Hot Weather Raises Risk of Chronic Pain for Older Adults

By Feinuo Sun

When a heat wave arrives, the public health advice follows a familiar script: drink water, watch for heat stroke, check on people with heart or lung conditions. That list saves lives. But it leaves out something that shapes daily life for millions of older Americans – chronic pain.

In a new study, public health professor Kai Zhang and I followed over 35,000 adults over age 50 across two decades, matching each person and their reports of chronic pain to the temperature history of their neighborhood.

We wanted to know whether living with extreme heat or cold – not one bad week, but months or years – changes whether pain interferes with people’s lives.

The results suggest that chronic pain deserves a place in how the country prepares people for extreme weather. They also show that rural residents may be the least protected.

What High-Impact Pain Means

Researchers use the term high-impact chronic pain for pain lasting at least three months that limits what a person can do: work, socializing and self-care. It is not occasional aching. It is pain that affects your decisions.

For adults over 50, that matters enormously. Pain that makes it hard to stand, carry groceries or sleep through the night is a leading reason people lose the ability to live on their own.

Temperature affects the body in different ways that can lead to pain:

Cold appears to increase pain sensitivity and stiffen joints, which is why people with arthritis often brace for winter.

Heat affects the body through dehydration, broken sleep and the way it quietly shrinks the range of things a person is willing to do in a day. On hot days, for example, people may walk less, and less movement can lead to stiffer joints and weaker muscles, which makes the pain worse.

What makes heat waves dangerous is often not the afternoon temperature peak but the hot nights that don’t cool off, leaving the body with no opportunity to recover.

What We Found

We tracked when each neighborhood hit temperatures that were extreme for that place. 

A day topping 84 degrees Fahrenheit (28.9 Celsius) in Maine, for example, would be among the hottest 5% of days there over the past decade. In Houston, meanwhile, it would have to reach 96 F (35.4 C) to be in the top 5% for heat, considered extreme.

We compared every community against its own 10-year record rather than a single national cutoff to see how months or years of exposure to extreme cold or heat temperatures in those communities affected their residents.

Two things stood out:

Among the one-fifth of our sample who lived with many extreme-cold days, reports of high-impact pain went up. However, those facing occasional cold spells didn’t report the same effect. People seemed to adapt to one hard winter, but adapting became harder over years of extreme cold.

Extreme heat was split by geography and by wealth:

• For urban residents, sustained heat showed no link to developing new pain. For rural residents, the connection was stronger. One likely reason is that people in rural areas may spend more time working outside or have older homes that are harder to cool and less access to cool places.

• Among the poorest older adults, sustained heat was also associated with a higher chance of developing high-impact pain. Among the wealthiest, it was not, likely because of better access to air conditioning, healthcare and being able to stay out of the heat.

Those who could get out of the heat were least likely to report feeling new chronic pain.

Three Key Lessons

Nearly every tool U.S. communities use to lower heat risk is designed for a city environment: cooling centers, tree canopy programs, urban heat island maps.

Rural areas have different challenges. Rural homes are often older and harder to keep cool. Energy costs tend to take a larger share of income. On top of that, rural hospitals have been closing across the country, leaving residents driving farther to reach healthcare.

Agriculture has the oldest workforce in the country – the average producer with decision-making roles on a farm is now about 58 years old, and nearly 40% of the farmland is owned by farmers who are 65 or older. Retirement does not move people out of the heat in rural areas, either.

The findings hold three key lessons for helping older adults:

1. Chronic pain belongs on lists of heat-related health risks, in our view. State and county heat plans flag cardiac and respiratory patients, but not the people whose independence depends on managing pain. With warning, people can plan ahead and get help, knowing chronic pain may worsen.

2. Cooling assistance programs need to be tailored to rural needs – the weatherization, energy assistance and delivery through trusted local channels that those homes need – rather than offering scaled-down versions of urban programs.

3. In the clinic, a patient’s housing and local climate details belong in their documented pain history, next to diagnosis and medication, to help better direct treatment.

Rising global temperatures are increasing the risk that people will be exposed to extreme heat for weeks at a time. In one high-risk summer, 2024, Phoenix saw 39 days with temperatures that didn’t drop below 90 F (32.2 C), even at night.

So, if you have a parent or grandparent facing a heat wave, particularly in a rural area, consider asking not just whether they’re drinking enough water to stay healthy but also whether their back or knees have been worse than usual. The pain may be connected.

Feinuo Sun, PhD, is an Assistant Professor of Demographics, Sociology and Population Health at the University of Texas at Arlington.

This article originally appeared in The Conversation and is republished with permission.  

Why Hot Weather Makes Pain Worse

By Gulnaz Anjum and Mudassar Aziz

This summer’s amber heat warnings have brought with them many risks to health.

Many people have experienced these health effects first-hand: brain fog, physical fatigue, restless nights and reduced productivity. If that sounds familiar, you’re not imagining it. Science shows that high temperatures can affect both our bodies and our brains – even before they reach extreme levels.

But one consequence of hot weather that many people may not know about is that it can also affect physical pain.

Our research analysed data from a large, nationally representative survey from the global analytics firm Gallup, which recorded daily measures of pain from more than two million US residents. We found that as temperatures increased so did the likelihood of people reporting they were experiencing some type of generalised physical pain.

The largest increases occurred on very hot days – around 32°C (89.6°F) or above. Middle-aged adults and people from lower socioeconomic backgrounds were most likely to report experiencing pain on very hot days.

Scientists have identified several possible explanations for why you’re more likely to experience worse pain on hot days.

Some of these causes are direct triggers of pain – including dehydration caused by the heat, inflammation and other physiological processes, such as blood pressure changes which can make existing pain worse.

Other causes are indirect triggers. For instance, hot weather can increase stress, disrupt sleep, reduce wellbeing and limit our ability to perform our usual daily activities, such as exercise. All of these factors are known to amplify experiences of pain.

The relationship between pain and these potential triggers can go both ways as well. Sleep is a good example of this.

Poor sleep makes people more sensitive to pain, while pain itself makes it harder to sleep. During heatwaves, many people struggle to get a good night’s sleep, creating a vicious cycle in which poor sleep increases pain and pain further disrupts sleep. Over time, this cycle can take a toll on people’s wellbeing and quality of life.

The effects of pain extend beyond physical discomfort, as well. Pain competes for our brain’s attention. When the body hurts, attention is diverted towards coping with that pain, leaving fewer resources available for concentration, memory and decision-making. This can affect performance at work, learning in school and even everyday decision-making.

In some situations heat can be beneficial for pain – for example, applying a heating pad to help relieve lower back pain after a long day on your feet.

But there’s an important difference between using targeted heat to treat a specific area of the body and being exposed to sustained high temperatures that affect the entire body. The latter places stress on multiple physiological systems and can worsen, rather than relieve, physical pain.

The consequences of heat’s effects on pain are not only personal – they’re also economic.

In our study, we estimate that hotter temperatures already cost the United States’ economy around US$2 billion (£1.5bn) every year through higher levels of pain. If temperatures continue to rise and no action is taken to help people adapt to extreme heat, these costs could exceed US$9 billion annually by 2050.

The increasingly frequent and intense heatwaves experienced in recent UK summers suggest that comparable losses in healthcare costs, reduced productivity and diminished quality of life could become an important challenge if hot summers become the new normal.

Bodily pain should therefore be recognised as another hidden health consequence of extreme heat.

Heat affects us in more ways than we often realise. The good news is that there are practical steps we can take to reduce these effects. Staying well hydrated, avoiding strenuous activity during the hottest hours of the day, seeking cool indoor spaces and planning outdoor activities for the morning or evening can all help reduce heat-related pain and discomfort.

Gulnaz Anjum, PhD, is an Assistant Professor of Climate Psychology at the University of Limerick.

Mudassar Aziz, PhD, is an Associate Professor of Psychology at the University of Oslo.

This article originally appeared in The Conversation and is republished with permission.

3 Tips for Surviving Summer Heat with Chronic Pain

By Crystal Lindell

While the official summer season started June 21, here in northern Illinois it has definitely felt like summer for almost three months already.

And with summer weather comes lots of heat, humidity, and thunderstorms – all of which can be tough to deal with when you live with chronic pain.

But there are some things you can do that make surviving the hottest months of the year a little more bearable, even if your body is doing its best to make your life miserable.

1. Learn How Weather Impacts You

I can always feel when a summer thunderstorm is coming. All of my joints hurt more, and the intercostal neuralgia pain in my ribs becomes so intense that it’s difficult for me to stay upright. 

But then, when the rain finally falls, there’s a relief that often envelops my body, as though the swelling is being released.

One thing I have noticed is that when I talk to fellow chronic pain sufferers, many of them don’t even realize that their pain is flaring because storms are coming. The flare may begin when the sky is bright and clear, and the storm itself is still a few hours away.

Learning how weather impacts your body can be very helpful when it comes to predicting and navigating flare ups. Try keeping a diary, either digitally or on paper, of your pain flares. Then compare local weather patterns to the flares to see if they are storm-related. You can look up past weather patterns for your area on Weather Underground. 

When you get really confident in the patterns, you can start to look at the weekly weather forecast as a sort-of pain forecast, which can then help you better plan out your commitments. 

For example, perhaps you’ll schedule your lunch with friends when you know it’s not going to rain for a few days. Or you can reschedule your dentist appointment if you see a storm coming.

2. Embrace Rest on Sunny Days

I’m not sure how things go in the rest of the country, but here in the Midwest everyone feels the need to be as active as possible whenever the weather heats up. It’s because we spend most of the year dealing with freezing temperatures and snow.

There’s a Midwest guilt that comes over us if we ever feel like we are wasting a good weather day. It’s like we are worried that if we don’t show enough appreciation for 80 degrees, we’ll face the punishment of an early winter.

When you have chronic pain though, summer can be especially difficult to deal with. Changes in pressure and humidity can cause inflammation and increased pain, while the heat can be more difficult to tolerate.

So, even if it’s sunny outside, try to remember that rest is both helpful and necessary. It’s good to “waste” a sunny day inside with air conditioning, if that’s what you need to feel your best. 

3. Wear Compression Socks

Personally, I’m a fan of compression socks all year round, but when the temperatures get past about 75 degrees Fahrenheit, they become a staple in my outfits.

Heat is one of the main causes of fluid buildup in your ankles, which in turn causes swelling. It’s more likely to happen if you have certain health conditions, or take medications like gabapentin and NSAIDs.

Compression socks can make a world of difference, by reducing the amount of swelling you’ll experience on the days when you need to be on your feet more or when it’s just especially hot outside.

Plus, keeping your foot and ankle swelling down with compression socks also makes the recovery cycle easier to get ahead of. The less swelling you have, the faster it will go away.

Summertime isn’t always a day at the beach for chronic pain patients, but with a little bit of planning and a few accommodations, it can still offer lots of fun!

What tips do you use to survive the hot summer months? Is your pain better or worse when the weather heats up? We’d love to hear from you in the comments below!

Migraine Drug May Prevent Headaches in Hot Weather

By Pat Anson, PNN Editor

With a dangerous heat wave expected this week in the Midwest and Northeast, the National Weather Service has issued “heat alerts” from Iowa to Maine through Friday. Temperatures are expected to reach the mid to upper 90’s, although it will feel hotter due to high humidity in some areas.

Health experts are giving the usual precautions about heat safety, such as staying hydrated and avoiding strenuous outdoor activity, but migraine sufferers may just want to stay inside in a cool, dark place. While there are no clear links between hot weather and migraine, the American Migraine Foundation says that seasonal changes in weather can trigger a migraine attack.

There are currently no FDA-approved treatments for the prevention of weather-related migraines, but according to a preliminary study, one of the new migraine drugs that block proteins known as CGRPs (calcitonin gene-related peptides) may help prevent headaches in hot weather.

A team of researchers analyzed over 71,000 daily diary records of 660 patients with episodic migraine, comparing them with local weather data on the same days. They found that for every temperature increase of 10 degrees Fahrenheit, there was a 6% increased risk of a headache.

“What we found was that increases in temperature were a significant factor in migraine occurrence across all regions of the United States,” says lead author Vincent Martin, MD, director of the Headache and Facial Pain Center at the University of Cincinnati. “It’s pretty amazing because you think of all the varying weather patterns that occur across the entire country, that we’re able to find one that is so significant.”

When researchers took a closer look at migraine patients being treated with fremanezumab, which is sold under the brand name Ajovy, the association between hot weather and headaches completely disappeared.

Ajovy is an injectable migraine prevention drug made by Teva Pharmaceuticals, which funded the study. Teva also paid consulting fees to Martin, who is president of the National Headache Foundation.

“This study is the first to suggest that migraine specific therapies that block CGRP may treat weather associated headaches,” says co-author Fred Cohen, an assistant professor of medicine at Icahn School of Medicine in New York City.

Findings from the study were recently presented at the American Headache Society’s annual meeting in San Diego, California. If the findings are confirmed in future studies, Ajovy and other CGRP inhibitors have the potential to help migraineurs who suffer from weather-related triggers.

The medications are not cheap. The listed cost for Ajovy is $640 for one monthly dose, although out of pocket costs will vary depending on insurance.