Friday, February 24, 2012

Weather and Rheumatoid Arthritis

Lots of patients will tell about effects of weather on their condition. German has an own term for sensitivity to weather or weather changes (Wetterfühligkeit). There aren’t many studies to either confirm or refute the hypothesis that certain weather conditions generally influence pain or disease activity of rheumatoid arthritis.
How about complaints by patients? That oo hot and too cold leads to more pain will be mentioned. And high humidity also seems to affect complaints.
The Chinese term for rheumatic disease, still in use nowadays, is also due to observations of wet weather and rheumatic complaints: 风湿病 – wind and wet disease.

A systematic review by G. Smedslund and K.B. Hagen (Does rain really cause pain? A systematic review of the associations between weather factors and severity of pain in people with rheumatoid arthritis. / Eur J Pain. 2011 Jan;15(1):5-10. Epub 2010 May 31) did not “show any consistent group effect of weather conditions on pain in people with RA.” But they found evidence, that in some individuals pain is more affected by weather than in other individuals. This would be congruent with pain reporting in clinical practice.

Geir Smedslund et al. published another study: 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 in Arthritis & Rheumatism (Vol. 61, No. 9, September 15, 2009, pp 1243–1247). In this study they correlated daily reports of pain over 84 consecutive days against variables of weather and solar activity (ultraviolet light dose, solar radio flux/sunspot count). Why solar activity? The research went back to an early study from the 1870s, which “reported that periods of Aurora Borealis were associated with increased pain (Everett JT. Studies in relation to the production of pain by weather. Chicago M J Exam 1879;38:253–60.)”. They concluded: “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.” They warned against generalizations: “However, these results have limited generalizability regarding geographic region, season, and patient sample and need replication.”

Maybe we should look for patients, who are susceptible to more pain and activity, and have them keep a diary to better counsel them. You will find all kind of tipps on the net like increasing resilience through Kneipp affusions. I think measures that help with other forms of increased activity or pain concerning rheumatoid arthritis also work if weather is in the discussion.

For further reading on the topic I highly recommend Dr. Shashank Akerkar's blog:  

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