
In 1982, at a nursing station in the frozen Canadian town of Davis Inlet, a young medical student made a troubling observation about arthritis.
“On the north coast of Labrador, let me tell you, the weather is terrible — you could have a snowball fight in the middle of July,” recalled Dr. Donald Redelmeier, who is now a professor of medicine at the University of Toronto. “There are days of extreme and severe weather, but there is no epidemic of osteoarthritis. … Yeah, people are suffering, but not much different from what I was used to in downtown Toronto.”
The absence of an epidemic usually isn’t noteworthy. But in this case, Redelmeier was challenging the deep-seated beliefs of grannies and fishermen everywhere, who rely on their joint pain as a kind of inner Weather Channel.
That was 35 years ago. The town where Redelmeier was suturing wounds and delivering babies no longer exists: The Canadian government shut it down in 2002, relocating its residents to a mainland community nine miles to the west.
But the question has persisted, like a weed that just won’t die. “Almost everybody with arthritis does have the conviction that the weather influences their condition,” said Dr. Timothy McAlindon, the chief of the division of rheumatology at Tufts Medical Center in Boston.
Same goes for patients with broken limbs, back pains, fibromyalgia — you name it — who feel the changes of the weather in their bones. When scientists have examined the claim, though, the results have been all over the place. Now, two Australian studies — one published in December, another this week — are hoping to set the record straight: Osteoarthritis and back pain, they found, are not dependent on the weather.
Even when Redelmeier first became intrigued, the question wasn’t new. Around the fifth century B.C., Hippocrates — the “father of modern medicine” — wrote that, in marshy regions, the icy rains of winter give men a troubling thinness about the shoulders and clavicles, not to mention that it makes them “liable to pneumonia and to madness,” and that “their viscera will be very dry and warm and thus require the stronger drugs.”
Some two millennia later, in 2007, McAlindon decided to look into his patients’ convictions himself, and found intriguing, though uncertain, results. An increase of barometric pressure — which usually means the weather’s getting fairer — was linked to a slight increase in osteoarthritic knee pain. But participants’ pain also worsened as the weather got colder. And it’s unclear how this study fits into the broader picture. “I think it’s all a little conflicting,” said McAlindon.
He said a change in pressure influencing knee pain could potentially make sense: In osteoarthritis, the cartilage is often worn away, so that the bone is no longer cushioned from pressure in the joint. And because the bone, unlike cartilage, contains nerves, increases of pressure in the atmosphere could also be seen in the joint — which could be picked up by the nerves in the exposed bone and translated into pain.
In the new study on knee osteoarthritis, the researchers asked 345 patients to log onto a website every time their pain flared up for eight hours or more — and then the team linked those episodes to the temperature, relative humidity, barometric pressure, and precipitation recorded in that patient’s neighborhood around that time by the Australian Bureau of Meteorology. The researchers also looked at the weather on days when the patients had no flare-ups. They found no significant relationship between pain and any kind of weather change. The same was true for the study on back pain.
“The good news is that we cannot change the weather, but there are a lot of things that we can change that we know will trigger pain in the back and the knee: stress, your weight,” said Manuela Ferreira, the first author on the knee study, who is a professor at the University of Sydney’s Institute of Bone and Joint Research.
These results are consistent with what Redelmeier found when he was studying this question in rheumatoid arthritis patients during a residency at Stanford University in the mid-1990s. He was working with Israeli psychologist — and devoted sports fan — Amos Tversky, who was famous for studying biases in the way people think.
The professor had previously applied himself to a courtside conundrum: If a basketball player scores, is that player any more likely to score again? In other words, is a shooter’s hot streak real or merely due to dumb luck? Tversky concluded that the “hot hand” was a fallacy — nothing more than chance.
“I always criticized Amos for spending way too much for watching professional sports,” said Redelmeier. “Why not look at real human life and individual suffering?”
So they turned to joint pain and the weather. And as with the shooter’s “hot hand,” they found that people are inclined to see patterns where none exists. If patients think their joint pain is related to the weather, they might pay more attention to the shifting clouds when their knee aches. “Individuals seize on times that support their ideas, neglect the times that are contrary to their ideas, and misinterpret the times that are ambiguous,” Redelmeier said.
But people didn’t give up their belief about the subject then — and Redelmeier doesn’t think they will now.
“Twenty years have passed, the belief has not been extinguished,” said Redelmeier. “Why would it be? Science only moves the needle so much … myths die hard.”
People still tell him that their arthritis is affected by changes in barometric pressure. Redelmeier doesn’t buy it. After all, we take elevators all the time, and in skyscrapers that means undergoing a drastic shift in pressure. Yet there is no more a joint-pain epidemic in lobbies and penthouses than there is on the northern coast of Labrador.
Studies seem to be useless, always contradicting what patients experience daily. Why do so many people move to dry heat areas that have limited changes in pressure if humidity/pressure changes don’t make arthritis hurt? I know changing barometric pressure while the humidity is high is the combination that causes all my pain. I notice it most while the pressure is dropping.
we all laughed and scoffed at granny when the bones would ache and she would predict an incoming storm. Now Im 70+ and with severe shoulder and hip deterioration the pain is extreme during barometric drops.
Those who claim to have ‘scientific evidence’ to the contrary can just wait a few years. They too will personally learn the truth.
You are correct-not buying it‼
I love Globe readers! What if we actually figure this out??
I was looking very carefully at the experimental design, because I had noticed that a previous one on cold remedies was off as well. In that study, the echinacea treatment commenced when the child reported two cold symptoms. That in my experience would be too late for such remedies to have a big effect (though I favor ginger tea and net pots. Zinc lozenge would be another candidate.)
Hope someone does further studies, based on twinges.
Its absolutely barometric pressure. The experimental design is all off. It’s twinges, not days of pain. I get twinges in my old broken tibia often when I’m ascending… or is it descending… in aeroplanes and before a good thunderstorm. No synovial fluid in my tibia. I imagine gas bubbles nucleating but it doesn’t make sense.
Your comment comparing to going in an elevator is non sequitur. The study used pressure as a proxy for good/bad weather. Going up in a lift changes the pressure but not the weather.
Perhaps we could trust the patients on this? They experience the changes in pain levels. Not those who try to measure, postulate, prove and puzzle it out. There are so many factors beyond their consideration, including potential reactions in the microbiome, changes in circulation with cold, damp or changing weather, impacts on electrical flows within the body, etc. Many people also get headaches with certain changes in the weather. I’d go with the patients on this. Maybe some day, science will catch up.
Here’s a hypothesis, another one. Synovial fluid may be subject to environmental pressure and its changes. At constant pressure, an equilibrium is established. A rise or decrease of environmental pressure affects differently cavities filled with synovial fluid and adjoining membranes. It’s not what weather is currently but weather changes that affect the pressure synovial fluid puts on synovial membranes. Those membranes may contract or dilate with temperature and/or pressure. The change may be more painful than the equilibrium state. All these could be studied with a few subjects suffering from osteoarthritis and a decompression chamber.
Here’s a hypothesis why people associate those pains with bad weather: When bad weather is about to commence, they will have to move faster to prepare for that bad weather. Like closing the windows, take clothes from the clothes line, fire up the fireplace, etc. So because of that sudden fast paced activities, their joints will be stressed.