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Why patients blame the weather for their aching joints

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.

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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.

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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.

This article is reproduced with permission from STAT. It was first published on Jan. 13, 2017. Find the original story here.