Cold Enough For You?!

I hear patients talk about being “human barometers” – everything hurts worse if it is rainy or humid, or they dread the winter months when temperatures begin to drop.
The question is this – is there any science to support such reports?

The answer is that it may depend on the pain condition you have. A review of the literature suggests that rheumatologic, neurologic and vascular issues (e.g., arthritis, RSD, Fibromyalgia, headaches) may be more impacted by weather conditions than other types of pain (e.g., muscle injuries, visceral pain, etc). Though, I did come across several reports of back pain being affected by the weather (and it was unclear if this pain was muscular or neurologic.) Many of the studies contradicted each other, and the majority were based on self-report, meaning that patients said “yes, the cold makes my pain worse” but their reports were not verified or tested in any meaningful way.

Also, many of the studies I read seemed to say the same thing – patients say their pain is affected by the weather, but we don’t know why or how. So I offer two thoughts: a) who cares about the mechanism, just accept that for THAT PATIENT it’s a real phenomenon and b) maybe the pain gets worse because of how the weather affects the whole person, not just their pain. Consider the possibility that measurable physiologic changes may not occur (e.g., neurochemicals, blood flow) as a result of the weather, but people may REACT to the weather physically (e.g., muscle tension, shivering, pulling shoulder up, less activity) or psychologically (recall that pain is subjective, and regardless of objective physical factors, your mood and perception largely determine your pain). Therefore, cold weather = sour mood = pain feels worse? Seems like a recipe for disaster to me.

For those who believe in (or live) this association between pain and weather, you can take an active role in preparing and coping by looking at this website. Remember, it is important to accept that certain factors are out of your control, but taking a helpless stance will only worsen your mood, your pain, and your life. Any area of control that you can take back is important. In an earlier post I made this point loudly – your body may be out of control but your behavior and your lifestyle choices are still in your hands – and these factors affect your quality of life.

In closing, the jury is out on whether the weather will make your pain unbearable. However, if it feels real (and worse) to you, that’s all that matters. Pain is an individual phenomenon and very relative and subjective in how we all react to the same stimulus. You need to know how YOUR body and pain react to temperature, weather, noise, activity, medication, and so on. Keep records, update your doctor, and make changes in your schedule where you can to avoid unnecessary pain flare-ups. And, of course, don’t neglect your mood in all this either. If cold weather = sour mood = pain feels worse, then maybe if we change your mood we can avoid the part where the pain intensifies…

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