Arthritis: a barometer for weather changes?
What effect does the weather have on arthritis? This question has been debated for over a thousand years (Redelmeier and Tversky, 1996) but it seems we are no nearer a definitive answer. Research on the subject has hinted at connections, but has yet to produce clear and unambiguous proof.
VOL: 98, ISSUE: 02, PAGE NO: 34
Richard Wilson, MA, BA, RGN, is a research fellow at the Trent Institute for Health Services Research, Sheffield University
Bernadette Hardware, BA, RGN, RM, is a research nurse at Barnsley District General Hospital
However, many people with arthritis are convinced that their symptoms - primarily pain and stiffness - are influenced by changes in the weather. This article reviews the evidence in an attempt to find objective support for these claims.
For every study that claims to have demonstrated a link, another has failed to find one. One large US study (Jamison et al, 1995) recruited more than 500 people with arthritis in four cities and recorded detailed information relating to changes in symptoms and the local climate. No obvious connection was found.
A smaller study (Redelmeier and Tversky, 1996) followed 18 Canadian subjects over 15 months. They were reviewed twice a month for a self-assessment of pain, joint tenderness as assessed by a doctor, and an evaluation of functional status. Again, no statistically significant link between arthritis pain and the weather could be found.
Another Canadian study (Sibley, 1985) of 70 patients was unable to demonstrate any coherent link. In Holland, Rasker et al (1986) examined the erythrocyte sedimentation rate and haemoglobin levels of patients with arthritis but were unable to find any correlation between these physiological parameters and reported changes in perceptions of symptoms and daily variations in the weather.
In contrast, a number of research projects appear to have found some possible link. However, where there is a statistically significant association, explaining how the link occurs is challenging.
One interesting piece of work is that of Hollander (1985) who, in 1960 and 1961, studied patients in a ‘controlled climate’ chamber. This enabled him to minutely control all aspects of the climate, for example, barometric pressure, vapour pressure and temperature, and to exclude external climatic variation.
Although Hollander (1985) was unable to demonstrate a clear and decisive link, he did find evidence suggesting that certain combinations of meteorological conditions exacerbated symptoms, in particular rising humidity and falling barometric pressure. It was noticeable that static ‘weather’ patterns did not cause much change; it was the transition that affected symptoms. Laborde et al (1986) have since argued that the increased pain and swelling reported by patients with arthritis could be the result of pressure differentials developing between intracellular fluids within the joints and the falling air pressure outside.
Despite the scientific rigour and careful attention to detail of Hollander’s (1985) study, attempts to replicate the results have been less successful. Other studies have produced results that tend to support the findings, but often only in part.
Gorin et al (1999) noted that there did appear to be a weather sensitivity in some people, and that this was broadly in line with Hollander’s findings, but the results were not statistically significant. Dequeker and Wuestenraed (1986) concluded that the research did demonstrate that high humidity and low temperatures appeared to be associated with increased pain, but that low barometric pressure did not seem to be responsible for increased pain. To the contrary, they found high barometric pressure correlated with increased pain in some cases. Most researchers have found little scientific evidence that weather and arthritis are linked.
Given these confusing and contradictory findings, it might seem that it is not possible to make any useful, scientifically validated statements on arthritis and the weather. However, what can be said with certainty is that many, if not most, patients with arthritis feel that the weather does affect their symptoms.
It appears that many researchers think there is no actual physiological link at work here and that this is purely a psychological phenomenon. However, there is nothing to be gained by dismissing the phenomenon as no more than a product of the mind.
The extent to which weather impacts on arthritis is debatable. Yet, although the research findings are conflicting, it is possible to extract some knowledge that could be useful in helping patients to understand and manage their day-to-day symptoms.
Patients who are ‘weather sensitive’ are most likely to experience variations in symptoms as one pattern of weather gives way to another. Changes in barometric pressure and humidity and, to a lesser extent, temperature are the factors most likely to produce a noticeable effect. Stable weather systems seem less likely to produce marked variations in symptoms.
In communicating this information to patients, it is important to point out that some people will respond strongly to falling pressure and rising humidity, others much less so. It would seem that the best type of weather for arthritis is warm (but not hot) weather, low wind speed, low humidity and a reasonably stable climate. But finding a location that can satisfy all these requirements is as much of a challenge as demonstrating the link between weather and arthritis in the first place.
- For more information on arthritis contact the Arthritis Research Campaign at Copeman House, St Mary’s Court, St Mary’s Gate, Chesterfield, Derbyshire S41 7TD; tel 01246 558033; website: www.arc.org.uk