It is that time of the year again… The leaves have fallen from the trees, days are short, and the weather outside is freezing cold. While we are spending our time sitting on the couch under a nice warm blanket, we daydream about sunny beaches, summer bars, and flip flops. Typically during winter, we have the feeling that our neck or low back is hurting more. Our joints are feeling stiff and we have less motivation to exercise. Health professionals experience that their patients with chronic musculoskeletal pain are feeling worse during bad weather. But is this only a feeling? Or does the weather actually influence our pain experiences?
Many studies investigated the association between pain and weather conditions, often with conflicting results. They all agree that the majority of patients with chronic musculoskeletal pain believe that their pain is influenced by the weather1. However, scientific evidence to objectify these beliefs remains inconclusive, possibly due to the need of large sample sizes and long follow-up periods to capture all weather circumstances, and due to the impossibility of blinding. A systematic review2 concluded that there was no association between pain and temperature, relative humidity or atmospheric pressure in patients with rheumatoid arthritis. Another review1 reported that there is evidence for the association between several weather variables and musculoskeletal pain, but that there are also many studies that did not find any association. A study investigating the influence of weather on patients with osteoarthritis3 showed that higher humidity resulted in more joint pain. This association was even stronger in cold weather. Another large study4 – named ‘Cloudy with a chance of pain’ – collected daily data of 2658 patients over 15 months and found that higher humidity and wind speed, and lower atmospheric pressure were associated with increased pain severity in chronic pain conditions. In all likelihood, at least a part of the patients can ascribe their pain fluctuations to weather changes.
The question remains ‘how’ the weather affects our pain experiences. Possible explanations vary from physiological responses, such as changes in blood pressure and viscosity, to psychological responses5. Given mental health is affected by the seasons6 and chronic pain is importantly influenced by psychological factors7, weather could be an essential factor to take into account while treating patients with chronic pain. Even if there is no physiological contribution, the patient’s belief itself could be enough to influence pain. Better understanding of the impact of weather might allow ‘pain forecasts’, enabling patients to take greater control of their lives4.
In conclusion, the relation between weather and pain has been difficult to characterize, but an association cannot be ruled out. In the end, we are all just longing for summer. No worries, soon the first spring flowers will reveal themselves and the sun will be shining more brightly.
Physical therapist and PhD student at Ghent University.
2022 Pain in Motion
References and further reading: http://www.sciencedirect.com/science/article/pii/S...
1. Beukenhorst AL, Schultz DM, McBeth J, Sergeant JC, Dixon WG. Are weather conditions associated with chronic musculoskeletal pain? Review of results and methodologies. Pain 2020; 161(4): 668-83.
2. Smedslund G, Hagen KB. Does rain really cause pain? A systematic review of the associations between weather factors and severity of pain in people with rheumatoid arthritis. European Journal of Pain 2011; 15(1): 5-10.
3. Timmermans EJ, Schaap LA, Herbolsheimer F, et al. The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis: Results from the European Project on OSteoArthritis. J Rheumatol 2015; 42(10): 1885-92.
4. Dixon WG, Beukenhorst AL, Yimer BB, et al. How the weather affects the pain of citizen scientists using a smartphone app. npj Digital Medicine 2019; 2(1): 105.
5. Farbu EH, Rypdal M, Skandfer M, et al. To tolerate weather and to tolerate pain: two sides of the same coin? The Tromsø Study 7. Pain 2022; 163(5).
6. Øverland S, Woicik W, Sikora L, et al. Seasonality and symptoms of depression: A systematic review of the literature. Epidemiol Psychiatr Sci 2019; 29: e31.
7. Turk DC. The role of psychological factors in chronic pain. Acta Anaesthesiol Scand 1999; 43(9): 885-8.