title: A Descriptive Study of Hot Aches: a Previously Unreported Winter Climbing Phenomenon.
abstract: BACKGROUND
  Hot aches, also known as the screaming barfies in North America, are a recognised phenomenon amongst winter climbers, assumed to be triggered by the reperfusion of cold peripheries which then rapidly progresses to a systemic vasodilatory syndrome. Symptoms experienced in the hands include pain, numbness and throbbing followed by systemic symptoms such as nausea, irritability, dizziness and in extreme cases a transient loss of vision and hearing. Despite being well known amongst the winter climbing community, there are no publications in the scientific literature characterising the hot aches.
  
  
  METHODS
  A survey was posted online at http://www.ukclimbing.com between the dates of 28th September 2014 to 1st December 2014. Data was collected and analysed offline using Microsoft excel.
  
  
  RESULTS
  This is a descriptive epidemiological study of UK winter climbers and their experience of hot aches. We found that hot aches are experienced by 96 % of these climbers. They generally last 1-5 min, and 75 % rate them as being 3-4 (out of 5) on a pain scale. The most common local symptoms are pain (87 %), throbbing (70 %) and tingling (52 %). The most common systemic symptoms are nausea (44 %), irritability (32 %) and dizziness (20 %). Twenty percent of climbers experience hot aches in locations other than their hands.
  
  
  CONCLUSIONS
  The hot aches are a highly predictable and consistent experience for almost all winter climbers. This study has characterised, for the first time, a recognised but previously unreported phenomenon that occurs in extreme winter climbers. The short- and long-term consequences are currently unknown and warrant further investigation.
authors.affiliation: Clinical Pharmacology and Therapeutics, Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Dundee, Scotland.
authors.forename: Andrew
authors.initials: A
authors.lastname: Melvin
authors.affiliation: Clinical Pharmacology and Therapeutics, Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Dundee, Scotland. j.george@dundee.ac.uk.
authors.forename: Jacob
authors.initials: J
authors.lastname: George
keywords: Climbing; Ice climbing; Mountaineering; Reactive hyperaemia; Screaming barfies; Vasospasm