UK Study Finds Weather Can Worsen Chronic Pain

By Pat Anson, PNN Editor

Do you feel “under the weather” when its rainy and cold outside? About 75% of chronic pain sufferers believe certain weather conditions can aggravate their pain. Some even think they can predict a storm coming because they “can feel it in their bones.”

A new analysis of weather patterns in the United Kingdom suggests there may be some truth to those old clichés.

For 15 months, researchers at the University Manchester collected data from over 10,500 UK residents, who recorded their daily pain levels on a smartphone app. The GPS location of their phones was then compared to local weather conditions.

The study found a modest association between weather and pain, with people more likely to feel pain on days with low barometric pressure – and the wet and windy weather that usually comes with it.

The key appears to be the upper level jet stream – a narrow band of air currents that circle the globe several miles above the earth. On days when the jet stream was aimed right at the UK, with above normal wind, humidity and precipitation, about 23% of people reported more pain.

But when the jet stream blew north of the UK, and pressure was above normal with less humidity and precipitation, only 10% of people reported higher pain levels.

“Although the weather may not be the primary cause of people’s pain, our results through multiple independent methodologies demonstrate that weather does modulate pain in at least some individuals,” lead author David Schultz reported in the Bulletin of the American Meteorological Society.

“The results of this project should give comfort and support to those who have claimed that the weather affects their pain, but have been dismissed by their friends, their coworkers, and even their doctors.“

The new analysis builds on earlier research from the Cloudy With a Chance of Pain study, which is the largest in both duration and number of participants to examine the link between weather and pain.  Previous studies have found little or no association between the two.

A 2014 Australian study, for example, found that acute low back pain was not associated with variations in temperature, humidity and rain.  And a 2013 Dutch study concluded that weather had no impact on fibromyalgia symptoms in women.

“Part of the reason for this lack of consensus is that previous researchers have treated the different measures of the weather such as pressure, temperature, humidity separately, which assumes that one could vary the temperature while holding all of the other weather measures fixed. Of course, the real atmosphere does not behave like this, as all the variables are changing simultaneously,” says Schultz.

Schultz and his colleagues plan to further study the data to see how environmental conditions modulate pain, insight that could be used to develop better treatments and individualized pain forecasts.

Humidity and Wind Affect Pain Levels, But Rain Doesn’t

By Pat Anson, PNN Editor

Many people with chronic pain strongly believe that rainy or cold weather aggravates their pain. Some even believe they can predict the weather based on their pain levels. 

But the results of a long-term study in the UK – recently published in the journal Digital Medicine -- show that weather conditions have only a modest effect on pain.

Researchers at the University of Manchester led a 15-month study of over 2,600 UK residents who recorded their daily pain levels with a smartphone app. The results were then compared with local weather conditions, based on the GPS locations of the participants’ phones.

Contrary to popular belief, rainfall was not associated with more pain. Results from the Cloudy with a Chance of Pain study showed that humid days were most likely to be painful, followed by days with low atmospheric pressure and strong winds. But the overall effect was modest, even when all three conditions were present.

“The analysis showed that on a damp and windy days with low pressure the chances of experiencing more pain, compared to an average day, was around 20%. This would mean that, if your chances of a painful day on an average weather day were 5 in 100, they would increase to 6 in 100 on a damp and windy day,” said lead author Will Dixon, PhD, Professor of Digital Epidemiology at the University of Manchester.

Dixon and his colleagues believe the study could be used to develop a “pain forecast” for people with chronic pain.

“This would allow people who suffer from chronic pain to plan their activities, completing harder tasks on days predicted to have lower levels of pain. The dataset will also provide information to scientists interested in understanding the mechanisms of pain, which could ultimately open the door to new treatments,” Dixon said.  

A 2017 study by Australian researchers at The George Institute for Global Health also found that damp weather increases pain. But because the symptoms disappeared as soon as the sun came out, researchers believe they could be influenced by psychological factors, not the weather itself. Previous studies on back pain, osteoarthritis and weather at The George Institute had similar findings.

The Greek philosopher Hippocrates in 400 B.C was one of the first to note that changes in the weather can affect pain levels. Although a large body of folklore has reinforced the belief that there is a link between weather and pain, the science behind it is mixed.

Scientists Use Light and Sound to Reduce Pain

By Pat Anson, Editor

British researchers have found that pain can be significantly reduced if the brain if “tuned in” to a particular frequency, a discovery that could potentially lead to new visual and sound therapies to treat chronic and acute pain.

"This is very exciting because it provides a potentially new, simple and safe therapy that can now be trialed in patients,” said Professor Anthony Jones, director of the University of Manchester Pain Consortium. “The potential is for this to be another treatment for chronic pain.”

Jones and his colleagues say nerve cells in different parts of the brain communicate with each other using different frequencies.  

Nerves in the front of the brain associated with a placebo analgesic effect are tuned in at 9-12 cycles per second, and apparently use that frequency to influence how other parts of the brain process pain.

To test their theory, researchers had 64 healthy volunteers wear goggles and headphones, and exposed them to different flashing lights and sounds while heat pain was induced with a laser on the back of their arms.

The volunteers who were exposed to an alpha frequency at 9-12 cycles felt significantly less pain than those who were exposed to other light and sound levels.

“This study provides new evidence that visual and auditory entrainment in the alpha range can influence the perception of acute pain independently of arousal and negative emotional influences,” the researchers said. “Overall, visual entrainment produced a larger effect than auditory entrainment in the mid- and lower alpha frequencies. This provides further evidence that external stimulation can modulate pain perception and requires further study to ascertain its relevance to clinical pain states.”

Further studies are needed to test the effectiveness of alpha wave therapy in patients with different pain conditions. Researchers say the simplicity and low cost of the technology should facilitate more clinical studies.

"It is interesting that similar results were obtained with visual and auditory stimulation, which will provide some flexibility when taking this technology into patient studies,” said Dr. Chris Brown, a lecturer in Psychology at The University of Liverpool who was involved in the research. “This might be particularly useful for patients having difficulty sleeping because of recurrent pain at night."

The study, which was self-funded as part of a PhD project, is being published in the European Journal of Pain.

Chronic Pain and Weather Study Underway

By Pat Anson, Editor

The Greek philosopher Hippocrates in 400 B.C was one of the first to note that changes in the weather can affect pain levels. A large body of folklore has reinforced that belief, with expressions like “feeling under the weather” and stories about people being able to predict a storm because they “can feel it in their bones.”

British researchers are investigating that ancient theory with a modern twist, a smartphone based study called Cloudy with a Chance of Pain that aims to prove whether there is an association between pain and weather.      

“This question has been around for more than 2,000 years, but it’s only now with widespread modern technology that we have the ability to answer it,” says Dr. Will Dixon, Director of The University of Manchester’s Arthritis Research UK Centre for Epidemiology.

Anyone in the UK with arthritis or chronic pain who is over the age of 17 can participate by downloading an app from here.

The app uses a smartphone platform called uMotif that allows users to record how they are feeling, while weather data is automatically collected using their phone’s GPS.

“And we’re not just inviting people to submit data – we want their ideas about the association between weather and pain too,” says Dixon. “We will be running a big citizen science experiment where anyone can explore the data and try and spot patterns and relationships in the data. We’ll gather ideas and theories from everyone to come up the best possible conclusion.”

Participants are encouraged to record their symptoms each day until the project ends in January 2017. Even people who don’t have pain can participate by browsing through the data and submitting their own ideas. Researchers hope to compile the information and develop “pain forecasts” based on weather predictions.

“Many people with arthritis believe that changes in the weather affect the level of pain they experience, however there is currently no scientific evidence to support this relationship," said Stephen Simpson, Director of Research & Programmes at Arthritis Research UK.

“This exciting study will for the first time enable us to investigate the link between pain and the weather. We’re delighted to support this project and we hope that the use of the uMotif app will help encourage a wide group of participants to take part, both in terms of submitting their data but also examining the results themselves to help our scientists reach a conclusion."”

The weather-pain connection remains controversial. A 2014 study in Australia found that acute episodes of low back pain are not associated with weather conditions such as temperature, humidity and rain.  And a 2013 Dutch study concluded that weather has no impact on fibromyalgia symptoms in women.

You can follow the University of Manchester study on Twitter at @CloudyPain.

You can also learn more by watching this video:

Researchers Say Chronic Pain Changes Brain Chemistry

By Pat Anson, Editor

A new study by UK researchers raises an intriguing question: Does chronic pain change brain chemistry and make pain more tolerable?

The answer is yes, according to a small study at the University of Manchester. Researchers there used Positron Emission Tomography imaging (PET scans) to measure the spread of opioid receptors in the brains of 17 arthritis sufferers and nine healthy control subjects

When they applied heat to the skin of study participants to induce pain, researchers found that the more opioid receptors they had, the higher their ability was to withstand pain. The number of opioid receptors was highest in arthritis sufferers, suggesting their brain chemistry had changed in response to chronic pain.

"As far as we are aware, this is the first time that these changes have been associated with increased resilience to pain and shown to be adaptive,” said Dr. Christopher Brown. "Although the mechanisms of these adaptive changes are unknown, if we can understand how we can enhance them, we may find ways of naturally increasing resilience to pain without the side effects associated with many pain killing drugs."

image courtesy of university of manchester

It’s been known for a long time that we have receptors in our brains that respond to natural endogenous opioids such as endorphins. Those same receptors also respond to opioid pain medications.

Some people seem to cope better with pain than others, and knowing more about their resilience and coping mechanisms may lead to the development of new ways of treating pain.

"This is very exciting because it changes the way we think about chronic pain,” said Anthony Jones, a professor and director of the Manchester Pain Consortium. "There is generally a rather negative and fatalistic view of chronic pain. This study shows that although the group as a whole are more physiologically vulnerable, the whole pain system is very flexible and that individuals can adaptively upregulate their resilience to pain.

"It may be that some simple interventions can further enhance this natural process, and designing smart molecules or simple non-drug interventions to do a similar thing is potentially attractive."

Researchers at Stanford University in California have also been studying this subject, trying to learn why some chronic pain sufferers are more resilient to pain.

“I think this study emphasizes some very important points about pain resilience,” said Dr. Drew Sturgeon, a fellow in the Stanford University Pain Management Center and Stanford Systems Neuroscience and Pain Laboratory. “If you think about chronic pain as something that poses a constant challenge and requires frequent adaptation, it makes sense that we would see changes in the brain that correspond with this process.  We see it frequently from a psychological standpoint, where people are able to learn and develop better strategies for coping with pain and reduce their fear and negative thoughts about pain after dealing with it for a while.”

Sturgeon and his colleagues say resilience may also stem from an enhanced ability to enjoy the rewarding parts of life – which makes it easier to cope with pain.  

“The idea would be that if a person had more opioid receptors available they would be more sensitive to the good stuff in life, and therefore more motivated by pleasurable experiences, such as spending time with friends, exercising -- rewards that get us back on the road to living a meaningful life,” said Beth Darnall, PhD, a pain psychologist, clinical associate professor at Stanford University and author of Less Pain, Fewer Pills.

“Theoretically, people who are known to be resilient probably have more endogenous opioids -- or they have made choices in life to optimize their experience of endogenous opioids and therefore have honed an internal reward system.”

Whatever the cause of resilience, many patients hope further studies will uncover new ways of treating pain.

"As a patient who suffers chronic pain from osteoarthritis, I am extremely interested in this research. I feel I have developed coping mechanisms to deal with my pain over the years, yet still have to take opioid medication to relieve my symptoms,” said Val Derbyshire. “The notion of enhancing the natural opiates in the brain, such as endorphins, as a response to pain, seems to me to be infinitely preferable to long term medication with opiate drugs.”

The University of Manchester study is being published in Pain, the official journal of the International Association of the Study of Pain.