligaments and tendons which support joints. Using a topical product to ease the pain can also help encourage people to move when the discomfort has eased.

Remind people they should listen to their bodies and do what they can. Even walking around the house or doing some exercises while sitting or holding the back of a chair will be helpful.

Management and prevention
The Mentholatum Company is committed to helping people manage back pain and help prevent it from recurring, so the company has developed Mind Your Back, a one-stop shop for back pain help and advice. Mind Your Back consists of five S.T.E.P.S. – Stretch, Therapy, Exercise, Posture and Strengthen.

Videos showing the stretching and strengthening exercises are available on the website – – where you will also find advice on exercise and maintaining good posture, plus a therapy section showing how the three Mentholatum topical analgesic ranges should be used to relieve different types of pain.

Mentholatum offers a wide range of products, including drug-free options, to help ease stiff or aching muscles and joints, with its hot, cold and topical NSAID brands, Deep Heat, Deep Freeze and Deep Relief.

Topical analgesics offer effective, targeted pain relief delivered at the point of pain and because drug-free topicals do not pass through the internal organs they are less likely to be associated with unwanted effects such as gastric issues.

But the array of different products and formats can be confusing, so be ready with advice on when and how to use them so customers identify the most suitable topical for their needs.

Keep the topicals section well-signposted and make it easy for customers to reach the products. Stock products from the heat, cold and topical NSAID sectors, with drug-free and medicated options and a choice of formats from creams and gels to sprays and patches. Leaflets and point of sale material will help customers make the most appropriate choice.

Older people who need to use topical pain relief on a regular, even daily, basis may find it costly, so include products which are not only effective and produced by trusted manufacturers, but also more affordable.

Which topical?
• Heat products can help relieve nagging back pain and painful, stiff and aching muscles. They may also be used before exercise as part of the warm-up.
• Cold products can help ease sharp, shooting muscle, joint and foot pain, sprains and strains. Research carried out at Stirling University on human volunteers showed that Deep Freeze Cold Patch and Gel cooled soft tissue to a depth of 3cm.
• Anti-inflammatory products (topical NSAIDs) penetrate deep through the lower layers of the skin to relieve inflammation and help reduce swelling. They can help ease inflammatory back, muscle and joint pain and some products, such as Mentholatum’s Deep Relief Joint Pain Gel may be recommended by the pharmacist for non-serious arthritic conditions. Deep Relief, which returns to TV with a new advertising campaign in September, is also now available on prescription. Deep Relief offers fast, cooling, effective relief thanks to its two painkilling ingredients – levomenthol and ibuprofen. The levomenthol quickly gets to work to cool and soothe, while ibuprofen reduces pain and inflammation.


Jillian Watt is director of marketing and new product development at Mentholatum.