Not a day goes by that at least one of my patients tells me that their pain is worse because of the recent weather. Most will complain of the humidity, some the cold, and others will say they can predict oncoming precipitation because of the increasing pain. There have been studies showing some effect, others countering the observation. I've always been somewhat bemused by these studies, wondering just what they thought their chances of separating out the many factors would be, and if they found some definite association, what they would suggest doing with it. While I have nothing against knowledge for knowledge's sake, I still think most of these researchers could have been doing something more productive with their time. I always kind of hoped that it was a high school science fair project rather than funded research.
In the May issue of The American Journal of Medicine, a new article tackled the question but at least with a rather novel and interesting approach. First of all, the impact of weather was studied at the same time that the authors were conducting a study on glucosamine, so they did ,in fact, have better things to do with their time. Because their study was internet based, the study population was across the United States and over several seasons. The patients were being studied for glucosamine, and were therefore completely unaware that the weather issue was being looked in to. Also of interest was the fact that the prevailing weather situation was gleaned, not from the patients, but from the National Oceanographic and Atmospheric Admin. Therefore, the pain scores and weather info were truly independant. Using this information, they determined that weather did actually affect pain, in a rather modest fashion, but with somewhat surprising result. Yes, cold did increase pain, and so did changing atmospheric pressure, but it was rising pressure that precipitated more pain, not the usually accepted low pressure scenario. I have no idea how accurate the weather information is , however, as they simply used the weather station closest to the patient. As well, the pressure change measured was from the day preceding the pain score to the day of the scoring. The following day was not considered. Not that I really care. I don't think this study is going to solve the issue but it was a rather unique approach.
I have seen a couple of interesting patients, though, that did make me consider this question myself and in some way made me a believer in the pressure theory. One was a forty five year old with OA of many small joints of the hands. She was a hobby scuba diver and asked me one day why her pain was so much better below about twenty to twenty five feet below. She was particularly curious because she thought logically it should be worse, given her exposure to so much cold and humidity. A second patient with near identical pathology went on a trip to Switzerland where she spent several weeks in the mountains. Despite being very relaxed on holiday, and away from her usual secretarial job, her pain actually worsened, and did not improve until her return. She too had expected that her pain would improve under the circumstances. These two patients, who experienced major atmospheric pressure changes, noticed pain variation that were contrary to their expectations, and significant enough that they brought it up themselves during their visits. Sure there must have been many other factors involved, but I can't help but think that they might represent true atmospheric pressure-related pain variation.
So there you go. A situation where a clinician draws conclusions from two minor anecdotes in his own practice over a contolled study of over two hundred patients. Probably a sad reflecton of something, but I'm not sure of what.