The Lower Quote, As If You Didn't Know, Is By Richard Dawkins, Son.

Wednesday, June 15, 2011

Joint Pain and Weather Changes

Working in the physio clinic for almost seven years now I have heard most tall tales, wives tales, bullshit tales, and verified truth tales. One tale that is oft-repeated is that you should soak in a hot bath with epsom salts after a workout to speed recovery and prevent delayed onset muscle soreness (DOMS). Turns out, not so much. Another is the claim so many patients make regarding joint pain and changing barometric pressure. But is it true? A hundred million Elvis fans can't be wrong...right?

Well, I checked the available research because, as you are all well aware, the plural of "anecdote" is not "data". There are five citations and I'll briefly hit each one with commentary.

The first one had 54 participants and those were followed over four months. The results stated:
Twenty nine patients kept daily records during the first 2 months. There was no positive correlation between weather parameters (such as temperature, humidity, and barometric pressure) and pain ratings. Interestingly, the pain rating significantly increased the day after the advent of a cold wave (sign test, p less than 0.01; Wilcoxon signed ranks test, p=0.001). The number of patients who experienced joint swelling was not related to weather conditions. Twenty one participants continued maintaining the diaries during the next 2 months. The patients reported higher pain levels in the first 2 months during the cold wave period than in the next 2 months when the cold wave period had ended (p less than 0.001).
To my untrained eye, this seems like no biggie. Joint pain doesn't seem to be related. The authors' conclusion, however said:
A dramatic weather change such as a sudden cold wave might influence the experience of joint pain.
Ok, they use the word, "might", but it still seems like they're trying to make it seem like there was more of a correlation than there actually was. On to number two...

This study, entitled, "Weather conditions can influence rheumatic diseases" came to the conclusion:
Our data demonstrate that osteoarthritic patients experience increased joint pain in response to a decrease in pressure, indicating that low atmospheric pressure conditions exacerbate joint pain in these patients.
I'm going to need someone versed in study analysis to check the methodology for me on this one, but there were 92 participants on one side of the blind and a control group of 42, so not enough to make sweeping generalizations.

The third study, done on rats, showed that:
...lowering barometric pressure and ambient temperature within the range of natural environmental fluctuation intensify pain in arthritic rats.
So if you're an arthritic rat, you better stay away from the rodent research lab at Nagoya University. Not sure how cross-applicable these results are, but you never know.

Fourthly, this study which focuses more on seasonal changes with respect to systemic lupus erythematosus (SLE) compared to Behcet's disease (BD). Not really relevant to the discussion here, plus the results were gathered by telephone survey. Objective data is really better than a subjective relay of remembered symptoms.

And lastly, a one-month prospective study involving 62 participants which concluded:
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.
I found a nice summary of the thinking on weather change/joint pain from Beth Israel Deaconess Medical Center. In it, they discuss the evidence and say:
The results of these studies have been varied. Based primarily on a compilation of patient anecdotes (reports of arthritis sufferers, for instance), increased barometric pressure (in fair weather conditions) has been associated with increased joint pain. Conversely, others studies have shown a relationship between increased joint pain and decreased barometric pressure (in stormier weather). Still other studies have suggested that changing weather conditions can cause immediate pain in some patients and delayed pain in others.
This paragraph seems to me to lean toward saying it's made up by the patients. If the reactions are this varied, it is consistent with a non-existent phenomenon - and this paragraph was in the "evidence for" section of the article. Interestingly, one point brought up shortly after the above one is this:
...many doctors claim that the wide variety of arthritic conditions and sheer complexity of atmospheric variability makes coming up with meaningful connections between joint pain and weather conditions next to impossible.
True enough. It has to be difficult to isolate a variable when you're dealing with a (literally) chaotic system like the weather.

The final point is one worth re-printing here. It is one skeptics make again and again with respect to myriad claims and beliefs, but here it is just as relevant:
(Belief that weather changes cause pain is ok) long as it doesn’t interfere with (the) motivation to change the things they actually can control. Anticipation of a favorable weather forecast is no substitution for exercise, weight loss and medication when necessary.
Shout the truth, Brother. Believe whatever you want, just do the shit you need to in order to fix what's wrong with you.

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11 Barbaric Yawps:

At 17/6/11 6:21 am, Blogger Shadeburst said...

It's one of the few remaining "black holes" of medicine and a loophole which lawyers love to exploit.

There's no way to measure pain levels objectively. You have to rely on subjective reports.

Gates alone knows how they measured pain levels in those poor rats.

Until a "dolorometer" or external pain gauge is invented, quack medicine and ambulance-chasers can continue to run riot.

At 3/8/11 8:42 am, Anonymous Anonymous said...

But what CAN you do about the pain?
I have a BMI of 22, runs 10-20 miles a week, do my strenght exercises, eat healthy, work full time, have a Ph.D. and soon an eMBA on top (education is the only thing that actually is proven to improve overall health, so I am about to exhouse the system in search for better health).
Still my joints hurt like hell each time the weather is about to change. Better weather forecast than the meterologists can provide; but is really disturbs my life! Doctors says; "keep eating pain killers". However, that's almost no effect. So, to all that warn about alternative solutions preventing thing that actually help: what are you talking about? What is your mystery cure?

At 3/8/11 9:58 am, Blogger Heathen Mike said...

There is no mystery cure. All I'm saying here is that it seems that the weather doesn't seem to affect joint pain.

You may have arthritis or some other undiagnosed condition and as such, I would recommend visiting your doctor and requesting a specialist visit where you could look more specifically at your pain and how to manage it.

I hope your pain gets better :)

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Mostly joint pain occurs due to changing the weather. We should take some precautions while the weather is changing.
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