Do weather changes affect arthritis?

Question

My father always claims he knows when a storm is coming by the pain in his knee. It turns out he might not be as crazy as I thought. Many people with arthritis report varying pain levels as a result of weather changes, as WebMD explains:

Many of us have an older relative who claims to have an arthritic joint with the power to tell the future, at least meteorologically. She will stare out the window on a perfectly pleasant, sunny day, distractedly rubbing her painful shoulder, and proclaim solemnly, "A storm's a comin'."

She's hardly alone in her belief. The idea that certain painful health conditions are affected by the weather is both widespread and ancient, dating back to at least Hippocrates in the fourth century B.C and no doubt earlier, according to James N. Weisberg, PhD, a psychologist who specializes in treating painful conditions.

Unfortunately for my dad, the article concludes:

But despite the venerable pedigree of the belief, should we ditch our Doppler radar and our well-groomed television meteorologists and replace them with Achy Joint Bulletins issued by our great aunts?

Probably not. Although many believe in the connection between weather and health, most medical studies have come up with equivocal support at best. So if there isn't a connection, or if the connection is relatively unimportant, why do we believe in it so strongly?

Closed case? Apparently not. Another article on the same website states:

Weather, Arthritis Pain Link Confirmed

Arthritis Pain Increases With Cool Temps, Barometric Changes

Chalk one up for conventional wisdom: Arthritis pain and weather really do appear to be connected.

Cooler temperatures and changes in barometric pressure go hand-in-hand with increases in arthritis pain, according to new research.

Color me confused. Is there any evidence that weather affects arthritis pain, possibly even prior a storm? Or should my dad leave meteorology to the professionals?

Answer 1

Finally a question where there is a ton of research that I can dig through, I'm sorry if this is a bit long winded. There appear to have been a great deal of different results, heres a few examples:

Weather and arthritis symptoms (1985) concludes that there's no significant change in arthritis despite the patients belief that there was.

In a one month prospective, double blind study of 70 patients (35 with rheumatoid arthritis [RA], 35 with osteoarthritis [OA]), severity of rheumatic symptoms was compared to changes in daily weather conditions using a visual analogue scale. The majority of patients (62%) believed that various aspects of weather aggravated their symptoms. There was no difference in age, sex, diagnosis or perceived symptom severity between weather sensitive and weather insensitive patients. No significant correlation was found between symptoms of any patient group or individual and any of 13 combinations of weather features. These results suggest that contrary to the belief of the majority of patients with RA or OA external weather conditions do not significantly influence the day-to-day symptoms of arthritis.

Effect of weather conditions on rheumatic patients (1990) showed positive results:

In a one month prospective study of 62 rheumatic patients--16 with rheumatoid arthritis (RA), 24 with osteoarthritis (OA), 11 with inflammatory arthritis, 11 with fibromyalgia joint pain--swelling and everyday activity was compared with changes in daily weather conditions. In most patients weather changes increased arthritic symptoms. Women were more sensitive to weather than men (62% v 37%). Pain was affected positively by barometric pressure and temperature in RA, by temperature, rain, and barometric pressure in OA, and by barometric pressure in fibromyalgia. These results support the belief of most rheumatic patients that weather conditions significantly influence their day to day symptoms.

On the belief that arthritis pain is related to the weather (1996) says no it's probably in peoples heads:

We studied patients (n = 18) for more than I year and found no statistically significant associations between their arthritis pain and the weather conditions implicated by each individual.

Rheumatoid arthritis patients show weather sensitivity in daily life, but the relationship is not clinically significant (1998) points out that of all the variables effecting pain, weather is only a small part of that:

In general, patients with higher levels of self-reported pain demonstrated more weather sensitivity. When considering the magnitude of these effects, however, weather variables accounted for only a small amount of change in pain scores. This pattern was true even for patients with the most pronounced pain–weather relationships. Thus, although weather sensitivity was found, the effect sizes were not clinically meaningful.

Which is the dominant factor for perception of rheumatic pain: meteorology or psychology? (2009) examined how strong the belief was when the subjects spent a year in a different weather:

[84%] of subjects belive in an association between weather and rheumatism, while 57% claimed to have ability to forecast weather. The maximum correlation coefficient between weather and arthritis symptoms was −0.451 and the maximum contribution of weather on symptoms was 17.1%. Arthritis symptoms were significantly contributed by Beck depression score. The belief about presence of weather–arthritis association was found to be stronger than its statistical power.

Does the weather really matter? A cohort study of influences of weather and solar conditions on daily variations of joint pain in patients with rheumatoid arthritis (2009) concludes that it depends:

Weather sensitivity seems to be a continuum and a highly individual phenomenon in patients with RA. In the present sample, pain was significantly associated with 3 or more weather variables in 1 out of 6 patients, for whom the magnitude of weather sensitivity might significantly influence pain reporting in clinical care and research.

What's in season for rheumatoid arthritis patients? Seasonal fluctuations in disease activity (2006) is a bigger study with 1665 that concludes positive results across seasons:

We found definite seasonal differences in RA patients, both subjectively and objectively. RA disease activity was higher in spring and lower during fall. Seasonal changes may play an important role in evaluating disease activity of RA patients and should be taken into account when examining these patients.

Weather effects in rheumatoid arthritis: from controversy to consensus. A review. is a meta-study of the research between 1985-2003 that finds that weather is something that has many variables, and a problem with many studies is that the methods are so different:

CONCLUSION: RA variables are positively correlated with the humidity of the microclimate at the patient's skin. High outdoor relative humidity is unfavorable, but has less influence when there are few barriers for water vapor, like clothes, and when air conditioning is used. High temperature is unfavorable since it increases absolute humidity, but beneficial as well, since it reduces the presence of barriers, and stimulates the use of air conditioning. The classic opinion, "Cold and wet is bad, warm and dry is good for RA patients," seems to be true only as far as humidity is concerned.

It seems to me that from the point of view of your father, if he experiences less pain in one weather than another then that should be what he should go on. It appears that what patients experience are so individual that it's hard to pin down an optimal weather condition that can be broadly suggested for everyone. It also seem that weather would be a small portion of pain management, or the research would show a strong correlation between certain conditions and others.

Looking into this reminds me of a quote from Niel deGrasse Tyson about cancer and cell phones (who - like me - is not a Doctor):

If you try to measure a phenomenon that does not exist, the variation in your measurement will occasionally give you a positive signals, as well as negative signals. If your idea is that A causes B, in this case cell phones causes cancer. Then a paper gets written about that result and then people might get concerned that cell phones cause cancer or that the power-lines might cause cancer, this go way back and so if you look at the full spade of these studies even those they don't publish because it was not a positive effect there are some cases where there is in fact less cancer and so these are the phenomenon of a no-result.

When you actually have A causing B the signal is huge and it's repeatable in time and in place in cell phones that repeatable signal is yet to emerge from the total experiments that are done with it. [..]

Maybe what we are seeing is the noise of a no-signal or maybe the jury is still out as they are actively publishing research in it.

Answer 2

The problem with your second article is that it confuses correlation with causation.

Donald A. Redelmeier (professor of medicine at the University of Toronto) writing in Scientific American, has a good readable explanation. His conclusion:

Ultimately, peoples' belief about wet weather and arthritis may reveal more about the workings of the mind than the body. Indeed, the innate tendency to identify patterns and discount randomness has evolutionary benefits because predictability can often be turned to advantage, whereas randomness is hard to exploit.

Answer 3

There are a couple different layers to this question, obviously changes in arthritis pain is the most obvious, but there is also a more subtle question about generalized pain due to weather changes. As the answer by Kit Sunde handles the arthritis side of things quite handily, this will focus a bit more on the generalized pain stand point.

With regards to generalized pain, it appears that the answer is yes but largely on the strength of the anecdotal evidence as properly controlled for studies tend to be lacking. A survey paper released in 1996 reviewed what had been published up to that point and found that when properly surveyed and controlled for, there is a link between the reports of perceived pain and changes in the weather; however, actual laboratory controlled research was lacking.

However, an article released in 1995 argued there is no link between changes in weather and arthritis pain following a small (n = 18) study, but given the limited study group and the fact that it stands in contrast to other findings, it is entirely possible that something else might be going on.

A recent (2011) literature review on osteoarthritis pain has also bore out the conclusion that most of the research supports a correlation between barometric pressure and various forms of chronic pain which seems to be the direction that the scientific community is going as the accepted explanation although you do still see some people going the direction of saying there is no link (or no proven link) and that there is a psychological aspect to the pain (e.g. bad weather leads to a lousy mood and more sensitivity to pain).

So in summary, there appears to be a link between weather and pain along with a tentative mechanism as to why; however, the general consensus is that there haven't been sufficient studies to prove the connection yet.