Does the weather make pain worse?

People say it all the time: “Oh, it’s gonna rain, I can tell in my knee” or “My knees really hurt over the weekend… they do that with bad weather.” What is it with these magical knees? From my personal vantage point, there is no logic to this… it’s simply psychological mis-attribution of causes… but it is heard so often, is there something to it?

Well, I asked on Twitter and fully enjoyed the convos that occurred…

Matt Dancigers Twitter convo weather

So here is a summary of what was shared:

1).  Wind speed and wind gust were shown be statistically significant, yet clinically irrelevant, in predicting an episode of low back pain. Neither temperature, nor humidity, wind direction, precipitation or air pressure were factors. The study asked the question about weather and the risk of low back pain occurrence. *it does not answer: Why?

Steffens D, Maher C, Latimer J, et al. Effect of weather on back pain: results from a case-crossover study.Arthritis Care & Research. December 2014;66(12):1867-1872. Abstract here.*

2. Rheumatoid Arthritis “known as “wind wet disease” in the Chinese language” (Fong Shi) is known to be a disease reportedly affect by weather. In the the study, 6/36 individuals were statistically influenced by weather changes. These influences were sun-spots, solar radio flux and UV and accounted for 19-64% of the “causation” of the pain. The associations were negative, I must mention. This leaves us with: Well, most are not sensitive to weather, and those that are, well, some are more sensitive than others. *again, not answering: Why?

Smedslund G, Mowinckel P, Heiberg T, Kvien T, Hagen K. Does the weather really matter? A cohort study of influences of weather and solar conditions on daily variations of joint pain in patients with rheumatoid arthritis.Arthritis & Rheumatism: Arthritis Care & Research [serial online]. September 15, 2009;61(9):1243-1247. Article here.

3).  A literature review found that, in patients with RA, higher humidity was more of a factor in irritating symptoms than was higher temperature. They point out that in some circumstances, the higher the temperature means that people will go indoors to seek air-conditioning, therefore pain might reduce in high temperatures. Interesting take.

Patberg W, Rasker J. Weather effects in rheumatoid arthritis: from controversy to consensus. A review. Journal Of Rheumatology[serial online]. July 2004;31(7):1327-1334. Abstract here.

4.) Oh arthritis! It also may have predictive qualities? “92% of the participants thought their symptoms would be affected by the weather change. Moreover, 48% of the participants believed that the weather can be predicted by their feeling of symptoms.”  So this study looked some previous studies (sort of like a soft systematic review), and concluded that… there is no conclusion. Some correlation with small significance.  So, more research is needed, right?!

Wai Chin L, Ye Z. Can the weather influence arthritis symptoms?. Rheumatology Reports [serial online]. January 2014;6(1):16-20. Article here.

5.) This “article” discusses, in lay-terms, what might account for this weather-pain phenomena. The authors points to barometric pressure, not temp or wetness, etc. This is the type of thing many patients may have read, it’s off of WebMD. The inconclusiveness runs right throughout this piece, it’s wonderful! The author states temp does not matter (ex: people in San Diego vs Michigan show no significant differences) but then suggests if it’s cold, you should bundle up. She also suggests that high barometric pressure effects pain, but then says to wear a compression glove to help the hand. Man, this stuff is exactly why… more research is needed! To her credit, at the end she emphasizes that pain is temporary and to improve your mood as a coping device as well.

Kam K, Does weather affect joint pain? WebMD online, March 2014. http://www.m.webmd.com/pain-management/features/weather_and_pain

6.) You can predict the trend so far, can’t you? Here’s a quote “The VAS reflects the patient’s level of pain on the day/days leading up to attendance. This can be affected by a number of factors, including emotions on the day of attendance, psychological stressors, or indeed the weather. It has been previously highlighted that seasonal variations in weather conditions may adversely affect a patient’s mood, which may in turn alter the perception of pain [13]. However, in this study, when a sub-analysis of the impact of the VAS was performed against weather variables, no statistical significance was observed.”

Savage E, McCormick D, McDonald S, Moore O, Stevenson M, Cairns A. Does rheumatoid arthritis disease activity correlate with weather conditions?. Rheumatology International [serial online]. May 2015;35(5):887-890. Abstract here.

It literally goes on like this forever in the search database… some slightly support a connection: Gorin AA, Smyth JM, Weisberg JN, Affleck G, Tennen H, Urrows S, Stone AA (1999) Rheumatoid arthritis patients show weather sensitivity in daily life, but the relationship is not clinically significant. Pain 81(1–2):173–177

And another that says: Nope. . Strusberg I, Mendelberg RC, Serra HA, Strusberg AM (2002) Influence of weather conditions on rheumatic pain. J Rheumatol 29(2):335–338

May I also share the Aches and Pains Index:

I believe the research question remains… unanswered. The personal perspective and individual truth of weather affecting an someone’s pain is answered by themselves (likely on a continuum based on many biopsychosocial factors, as is always the case). As far as the ‘Bio’ part is concerned, perhaps mechanoreceptors or baroreceptors (sensitive to pressure) become sensitized to a degree that could detect an atmospheric change. It has been shown that those living in San Diego can detect small temperature changes (from 75 F and perfect to 73 F and perfect, etc) so plausibility exists indeed.

In my professional opinion there are some learning and causation fallacies, post hoc, confirmation bias followed closely by recall bias and some belief reinforcement and a few rain drops later… here we have it. I can predict the weather with my knees.

FarSide Weather

Still a fascinating topic, no doubt. I know that when it rains, my clinic empties out with people in too much pain to make it to their visit. It’s just one of those things…

*Shout out to those that shared research and images via Twitter, I did not compile this all on my own. Cheers.

Matt D

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2 thoughts on “Does the weather make pain worse?

  1. Pingback: A Year In Review: II | PTbraintrust

  2. Pingback: Split brains and causation | PTbraintrust

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