Many of my patients (and even more of my relatives) tell me that their arthritis pain is affected by weather. More remarkably, for many the joint symptoms precede weather changes. Often my patients say they are better at predicting weather than the weatherman.
Could that be true, or is it another well-accepted, untested medical myth? Perhaps it’s just a commentary on the accuracy of our meteorologists? There have been attempts to study how weather affects symptoms of joint disease. The results may hold clues into how our joints work, how to treat the pain, and why there is such variability in symptoms from one day to the next.
The Case For Weather Affecting Arthritis
As I learned about joint disease during my medical training, no one taught me that weather mattered. Yet I heard about the association so often from my patients that I wondered whether there was something to it. After all, the lack of convincing evidence connecting weather to arthritis flare-ups and the fact that it is not taught in medical schools do not prove that there is no connection. As the saying goes, "absence of proof is not proof of absence."
So, besides the stories of individuals who are absolutely convinced about weather's role in arthritis, what is the evidence that weather affects joint pain or that joint symptoms can actually predict the weather?
The medical literature dating back to at least 1859 describes theories (though no proof) that changes in barometric pressure at least partly explain changes in joint pain.
In addition:
- A study published in 1929, and several others since, asked arthritis patients about their symptoms and found that during periods of increasing barometric pressure joint pain increased.
- A similar study published in 1990 found just the opposite — that joint pain increased when barometric pressure was falling. Other, more recent trials have found small effects of humidity, pressure, temperature, the amount of sunlight, or combinations of these on joint pain.
- Some studies suggest that the effects of weather on arthritis are immediate; others say there is a delayed effect of up to a month or more. For example, a 1997 study published in the Journal of Rheumatology found that the ESR, a blood test that often reflects the presence of joint inflammation, closely followed the average daily temperature from 30 days earlier; thus an increase in the temperature seemed to predict a rise in the ESR (indicating an increase in arthritis activity) 30 days later. Similarly, joint pain increased with rising temperature and improved with falling temperature, but the symptom changes occurred 48 days later than the weather changes.
The Case Against Weather Affecting Arthritis Pain
Studies finding a link between changes in weather and changes in joint symptoms have almost all relied on "subjective" measures of arthritis — that is, increases in pain as reported by patients. There are far fewer studies relying on examinations by physicians or results of blood tests that might be more convincing to skeptics. In addition, for each study finding an effect, there seems to be another showing the opposite effect or no effect.
Is It All Intuition?
A study in the April 1996 Proceedings of the National Academy of Science found no association between arthritis (measured by patient report of pain or by the observation of swelling by an examiner) and weather, even though the patients thought that a strong relationship existed. More remarkably, when the data was presented in graphic form to 97 college students, many thought correlations existed when none did according to standard statistical analysis. As summed up by the authors of the study, "… the intuitive notion of association differs from the statistical concept of association." They attributed this phenomenon to a common human attribute called "selective matching," in which we tend to remember when two things occur or change together but remember less when they do not. People with arthritis may notice what the weather is doing when their arthritis is worse, but take less notice of the weather when their arthritis is stable or improving.
Weather and Arthritis — Does It Matter?
Some would argue that even if weather did affect arthritis, there would be little practical importance to proving it. We cannot readily change the weather, so we are left with whatever options are currently available for the treatment of arthritis. However, some people with arthritis move to a climate they think will be better for their condition or have received that advice from their doctors. More importantly, if we did figure out the exact way weather affects the joints, it could lead to better treatments to counteract that effect. For example, if a particular chemical in the joint increased whenever the barometric pressure rose and that led to an increase in joint inflammation a day or two later, perhaps a medication to counteract that chemical could prove useful as an arthritis treatment.
The Bottom Line
It has not yet been proven that weather reliably affects arthritis. That said, it has not been disproved, either. Attempts to study the effects of weather are fraught with difficulty. There are many different types of arthritis and many different features of the weather that could act in combination to have an impact on joint symptoms. In fact, it’s not clear to me that a definitive study is even possible.
Given the widespread belief that weather matters for arthritis pain, it's probably best to assume there may be an effect that we do not yet understand. If it is true that arthritis sufferers can predict the weather, it might be the only good thing about having arthritis.
Do you think weather affects arthritis? Have you noticed a connection? What type of weather has the most impact on your joints?
Robert H. Shmerling, M.D. is an Associate Physician at Beth Israel Deaconess Medical Center. He is also a Senior Medical Editor for Harvard Health Publications.
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Comments: 19
I think it'd be interesting to actually study the accuracy of weather forecasters compared with arthritis sufferers, at least for certain aspects of the weather (such as whether it's going to rain). It's possible that people with joint disease are pretty good at it which would be remarkable given all the high-tech equipment weather forecasters now rely on!
And, for what it's worth, I think the reason we have no definitive answers from research to explain the effect of weather on joint disease is simply that it's very hard to study well (not because researchers are biased).
bottle treatment called ? Dr. Ra puts the med's into the bottle, use to give myself treatment in the upper leg or stomach, I am diabetic as well type 2 but need med's as well Insulin.spelling? Oceania,was on remicade, humira , umiura ? Made me really sick. There was something in the three agent . I spent a year in bed, wheel chair, than a walker, cane, my grandmother was in a wheelchair & she had RA really bad.Spelling/ next thing a know I got a blood disease. Now I have another specialist, I think it has come from all my treatment from Ra? what do you think?
God Bless
10& Weather is a key factor in my opinion. Morphine & the openit deagerit patch, been in pain management for a year before that. I have sterone's ,gold treatment, cortisone , etc.. I fell God has blessed me, want me a while longer. I wrote a few article about it, my life Diary true story about Ra among other thing, Fibermolage, pain!!!!
I can tell when it's going to get damp and cold. I live in Texas, so the heat is a a good thing. If I travel north in the winter I am barely able to get around. Come back home, to the relative warmth, and I'm back to my old self.
Temperature?
Pressure?
Humidity?
I know when it is cold and I wake up my body is more stiff
and my circulation is down. Don't all warm-blooded mammals
pull blood from their extremities in the cold?
I have been told I have some arthritis, in my neck, but I never
feel it at all if it is really even there unless I am very stressed,
or I sleep wrong, then I wake up with a head and neck ache.
I don't think medicine really knows much about arthritis. It would
seem easy to do something about if they did. Even providing
pain relied you guys cannot come up with a medication that
does not give some people heart attacks, yet year after year
you such up more of the nation's money.
One year somthing is bad for you that was previously good,
and then the next year it reverses, it is all based on selling
and money.
Weather also affects my incision scars.
I find it so interesting (and hard to explain) that many patients I see here in the northeast often tell me that they feel better when they travel to the west coast or southwest U.S., especially when the weather is warm and dry. Some have considered moving there for just this reason! Yet, you've noticed that the weather there can make you feel worse.
Maybe this shouldn't be so surprising: there are many types of arthritis, no two people experience it in just the same way and weather's effects have simply defied under-standing so far.
He continued to take NSAID's, and if he did not move, his symptoms would get worse.
I have arthritis as well, but I cannot take NSAID's because of side effects. Between the heat of hot flashes and exercise to the point of sweating a great deal, I have been able to control pain. Exercise was even helpful after chemotherapy.
If I stop moving, I am in trouble.
Yoga and dance keep me moving. Working to the point of sweating helps. I maintain range of motion, a feeling of lubrication in my joints, balance, and a consciousness of where my body is in space. I feel stronger and healthier. I also notice I am less subject to infection from cuts and scrapes, and I am much surer on my feet than before.
Some people find improvement with tai chi exercises as well. There are many forms and kinds of yoga, tai chi, and dance. They can heat you up and help to maintain function across varied body types. Repetitive-motion exercise, such as long-distance running, does not work for me.
Warming the body before getting out of bed in the morning is not so hard with abdominal exercises and back-extension exercises. Back-extension exercises counteract bad posture in addition to being very heating for people who are not used to them.
It is amazing how people working out hard in a room can raise the temperature and the humidity in the room. I sometimes look at people working out in gyms and wonder how much less oil we would have to use if we could harness all that work.
Thanks for the posting.
Finding an effective treatment for arthritis can be challenging - with or without the effects of weather. And while there is plenty about arthritis we don't understand – including the impact of weather - there are more arthritis treatment options than ever before.
Through careful and creative scientific study, we may eventually have an answer. And that raises this question: will understanding the impact of weather on arthritis be helpful?
You both mention something important: the importance of exercise and movement.
My recommendation to patients, family and friends with arthritis is to keep moving. Whether it's a supervised exercise program with a physical therapist, regular walks with the dog, workouts at the gym, or something else, moving is better than not moving. There's little evidence that exercise is harmful for people with arthritis (as long as the exercise is not extreme and does not involve high impact on bad joints). And there's plenty of evidence that exercise can be helpful. I recommend a combination of stretching, strengthening, balance and aerobic activities.
If you can predict worsening of your joint symptoms during certain weather conditions, you may be able to reduce your symptoms by exercising in advance. And even if your arthritis symptoms are not particularly predictable, find an exercise routine you enjoy and can tolerate. Start slow and gradually build up duration and intensity. Many people find they can do more than they thought and that exercise reduces pain and stiffness.
Not only can I predict weather changes by achy joints and a rushing sensation that I believe is my immune system looking for a place to terrorize, others can predict the weather by touching my knees or shoulders. My joints are cold to the touch. I can deter joint pain by keeping those joints warm. A soak in a warm tub with epsom salts seems to help the 'rushing' sensation, and I eat ice chips while I soak to keep my body temperature regulated. (I don't know if all arthritis patients have fluctuating body temps like I do, so I mention that in case it will help someone else.)