Does the weather affect our joints?

midsummer

Therefore the moon, the governess of floods,
Pale in her anger, washes all the air,
That rheumatic diseases do abound.

A Midsummer Night’s Dream

Long before Shakespeare, vagaries in the weather have been blamed for flare-ups of joint pain. The rheumatic curse seems to redouble on a cold, wet day…or is it a hot, dry one?

But a new study from The George Institute casts doubt that we can ever really “blame it on the weather”.

In every place I have ever worked, patients will swear their knee or back pain has eased since they moved to that town, crediting their temporary cure to the local conditions. Curiously, this remains true regardless of where I am working at the time, whether at the bottom or the top of Australia: from the windswept southern coast to the burning central deserts or humid tropics.

Are rainfall, humidity and temperature really affecting my patient’s joints, or is there a less exciting interpretation? Perhaps joint pain is a randomly relapsing condition, and we humans love attributing causation whenever two unrelated events roughly coincide.

Previously, researchers at the George Institute published a study where 345 Australians with confirmed knee osteoarthritis recorded their pain scores. No correlation whatsoever was found between pain flares and the local weather conditions (temperature, precipitation, humidity, barometric pressure).

This negative study, which countered such a long-held belief, not surprisingly copped plenty on social media. Contrarian anecdotes flew in faster than a cold southerly over Bass Strait.

So other researchers decided to see if they could replicate the findings in different circumstances.

 Nothing burns like the cold.

Game of Thrones

The PACE trial, a double-blind RCT involving 981 GP patients in Sydney, had already produced one of the most talked-about negative findings of 2014; that paracetamol doesn’t help relieve low back pain.

The PACE authors hadn’t even considered weather as a factor, but their three years of meticulously collected data on the dates of pain exacerbations allowed for cross-matching with the Australian Bureau of Meteorology. If any weather variation reliably caused an increase or decrease in low back pain exacerbations, it would be expected to show up on the data.

No such association was found.

We can never entirely disprove the “I can feel it in my bones” theory, and individuals could still argue that a particular climate works for them. However, this negative study is another nail in the coffin for any general statement about a particular temperature or humidity either exacerbating or relieving arthritic pain.

So, if Shakespearean fairies continue to blame rheumatic diseases on the phase of the midsummer night’s moon? Tell them they’re dreaming.

This article was first published in Medical Observer, Jan 2017

About Dr Justin Coleman

Justin is a GP working in Aboriginal health in Brisbane, Australia. He is also a medical writer, editor and blogger. Further details at https://drjustincoleman.com/
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