Tuesday, June 13, 2017

Rheumatoid Arthritis and the Comfort Zone

Most patients complain about weather associated aggravation or even flares of their rheumatoid arthritis. There are one few studies addressing the issue, of which I’ve selected some recent ones.

E.M. Savage and colleagues published a study [1]: “Does rheumatoid arthritis disease activity correlate with weather conditions?” They concluded: “In this study, rheumatoid arthritis disease activity (as measured by DAS-28) was significantly lower in both more sunny and less humid conditions.”
L. Abasolo an colleagues presented [2]: “Weather conditions may worsen symptoms in rheumatoid arthritis patients: the possible effect of temperature.” In results the authors tell us: “245 RA patients who visited the emergency room 306 times due to RA related complaints as the main diagnostic reason were included in the study. Patients from 50 to 65 years old were 16% more likely to present a flare with lower mean temperatures.”
G. Smedslund and K.B. Hagen presented a meta-analysis [3]: “Does rain really cause pain? A systematic review of the associations between weather factors and severity of pain in people with rheumatoid arthritis.” This is their conclusion: “The studies to date do not show any consistent group effect of weather conditions on pain in people with RA. There is, however, evidence suggesting that pain in some individuals is more affected by the weather than in others, and that patients react in different ways to the weather. Thus, the hypothesis that weather changes might significantly influence pain reporting in clinical care and research in some patients with RA cannot be rejected.”
G. Smedslund and another group of colleagues presented [4]: “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.” The authors 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.”

About four years ago I collected statements of patients concerning weather sensitivity [5]. Most complaints are centered on wet and cold weather, weather change, high or low temperature, which all lead to discomfort.

I would like to see a study in which the comfort zones of patients with inflammatory diseases like rheumatoid arthritis are compared to normal individuals. Parameters could be air temperature, air pressure, humidity, air speed. What are the effects of a breeze at high or low temperatures?

To sum it up, weather conditions influence comfort or discomfort in patients with inflammatory diseases like rheumatoid arthritis, but we still don’t know how to enlarge the comfort zone for our patients.



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