How often have you heard a patient say, “This weather… oh, my arthritic knees”! Some patients say that with such conviction, but is there a correlation between weather changes and arthritic pain?

Osteoarthritis (OA) is characterized by synovial inflammation, articular cartilage degeneration, and subchondral bone thickening, leading to joint pain, stiffness, and disability (Wang et al., 2023).  Patients seen by a physiotherapist generally complain of pain and stiffness. Also, Brennan et al. (2012) think that pain severity in individuals with knee osteoarthritis is modestly influenced by the weather.

OA Pain and Barometric Pressure

Quantitative analysis has shown that there is a moderate correlation between OA pain and temperature or barometric pressure (atmospheric/air pressure), with relative humidity bearing a weak correlation. Actually, there has been a growing interest in the connection between barometric pressure and health and its impact on chronic pain conditions, including arthritis. While the exact mechanisms behind this association are not yet fully understood, several theories have been proposed (Fay, nd.). McAlindon et al. (2007) believe that the association of weather to an increase in arthritic pain is not straightforward; they assert that severe weather deterioration is generally associated with marked fluctuations in pressure and increasing pressure is associated with increased pain Also, it is believed that changes in barometric pressure can lead to cooler temperatures and cloudless skies, and lower barometric pressure can lead to warmer temperatures, clouds and possibly accompanied by rain (Perles, 2017), i.e. warm temperature causes air pressure to rise, and cool temperatures cause air pressure to drop.

However, following an internet-based clinical trial, McAlindon et al. (2007) noted that precipitation and temperature were not confirmed to be associated with pain severity. Also, given that pain-related (nociceptive) nerve fibers are more sensitive in patients with arthritis due to the high level of inflammatory mediators, Horvath et al. (2023) postulated that low/fluctuating pressures can result in a change in intracapsular fluid flow, leading to pain and stiffness. Also, Golen and Ricciotti (2022) mentioned that as the weather changes, the barometric pressure also changes, and this triggers pain in the joints, and air pressure causes the expansion of tissues around the joints, which could lead to an increase in pain.

Changes in barometric pressure, which happens as weather systems change, can cause an increase in pain, and this may be due to changes in intracapsular fluid balance, an alteration in pressure within joints, and an increase in pain perception due to the effect of an increase in pressure on nerve sensitivity on an already inflamed arthritic joint. This may be important to physiotherapists practicing in areas where there is a frequency of high-pressure systems associated with weather systems.

Sibyl Edward (PT, DPT)

Sibyl Edward (PT, DPT)

Chair of the Northern American and Caribbean Region of World Physiotherapy

Dr. Sibyl Edward is a Physiotherapist with 34 years of experience and is currently the Head of Rehabilitation at the Millennium Heights Medical Complex in Castries, Saint. Lucia. She is also the Chair of the World Physiotherapy North America Caribbean region, a founding member of the Physiotherapy Association of Saint Lucia (PASL) Inc., and current Treasurer of the Association, a Member of the Ad hoc Committee of the Allied Health Council of Saint Lucia and a member of the Environmental Physiotherapy Association.

References

Header image by Raychel Sanner on Unsplash

Brennan, S. A., Harney, T., Queally, J. M., O’Connor Mcgoona, J., Gormley, I. C., & Shannon, F. J. (2012). Influence of weather variables on pain severity in end-stage osteoarthritis. International Orthopaedics36(3), 643–646. https://doi.org/10.1007/s00264-011-1304-9 

Faye, D. M. (n.d.). Does barometric pressure affect arthritis? Retrieved from https://careclinic.io/does-barometric-pressure-affect-arthritis/ 

Golen, T. & Ricciotti, H. (2022). What triggers weather-related joint pain? Retrieved from https://www.health.harvard.edu/pain/what-triggers-weather-related-joint-pain 

Horvath, G., Nagy, K., Tuboly, G., & Nagy, E. (2023). Pain and weather associations – Action mechanisms; personalized profiling. Brain Research Bulletin, 200, N.PAG. https://doi.org/10.1016/j.brainresbull.2023.110696 

McAlindon, T., Formica, M., Schmid, C. H., & Fletcher, J. (2007). Changes in barometric pressure and ambient temperature influence osteoarthritis pain. American Journal of Medicine120(5), 429–434. https://doi-org.ezproxy.utica.edu/10.1016/j.amjmed.2006.07.036 

Perles, C. (2017). The causes of barometric pressure. https://sciencing.com/causes-barometric-pressure-5101048.html

Wang, L., Xu, Q., Chen, Y., Zhu, Z., & Cao, Y. (2023). Associations between weather conditions and osteoarthritis pain: a systematic review and meta-analysis. Annals of Medicine55(1). https://doi.org/10.1080/07853890.2023.2196439