People with arthritis often claim they can predict when rainy days are coming, based on the pain in their joints. But is it true or based on folklore? Studies support a variety of weather factors can causes physiologic changes in joints, particularly changes in weather. Two of these factors are barometric pressure (primarily when decreasing) and decrease in external temperatures. Let’s examine the evidence on whether these changes do indeed affect arthritic pain.
A study published in 1995 investigated an association between weather and chronic pain in four cities: San Diego, Nashville, Boston, and Worcester, Massachusetts (1). The majority of all patients believed that changes in the weather affected their pain. Pain patients who were younger and also had arthritis reported the most sensitivity to changes in weather. However, the belief that overall pain worsened by living in a colder climate was not supported.
Despite this, a number of plausible theories exist as to why people state their pain worsens with rainy weather. Research has shown that it’s not the cold, wind, rain or snow but rather the barometric pressure. Barometric pressure refers to the weight of the atmosphere. The easiest way to describe these changes is to think about the joint itself as a balloon. When there is high barometric pressure pushing against the joint, it will keep tissues from expanding. However, immediately before bad weather comes, barometric pressure drops. This lower pressure allows the tissues to expand, hence causing increased pressure within the joint.
The truth is we don’t know for sure. Some studies indicate an increase in barometric pressure increases pain, others report a decrease does. It’s overall hypothetical. As of now, there is no concrete evidence that a certain geographic area exists where people report less pain. If it did, I would tell all my patients to move there.
A lot of research shows that there are no definite weather-related changes in pain. But several recent studies show small changes. Bossema 2013 looked at 50 fibromyalgia patients and found 10% showed a small effect on pain or fatigue related to the weather (and not attributed to other factors they accounted for such as demographics, functional status, etc) (2).
And we can just as easily find a contradictory study. A study by Fors and Sexton in 2002, looked at 55 fibromyalgia patients found weather did not affect have a pain response. They did, however, show that patients with less than ten years of fibromyalgia experienced greater weather sensitivity to pain than those who had the diagnosis for longer (3).
A larger, well-designed study enrolled 810 adults living in one of six European countries (4). All the patients had osteoarthritis of the hip, knee, or hands. They found higher humidity was linked with increasing pain and stiffness, particularly in colder weather.
A study by Cioffi et al published in May 2017 looked at masticatory muscle pain (MP) and migraine (MH) and found there was a notable change in pain related to atmospheric pressure (5). Interestingly enough, each group had a different response in pain to weather changes (i.e. negative association of pain with atmospheric pressure in MP group and positive with atmospheric pressure in MH group). Of note, within the group, the responses were consistent.
I believe future research is around the corner. An interesting study I came across, recently published in March 2017, utilized a smartphone app in which rheumatoid arthritis patients documented their pain data. The app can even utilize GPS information from the smartphone to populate data regarding the weather on the day/location of the entry. Using this technology, I expect we can obtain large numbers of weather-related pain information and perhaps more answers into this interesting phenomenon (6).
In conclusion, I believe that weather certainly can affect an individual’s arthritis and muscle pain, but the mechanisms are not entirely understood. Doctors are definitely not rushing to recommend all chronic pain patients flock by the herds to Florida or California. That being said, I do think that it’s important to stay as healthy and active as possible during the winter months when it is simply harder to do so. Stay active, eat healthily, check vitamin D levels, and optimize your mood.
- Jamison RN, Anderson KO, Slater MA. Weather changes and pain: perceived influence of local climate on pain complaint in chronic pain patients. Pain. 1995. 61(2): 309-15.
- Bossema ER et al. Influence of weather on daily symptoms of pain and fatigue in female patients with fibromyalgia: a multilevel regression analysis. Arthritis Care Res. 2013. 65(7) 1019-25.
- Fors EA, Sexton H. Weather and the pain in fibromyalgia: are they related? Ann Rheum Dis. 2002. 61(3): 247-250.
- Timmerman’s et al. The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis: Results from the European Project on OsteoArthritis. J Rheumatology. 2015. 42(10):1885-92
- Cioffi et al. Effect of weather on temporal pain patterns in patients with temporomandibular disorders and migraine. J Oral Rehabil. 2017 May;44(5):333-339.
- Reade et al. Cloudy with a Chance of Pain: Engagement and Subsequent Attrition of Daily Data Entry in a Smartphone Pilot Study Tracking Weather, Disease Severity, and Physical Activity in Patients With Rheumatoid Arthritis. JMIR M Health. 2017. 5(3) e37.
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