Does the weather make a difference to your neck pain? With cooler weather setting in as we near Halloween, this week’s blog takes a look at the strange science of the human barometer and why winter is a time of discontent for many of those with spondylitis, along with other neck pain sufferers.
One popular weather website actually includes an ‘aches and pains’ prediction in its forecast, although how accurate any of its ‘future trends’ are is up for debate. Can one’s joints really predict the weather? Does that winter chill really ‘get into the bones’? Can the weather make neck pain worse?
These questions have perplexed scientists for years, and driven some of them to conduct studies in order to determine peoples’ susceptibility to changes in the weather. Many people claim to be able to predict the weather by assessing their joint aches and pains. Unfortunately, the research does not back up these claims of predictive meteorology, with a study by Drane (1997) just one of many that found patients could not accurately predict the weather simply by observing their joints. Still, there is plenty of anecdotal evidence, meaning that the debate is unlikely to be resolved any time soon. Interestingly, there is a growing body of evidence demonstrating that weather does affect the joints, whether patients are able to predict this or not.
What the Research Shows
So far research has concentrated on two particular weather variables; temperature, and air pressure. The first, temperature, appears to be associated with an increase in musculoskeletal symptoms, including neck pain. Piedrahita’s 2008 study looked at those working in very cold conditions (-43C to -62C) whilst freeze-drying coffee. With 21% of workers suffering pains in the neck, it was recommended that the company alter its practices to aid the workers’ health; unfortunately an additional finding showed that the more protective clothing the workers wore the heavier the strain on their muscles to carry out their work – talk about a catch22!
Neck Pain and Blood Vessel Narrowing
Cold temperatures have also been found to contribute to neck pain through a different mechanism with an interesting case reported by Schiller (2007) of a patient whose neck pain was induced by the cold due to stenosis of the external carotid arteries. The patient’s neck pain symptoms were successfully relieved by an operation to revascularize the arteries. Temperature is also indicated in some cases of pain exacerbation in those suffering from rheumatoid arthritis, but not osteoarthritis (Patberg, 2004) . In particular, damp, cold weather can raise pain levels, with dry, warmer conditions lowering symptoms such as pain associated with the neck.
Air Pressure and Joint Pain
The area where most research has been carried out though is into air pressure and joint pain. No specific mechanism has been identified, but the main hypothesis is that external air pressure causes changes in the pressure of the joints in the body (i.e. in the synovial fluid), which leads to compression of the nerves (pinched nerves) and blood vessels in the cervical spine. Similar to what happens when you crack your joints, the relief of this increased pressure can feel good.
Osteoarthritis and the Weather
A double blind and controlled study conducted by Vergés (2004) found that patients experienced an increase in osteoarthritic pain when the air pressure fell below certain levels, but were not affected significantly by temperature changes. In the same study, the patients with rheumatoid arthritis were not affected by the pressure changes but did experience increased pain when the temperature fell. The discrepancy between the two groups remains unexplained but may provide a reason for the inconsistent findings of other studies, such as those by Smedslund (2010), and Wilder (2003), where individual weather variables were not considered, or measured frequently enough, and those with different pathologies causing joint pain were not differentiated.
Oxygen Content & Fatigue
A related issue to air pressure is that of air oxygen content. As the pressure goes down there is a lower concentration of oxygen for us to breathe, meaning that our bodies become more easily fatigued and able to do less work without neck pain, cramp, and exhaustion occurring. Whilst this is rarely an extreme problem, as air pressure changes are usually quite modest, it may mean that those who are already experiencing a reduction in energy levels, such as patients with fibromyalgia and neck pain, may experience more severe and frequent neck pain and musculoskeletal symptoms.
Depression, Neck Pain, and Nutrition
Some further avenues of research connecting the weather with neck pain include seasonal nutritional deficiencies, and mood disorders such as depression. Many people experience the ‘winter blues’ or seasonal affective disorder, where they feel depressed, have low energy levels, and may have an altered response to pain. Depression was associated with a lower level of pain tolerance when exposed to cold in a study by Klauenberg (2008), particularly in cases of fibromyalgia which often results in neck pain and tenderness. Back in 1944 T.G. Heaton, a military physician, wrote a report considering the cases of soldiers suffering from joint pain with no clinical signs, diagnosing them with arthralgia, and noting their increased sensation of pain in wet, cold, and damp weather. Those who are depressed or are suffering from low mood often talk of being ‘under the weather’, and, as the incidence of depression increases over the winter months, it may be that there is a longer term connection to look at rather than a simple day by day correlation.
The Winter Months and Joint Pain
Those suffering depression may also have an exaggerated response by the immune system to threats, with increased inflammatory responses that could lead to neck pain and joint pain. It is also worth noting that during the winter months vitamin D levels often decrease. Vitamin D can affect the mood, the immune system, and the bones and joints, and may be responsible, when deficient, for increasing severity and frequency of neck and joint pain (Mühlebach, 1994, Fabbriciani, 2010). Some more extreme examples of the weather affecting the joints occur in familial cold auto-inflammatory syndrome (FCAS) which can cause fever, a rash, and/or joint pains after a patients is exposed to the cold (Goldbach-Mansky, 2010). Whilst this syndrome is very rare, its more common counterpart, cold urticaria, has similar symptoms and may offer a differential diagnosis in cases of neck pain, rash, and fever. Symptoms are, however, quite similar to meningitis and the latter should be ruled out to reduce the likelihood of serious long-term disability or death.
Living in a damp, dark, and wet place may indeed be contributing to neck pain in a variety of ways. As winter approaches, perhaps a mass migration to California is in order to top up vitamin D levels. Tales of the human barometer will no doubt continue, those freeze-drying coffee will likely go on suffering, and scientists will persist in finding the mechanisms that connect the weather and neck pain.