Cold fact or hot air? Joint pain from changing weather is a myth, Australian researchers say
The common belief that changes in temperature and humidity can trigger musculoskeletal aches or common forms of arthritis has been challenged by the first comprehensive review to examine the effect of weather on joint pain.
Researchers led by Prof Manuela Ferreira, a pain expert from the University of Sydney, analysed 11 international studies on weather and musculoskeletal pain that involved more than 15,000 participants. The subjects had reported new or worsening muscle or joint pain due to factors such as hotter or colder temperatures, wind speed, humidity and air pressure.
“We needed to focus on high-quality studies, specifically designed to evaluate a direct link,” Ferreira said.
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“This is because various other factors, and especially behaviours, can be influenced by the weather and consequently shape how we cope and perceive muscle or joint pain. By looking at the most appropriately designed studies, we could provide a more definite answer to this question and debunk this myth.”
Their meta-analysis found that despite anecdotal reports from patients, changes in weather factors do not seem to directly increase knee, hip, or lower back pain, including rheumatoid arthritis or osteoarthritis symptoms.
Ferreira believes reports of pain as being triggered by weather conditions may be explained by how we change our behaviour in different types of weather.
“For example, some people will exercise more, some will exercise less, and that will influence our perception of pain, or even our coping mechanisms,” she said.
“It is similar to the long-standing belief that cold weather will give you a cold. While we know that there is no direct link between weather and viral infections, we understand that when it is cold, people tend to spend more time indoors, encouraging the spread of viruses.
“Likewise, the weather will not affect your joints or your muscles directly and therefore will not increase your symptoms. The change in behaviour in some may, however, change how they perceive and cope with their pain.”
The findings published in February in the journal Seminars in Arthritis and Rheumatism, mean most patients and their doctors should manage pain through modifiable risk factors, such as physical inactivity, obesity and smoking, Ferreira said.
High temperatures combined with low humidity, however, may double the risk of a gout flare, the study found.
“Gout has a very different underlying biological mechanism compared to back pain or knee and hip osteoarthritis, and it may be that warm and dry weather could lead to dehydration and increased uric acid concentration, and crystal deposition in people with gout,” Ferreira said.
Although 1.71bn people globally live with musculoskeletal conditions, making them the leading contributor to disability, there are still widespread misconceptions, limited treatment options and a lack of clinical guidelines. Ferreira said this may lead to patients trying to find their own explanations for their pain.
Neuroscientist and pain expert Prof Lorimer Moseley from the University of South Australia said pain, and the way people communicate it and try to manage it, “is very individual”.
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“Findings like this can be really challenging for researchers like us because the data are telling a clear story,” he said.
“But if we’re not sensitive and respectful in how we introduce that into our own decisions and treatment, then patients will be pissed off. Because they say‘Are you telling me my knees aren’t more painful today?’.”
Moseley said it is therefore critical to recognise that the pain felt is real regardless of the cause.
This will help reveal any patterns or indirect links between the pain and the weather, he said.
“If your brain has got good reason to think, ‘OK, the weather today is just like the weather when I had my car accident,’ then you might get a fluctuation in pain driven by the weather, because the weather impacts you in light of your history,” Moseley said.
“While these studies give us good, general, population data, a patient might say, ‘Yeah, but I’m not average’. And pain is extraordinarily complex.”
