Weather and Pain

Often I have patients who claim they can predict the weather or that their pain is influenced by the weather. I often assumed that the patient was seeing a correlation that didn’t really exist possibly because they have been told by others that weather influences joint pain. This subject, even in the area of research is controversial. Results of studies have shown connections while others show no effect. I decided to see what some of the research says.

From what I have learned from some of my research is as follows:

1. Low temperature, more often than not, has some effect on pain (osteoarthritis, rheumatoid arthritis)
2. Low temperature makes those 50 – 65 year old 15% more likely to experience rheumatoid arthritis pain
3. Relative humidity has a significant association with hand osteoarthritis pain
4. Absolute change in atmospheric pressure is associated with pain.
5. Limited evidence between fibromyalgia and weather conditions

I admit this isn’t not an exhaustive study of the subject but it is food for thought. Feel free and read the abstracts found below

Dr Notley

Influence of weather on osteoarthritis of the hands

Background: The aim of this work was to investigate the association between meteorological variables and pain, stiffness, and function of the hand in patients with osteoarthritis.

Methods: The survey was carried out over 2 months in 2009, covering July and November. The patients filled out a questionnaire, consisting of visual analogue scales covering the three categories of symptoms that primarily determine the situation with rheumatism of the hands: function, joint stiffness, and pain. The questionnaire was completed on Monday, Wednesday, and Friday for every week in July and every week in November. The meteorological variables recorded included atmospheric pressure, air temperature, relative humidity of the air, and precipitation. The climate records were checked against the variables of functional evaluation of the hands from each patient using bivariate analysis and multiple regression analysis.

Results: In general, air temperature and relative humidity were the variables that displayed statistically significant higher association in all evaluated aspects of the hands, being explained by the influence of temperature in 40-88% (r) and relative humidity in 39-85% (r). In the multivariate analysis, there was a reduction in the number of weather variables that influenced pain. The variation of pain was explained by the average atmospheric pressure of the day of the questionnaire and the temperature the day before and the day after the questionnaire (52-88% [R2]).

Conclusions: The results implied individual variation in perception and quantification of function, stiffness, and pain. The lowest temperature associated with worsening of symptoms of pain and function in osteoarthritis of hands was the variable weather most frequently observed.

Weather conditions may worsen symptoms in rheumatoid arthritis patients:
The possible effect of temperature

Lydia Abasolo, Aurelio Tobías , Leticia Leon, Loreto Carmona, Jose Luis Fernandez-Rueda, Ana Belen Rodriguez, Benjamin Fernandez-Gutierrez, Juan Angel Jover

Objective: Patients with rheumatoid arthritis (RA) complain that weather conditions aggravate their symptoms. We investigated the short-term effects of weather conditions on worsening of RA and determined possible seasonal fluctuations.

Methods: We conducted a case-cross over study in Madrid, Spain. Daily cases of RA flares were collected
from the emergency room of a tertiary level hospital between 2004 and 2007.

Results:245 RA patients who visited the emergency room 306 times due to RA related complaints as the main diagnostic reason were included in the study. Patients from 50 to 65 years old were 16% more likely to present a flare with lower mean temperatures.

Conclusions: Our results support the belief that weather influences rheumatic pain in middle aged patients.

Influence of weather variables on pain severity in end-stage osteoarthritis

Stephen A. Brennan, Thomas Harney, Joseph M. Queally, Jade O’Connor McGoona, Isobel C. Gormley, Fintan J. Shannon

Purpose

Patients often attribute increasing pain in an arthritic joint to changing weather patterns. Studies examining the impact of weather on pain severity have yielded equivocal and sometimes contradictory results. The relationship between subchondral pseudocysts and the role they play in this phenomenon has not been explored.

Methods

Fifty-three patients with end-stage osteoarthritis of the hip completed daily pain severity visual analogue scale (VAS) scores over a one month period. Radiographs were reviewed to determine the presence of pseudocysts. Data pertaining to precipitation, atmospheric pressure and temperature were collected from the nearest weather station. A generalised linear mixed model was used to explore the relationship between weather variables, cysts and pain severity.

Results

Pain levels increased as a function of absolute change in atmospheric pressure from one day to the next
. Precipitation, temperature and the presence of subchondral pseudocysts were not shown to influence pain severity.

Conclusions

This data supports the belief held by many osteoarthritic patients that changing weather patterns influence their pain severity.

Influence of Weather on Daily Symptoms of Pain and Fatigue in Female Patients With Fibromyalgia: A Multilevel Regression Analysis

Ercolie R. Bossema, Henriët van Middendorp, Johannes W. G. Jacobs, Johannes W. J. Bijlsma, Rinie Geenen

Objective

Although patients with fibromyalgia often report that specific weather conditions aggravate their symptoms, empirical studies have not conclusively demonstrated such a relationship. Our aim was to examine the association between weather conditions and daily symptoms of pain and fatigue in fibromyalgia, and to identify patient characteristics explaining individual differences in weather sensitivity.

Methods

Female patients with fibromyalgia (n = 333, mean age 47.0 years, mean time since diagnosis 3.5 years) completed questions on pain and fatigue on 28 consecutive days. Daily weather conditions, including air temperature, sunshine duration, precipitation, atmospheric pressure, and relative humidity, were obtained from the Royal Netherlands Meteorological Institute. Multilevel regression analysis was applied.
Results

In 5 (10%) of 50 analyses, weather variables showed a significant but small effect on either pain or fatigue. In 10 analyses (20%), significant, small differences between patients were observed in the random effects of the weather variables, suggesting that symptoms of patients were, to a small extent, differentially affected by some weather conditions, for example, high pain with either low or high atmospheric pressure. These individual differences were explained neither by demographic, functional, or mental patient characteristics, nor by season or weather variation during the assessment period.

Conclusion

There is more evidence against than in support of a uniform influence of weather on daily pain and fatigue in female patients with fibromyalgia. Although individuals appear to be differentially sensitive to certain weather conditions, there is no indication that specific patient characteristics play a role in weather sensitivity.

On the belief that arthritis pain is related to the weather (1996)

D A Redelmeier and A Tversky

Abstract

There is a widespread and strongly held belief that arthritis pain is influenced by the weather; however, scientific studies have found no consistent association. We hypothesize that this belief results, in part at least, from people’s tendency to perceive patterns where none exist. We studied patients (n = 18) for more than I year and found no statistically significant associations between their arthritis pain and the weather conditions implicated by each individual. We also found that college students (n = 97) tend to perceive correlations between uncorrelated random sequences. This departure of people’s intuitive notion of association from the statistical concept of association, we suggest, contributes to the belief that arthritis pain is influenced by the weather.

.
Does rain really cause pain? A systematic review of the associations between weather factors and severity of pain in people with rheumatoid arthritis.
Smedslund G, Hagen KB.

OBJECTIVE:

To examine the association between weather and pain in rheumatoid arthritis (RA).

METHODS:

Systematic review of longitudinal observational studies (up to September 2009) with data on the association between weather variables and severity of pain in RA. The methodological quality was rated independently by the two authors according to an adapted Newcastle-Ottawa Scale. We analyzed the data on an aggregated (group) level with a meta-analysis of correlations between pain and weather, and at an individual level as the proportion of patients for whom pain was significantly affected by the weather.

RESULTS:

Nine studies were included. Many different weather variables have been studied, but only three (temperature, relative humidity and atmospheric pressure) have been studied extensively. Overall group level analyses show that associations between pain and these three variables are close to zero. Individual analyses from two studies indicate that pain reporting in a minority (<25%) of RA patients is influenced by temperature, relative humidity or atmospheric pressure. We were not able to relate the findings to methodological quality or other aspects of the studies.

CONCLUSION:

The studies to date do not show any consistent group effect of weather conditions on pain in people with RA. There is, however, evidence suggesting that pain in some individuals is more affected by the weather than in others, and that patients react in different ways to the weather. Thus, the hypothesis that weather changes might significantly influence pain reporting in clinical care and research in some patients with RA cannot be rejected.

Previously published August 1 2013

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