It's Cold Outside! Do Your Joints Hurt?
Does your grandmother know when a storm is coming because her knees start to ache? Or have you felt your joints ache when the temperature takes a dip? Maybe grandma was right and her achy knees really could sense rain on the way. People commonly blame joint pain flare-ups on changes in the weather, but the research on the connection between the two isn’t clear. Scientists don’t agree exactly on how weather affects joint pain, but the anecdotal evidence is overwhelming. Many of our patients notice a clear connection; some are so convinced of the link, they believe they can predict the weather better than the weather-person.! And maybe that’s true.
Here is what science says.:
A recent study finds no connection between rainy weather and symptoms of back or joint pain. This conclusion was based on data from more than 11 million medical visits occurring on more than two million rainy days and nine million dry days. Not only was there no apparent pattern linking rainy days and more aches and pains, but there were slightly more visits on dry days.
Still not convinced? That’s understandable. Maybe it’s not raining or shine that matters — perhaps it’s barometric pressure, weather changes, or humidity that matters most. Or perhaps the study missed some essential information, such as when symptoms began or got worse — after all, it can take days or even weeks after symptoms begin to see a doctor.
The question of whether there’s a link between weather and aches and pains has been studied extensively. While a definitive answer is nearly impossible to provide because it’s hard to prove a negative, prove that something doesn’t exist. The researchers have been unable to make a strong case for a strong connection. The deeper we look, the more confusing it gets.
A 2014 Australian study found no link between back pain and rain, temperature, humidity, or air pressure. This study collected data regarding the weather features at the time of first symptoms and compared it to the weather a week and a month before. An earlier study found that among 200 patients followed for three months, knee pain increased modestly when the temperature fell, or barometric pressure rose.
In one survey of 200 people with osteoarthritis in their knee, researchers found that every 10-degree drop in temperature -- as well as low barometric pressure --corresponded to a rise in arthritis pain.
A Dutch study of 222 people with osteoarthritis of the hip found that over 2 years, people said their pain and stiffness got worse with rising barometric pressure and humidity.
Two Australian studies, one on knee pain and one on lower back pain, also found no connection to weather change.
Arthritis is a general term for joint diseases causing pain, swelling, stiffness, and a decreased mobility. There are multiple hypotheses about the relationship between arthritis and weather. Although none of them have been established, a few of them are:
People with joint pain may be sensitive to changes in barometric pressure. How? It could be that when the cartilage that cushions the bones inside a joint is worn away, nerves in the exposed bones might pick up on changes in pressure.
Barometric pressure is the weight of air. During rain and snow, the temperature drops and barometric pressure decreases. Decreasing pressure (which ushers in bad weather) means air presses less on our bodies. This can cause fluid in the joints to swell slightly, which makes them stiffer. If you have stiff joints, you may be more sensitive to pain during movement, making arthritis pain seem worse.
Changes in barometric pressure may make your tendons, muscles, and any scar tissue expands and contract, and that can create pain in joints affected by arthritis.
Weather plays a key role in how much physical activity they are getting. People tend to stay indoors and lounge around more when it’s cold and rainy outside, and inactive joints can get stiff and painful. Staying in on one lousy day might not make a huge difference, especially if you have a milder case of arthritis. However, long stretches of bad weather where you don't get enough physical activity can start to make the pain worse.
Emotions drive pain perceptions. When you're happier, you tend to have less pain, and vice versa. If you are depressed, you're even more likely to have your emotions and mood affect your pain levels. It's common for the weather to affect your mood. Rainy days can put you in a gloomy funk, while sunny days can put a smile on your face. Seasonal affective disorder (SAD) is a specific type of depression that comes with seasons. Depression usually begins in late fall or early winter and goes away during spring and summer. Every year, about 5% of Americans experience seasonal depression. It doesn't matter if you have SAD or are sad — bad weather can cause a bad mood, increasing pain. And nice weather can make you happy, and you feel less pain.
Cold temperatures cause changes in blood flow as the body naturally wants to keep us warm. When cold weather strikes, some blood flow is rerouted from our limbs to important organs, such as our heart and lungs. This takes warmth away from our joints, which can cause discomfort.
There is something else that's very important to keep in mind regarding the weather and arthritis: Influenza season. Influenza season is typically considered to last from early fall through late winter or early spring. It tends to peak in the US between December and February. The flu and arthritis are linked in several ways: People with arthritis have a greater chance of getting the flu. Both the disease itself and certain treatments, such as prescribed corticosteroids, can lower the immune system's ability to fight germs. Arthritis increases the risk of having serious complications from the flu, such as pneumonia. Again, this may be due to a weak immune system. Some of the main flu symptoms are body aches and pains. If you already have arthritic pain, these symptoms can feel even worse. One of the most important things you can do is get your flu shot. It's the most effective way to prevent Influenza. The flu vaccine is absolutely safe for people with arthritis. The Centers for Disease Control and Prevention recommends getting the shot before peak flu season in early October. However, you can get it at any time throughout the flu season, and it will still be beneficial.
If damp cold weather exacerbates pain, you may wonder — why not move to where the weather is milder, warmer, or dryer? Some researchers say climate doesn’t matter. In the U.S., for example, where different regions have varied weather and climate types, one study found that even people in mild, moderate San Diego weather reported weather-related pain. In fact, they reported more pain than residents of the study’s three colder U.S. cities: Nashville, Boston, and Worcester, Massachusetts. Chronic pain doesn’t care where you live. Humidity and barometric pressure tend to change everywhere.
Ease Weather-Related Joint Pain
The studies' results are all over the place, but thankfully, you can do things that may ease the problem. You don’t need to move to a tropical climate to avoid this kind of pain. Use these ideas to get relief from weather-induced joint pain:
Stay warm: Take warm showers or baths, dress in layers during the day (including gloves and warm socks), use an electric blanket at night, or crank up the heat inside your home. This is a no-brainer!
Paraffin bath. It’s a small machine that melts paraffin wax. You dip your hands and feet in, and then you let the wax harden on your skin. Your body absorbs the heat, which may soothe achy joints. You can also use a heating pad on sore spots.
Ask your healthcare provider about non-steroidal anti-inflammatory drugs, such as ibuprofen, naproxen, or aspirin, which can reduce inflammation and pain.
Stay active. Begin exercise gradually. Try exercise that’s gentle on the joints, like yoga, pilates, or swimming. It will help you build up muscle and bone strength. If you go outside to exercise, limber up first with gentle stretches to warm up your muscles.
Healthy weight: Shedding some extra pounds has many health benefits as well, but specifically, it can take the stress off your joints. Let's look at the weight and your knees. When you walk across level ground, the force on your knees is the equivalent of 1½ times your body weight. That means a 200-pound man will put 300 pounds of pressure on his knees with each step. Add an incline, and the pressure is even greater: the force on each knee is two to three times your body weight when you go up and downstairs, and four to five times your body weight when you squat to tie a shoelace or pick up an item you dropped. Don’t strain your joints if you don’t have to. Let someone else lift those heavy boxes.
Good nutrition, hydration, adequate sleep, and keep a positive outlook. When you’re dehydrated, your sensitivity to pain increases, eat a balanced, nutritional diet, and stay hydrated.
Supplement with vitamin D or fish oil. You naturally get less vitamin D in the winter, and being deficient might make your joints hurt more. Fish oil is rich in omega 3, which helps decrease inflammation.
Be safe. Cold weather yields icy surfaces. Protect your joints from further damage from falls by wearing sturdy shoes and walking carefully.
Get a massage. Relax the muscles around your joints.
Does research matter when you have personal experience? That’s a fair question. And it’s something we’ve even heard in TV commercials about headache medicines: “I don’t care about the research. I know what works for me.” But it’s worth remembering that we humans have a remarkable tendency to remember when two things occur or change together (such as wet, gloomy weather, and joint pain), but remember less when things do not occur together. That rainy day when you felt no better or worse is unlikely to be so notable that you remember it. If you rely solely on memory rather than on more rigorous, data-driven evidence, it’s easy to conclude a link exists where, in fact, none does. Association doesn’t prove causation.
Medical myths die hard, and some seem immortal. One should remember that yesterday’s medical myth is only one discovery away from becoming tomorrow’s medical fact. Still, when the evidence is compelling, we think we’d be better off letting go of what’s been disproven, give more credence to evidence than folklore, and keep an open mind — just in case the evidence changes. When our patients tell us they can predict the weather by how their joints feel, we believe them. It’s hard to discount it when so many people notice a connection. They could represent an exception to what the studies show. But we also believe the science. Until we see evidence that’s even more compelling, we remain skeptical about the weather/arthritis connection.
References:
https://www.bmj.com/content/359/bmj.j5326
Posted 2/25/2021
About Us
Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone re-balancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP, for their excellence and contributions to medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients. Their mission is to share simple, effective, and proven strategies that lead to meaningful, sustainable, and long-lasting well-being.
