Under Pressure

We’ve all heard the old wives’ tale that some people can tell when it’s going to rain because they can “feel it in their bones”. In my education the effects of barometric pressure changes on various conditions were rarely -if ever mentioned. However, over the years of working with patients, I have developed a much greater respect for the weather -beyond it determining my weekend plans! I noticed that often those with migraines, inflammatory conditions or arthritis would complain of their symptoms being worse around the same time. None of these people had much in common; they lived very different lifestyles, were interested in different hobbies, hung out in different social circles, had varying degrees of health and certainly very different body types. What the heck was happening that would make them all have increased pain around the same time? I figured in the absence of someone putting something in the water, perhaps there might just be something to that old wives’ tale after all So what is it about the changes in the weather that seem to affect some people but not others? Well, it would appear that the research in this department is a bit of a mixed forecast in itself. 

Some suggest a change in the temperature and barometric pressure can alter the viscosity of the fluid inside our joints. When the fluid is a bit thicker we feel more stiff and when it’s a bit thinner we feel more limber. Another theory is that when there is a change in the weather there is either expansion or contraction of the tissues surrounding our joints. The barometric pressure is the pressure that the atmosphere is exerting on us all the time. In this theory, if the barometric pressure drops there is less pressure from the atmosphere on our tissues and they can expand and enlarge. This can result in pain either by the tissues taking up more space (so putting more pressure on each other), orrr by allowing the joint to be ever so slightly less stable - sort of like taking off a compression sleeve. 

Some studies have found that people with osteoarthritis feel that their pain increases as the temperature and barometric pressure drop (like when a storm is coming in). Other studies have found that people with the same type of arthritis report the opposite: that increasing barometric pressure makes their symptoms worse. Perhaps then it’s the rate of change that is the key variable rather than what direction the pressure goes. Our bodies prefer a pretty constant environment - they run a tight ship. Slow gradual change, we can adapt, but pull a fast one on us and there might just be a bit more protesting while we reacclimatize ourselves. We’re a bit like the old frog in the water story that way. Put it in luke-warm water and slowly heat it up to boiling, it won’t jump out, but go from nothing to boiling and he’ll be angry and hopping right outta that pot in no time!

Another theory worth consideration is that it may actually be a behavioural change rather than a direct environmental change that accounts for increased pain on cold, damp days. When it isn’t nice out, we are more likely to hunker down inside and watch a movie than we are to head outside and go for a walk. Not doing our usual activity - especially when we have underlying problems, can definitely lead to increased stiffness and pain in our joints. So that variable we can control! Even if the weather is not quite optimal, try to get yourself out and moving to keep your joints limber.

So why do some people seem affected by the weather but not others? In general, people with symptomatic arthritis, chronic pain or inflammatory conditions of any kind have increased sensitivity of the nerves in the areas of the body that their condition affects - this includes those nerves that are found within and surrounding the joints. So it makes sense that if these environment factors (be it barometric pressure, temperature or humidity) exert even subtle changes on our body, it’s these folks who are going to be the ones most susceptible to noticing them. It isn’t going to be the 5 year old healthy active child, it’s gonna be us oldies that have a few miles and a bit of wear and tear on the body ;) 

As for migraines, the research is still mixed on the exact physiology of the cause of them -without even taking into account different triggers like the weather! So migraines definitely deserve a separate discussion all to their own, but for the sake of our weather investigation here’s a tidbit: Migraines appear to be triggered by a change in blood flow within the vessels of the brain and/or an altered firing pattern of the nerves. This means that anything that could affect either has the potential to wreak havoc for these peeps - including changes in barometric pressure and temperature. Just like the nerves are sensitized around the joints in people with arthritis, the nerves surrounding the blood vessels in the brain of people with migraines seem to be more susceptible and sensitive to pressure changes as well. 

Old wives’ tale or not, I think many healthcare providers would tell you that anecdotally they observe trends with their patients and the weather. The problem is when we try to get down to the nitty gritty and study the phenomenon, there are just so many variables at play in the environment and within each of us that it’s impossible to control them all. The inability to single out an exact cause and effect relationship means there’ll probably always be a lack of “scientific proof”. But just in case you are one of those who do “feel the rain in your bones” here’s a few things you can try to help combat it: Keep moving! As discussed, it’s possible that it’s our tendency to want to hibernate when the weather is nasty that causes us more pain. Getting out for a walk every day (yes, even in the rain) can help keep our joints limber - not to mention it just generally helps us feel better. Movement can also help flush out swelling from inside the joints. Applying some heat to the sore spots on cool days may be beneficial as well. For those with migraines, when you know the weather is bound to be stormy or is likely to change drastically, it is important to avoid any of your other triggers during that time - no need to be compounding problems and further increasing your changes of setting one off. 

So the next time you feel a storm rolling in, resist the temptation to hunker down and stiffen up- grab your gear and go out dancing in the rain!