Weather, Rheumatoid Arthritis, and More
Is there a connection between weather and rheumatoid arthritis?
Yes, there are anecdotal accounts. Some report a connection; others do not. A Johns Hopkins health newsletter that describes two scientific studies on the subject.
One study, in Argentina, showed an association. Another study, in Arizona, did not. Is the Arizona study a conversation-stopper? Not necessarily.
The Argentine study included patients with Rheumatoid Arthritis (RA), Osteoarthritis, and fibromyalgia. The Arizona study included only patients with Osteoarthritis. (My focus is on RA.)
The article did not mention which medications were taken by the patients in the two studies, and in what doses. It's possible that the Arizona patients received more aggressive treatment, which masked the impact of weather changes on Arthritic pain. The two studies may or may not lend themselves to a direct comparison.
It's also possible that weather affects only some--but not most--RA patients. If that percentage is small, it's understandable that two studies with small sample sizes could arrive at different results. The safest conclusion:
More research is needed.
I have self-diagnosed RA. I never felt the need for a physician's permission to feel excruciating pain in my right hip when moving around. The first attack came from out of the blue in October of 2006. This is consistent with an autoimmune reaction. I also found hard lumps under the skin of the palms of both hands, which also suggests RA.
At the moment, more than five years later, my RA is basically in remission, without medication of any kind. I'll say more about that in the final section.
The Johns Hopkins article speculates about the direct effects on arthritis of minuscule changes in barometric pressure before and during a rainstorm. In the next section, we'll look at a straightforward way to test that hypothesis.
If science speculation is not your cup of tea, you may want to skip the next two sections, and jump to the final one, which is about do-it-yourself approaches. Suffice it to say that I'm inclined to believe people who report increased RA pain during rainy weather. I'm very skeptical about the barometric pressure conjecture. Humidity is more likely to be the culprit.
Arthritis and weather survey
Do you notice a connection between arthritis symptoms and weather?
The obvious experiment
Are decreases in barometric pressure before a storm the reason that some Rheumatoid Arthritis patients experience more joint pain at that time? And do increases in pressure decrease RA symptoms? Fortunately, that question can be put to the test in an experiment. Here's how.
Study the effects of short bus rides on three groups of RA patients during clear weather. While away from home, each group receives free meals and a free motel room for the night. Then they are returned to their home towns the following day. Each participant fills out a Before questionnaire and a During questionnaire. The questionnaires ask about arthritic symptoms and their intensities.
One group lives in a city at the base of a mountain range. Charter a bus, and drive them up the hill until the elevation gain--on the order of 200 ft (60m)--simulates the very small pressure change associated with a storm.
Do the exact opposite for a second group of patients who live in the foothills of the same mountain range. Drive them downhill, to simulate the pressure change associated with going from a rain storm to a total clearing.
For a third group, the Control Group, take them on a short bus ride having negligible elevation change within the valley. Why? It's theoretically possible that the bus ride itself, together with the overnight stay, may affect RA symptoms one way or the other. If this third group of volunteers does not experience any change in RA symptoms, we can rule out that possibility.
To what extent does elevation change affect the RA symptoms? The Null Hypothesis is that there's no statistically significant effect. Obviously we can't be confident about rejecting the Null until some enterprising researcher rolls up his sleeves, and does the actual experiment.
What about humidity?
Assuming that there is a relationship between humidity and rheumatoid arthritis for some--but not all--sufferers, here's a conjecture about the mechanism. Many people--including those with healthy joints--can sense humidity changes. What are the possible mechanisms by which that information gets to the brain from skin tissue or nasal tissue? The first candidate is ordinary nerve transmission.
The second candidate is a peptide (similar to a protein, but smaller), generated by a receptor on some specialized neuron, which monitors the relative humidity of the air. That peptide enters the bloodstream, and finds its way to the brain after a minute or so. Then one becomes consciously aware of the change in humidity.
Now here's a new wrinkle: You're allergic to that particular peptide. And your immune system responds not only to the peptide in question, but to proteins on the surfaces of cells in certain of your joints. Why? Because these cell surface proteins have parts that are similar to this peptide.
Mistaken identity on the part of our immune systems is responsible for Celiac Disease, in which a person gets a cross-reaction to the gluten in wheat, rye, or barley. When one of these problem foods is ingested, the immune system becomes trigger-happy, and attacks the villi (tiny projections) in the lining of the small intestine, when it senses certain protein fragments (peptides) that result from the digestion of gluten.
Humidity may affect my hip joint slightly. However it definitely increases my nasal allergies during the Winter months here in Northern California.
Again, I must emphasize that this conjecture about the mechanism for the putative RA-humidity connection is a guess on my part. I do not know of any scientific studies that corroborate or falsify my speculation.
If I'm correct, there may be a clinical application. Suppose that the following conditions are all true:
•There are two humidity-related peptides released by specialized nerve cells: one that corresponds to high humidity (call it Peptide H), and another that corresponds to low humidity (call it Peptide L).
•An immune response occurs when there's too much Peptide H in proportion to Peptide L.
•Those putative peptides are eventually identified and synthesized.
Then Peptide L could be put into a nasal spray. Why a nasal spray? After ingestion, the contents of a peptide L capsule would be digested into its component amino acids, which could not benefit arthritic joints. Nasal sprays are sometimes used to bypass the digestive tract, in order to sneak medications into your bloodstream.
On high-humidity days, when your RA is worse than usual, you could use the nasal spray. Then the Peptide H:Peptide Y ratio would decrease. You'd feel a little better, and you would not need as much of the standard arthritis medications, some of which have nasty side-effects.
Of course, this is highly speculative, and to the best of my knowledge, there is no such nasal spray in the 'pipeline'. In the next section, we'll look at a few nonstandard approaches that are helpful for some people with arthritis.
Hubpages author BlossomSB has shared her inspiring story about getting a handle on her arthritis, and putting an end to her need for medication. Through experimentation with an elimination diet, she found that it was necessary to delete coffee completely; and to cut way back on tea, Nightshade fruits, Nightshade veggies, oranges, red meat, spices and sugar.
I'm not saying that all arthritis sufferers should eliminate the same foods and beverages that BlossomSB found to be problematic, and to throw their meds out the window. However most of us have more power over our health than we give ourselves credit for. And the art of listening to our own bodies is definitely underrated.
Cardiovascular exercise can be quite helpful for arthritis sufferers. It generates endorphins, the body's natural pain-killers.
Opiates stimulate our endorphin receptors. That's how they work.
The catch for me is that the Rheumatoid Arthritis mainly affected the right hip. And the most popular aerobic exercises would have put way too much stress on that already-damaged joint; so I purchased a Trikke. (See picture.) Zipping around on the sidewalks of my neighborhood was ultra-low impact, and it decreased the pain in my hip. In an earlier article, I described my Trikking experience in greater detail.
In that same article, I also described a strength-training exercise, "F-shrugs," which work the serratus anterior muscles. The low-resistance, high-repetition version of this exercise would almost always decrease the excruciating pain of an arthritic attack in my hip.
Specialized equipment is not necessary for this exercise. However if I'm at home when the arthritic attack strikes, it's more comfortable to use my old fold-up Total Gym 1000. (See the above picture of the more expensive model.) I set mine at Level 6, and do as many repetitions as possible.
I originally bought the Total Gym to strengthen the upper legs for hiking. One-leg squats have been very helpful in that respect.
Of course, there are Total Gym exercises that target most other skeletal muscles. And that can be valuable cross-training for your sport of choice.
Two caveats about the Total Gym. First, it may not be suited to people with marginal balance. Second, long hair can get snagged in a Total Gym. If you have long hair, please put on a bathing cap, as a precaution.
I'm strong enough now to do hook squats, the difficult version of Bulgarian squats; so I don't need to pack up the Total Gym if I go out of town for the weekend.
Anyway, I'm convinced that regular right squats have dramatically decreased the frequency and intensity of arthritic attacks in my hip. (Left squats are not helpful for my hip.) I'm right-handed, by the way. Even if my experience with one-leg right squats is helpful for other right-handed RA sufferers, I have no idea if it would apply to lefties.
My conjecture is that strength training exercises for various muscles cause different peptides to be released into the blood stream. These peptides act as signals that repair is needed in those specific locations.
The repair-signal peptides from the right quadriceps also have a normalizing effect on my overactive immune system. At least, that's my tentative explanation.
Section summary. To recap this section, I suggest reading BlossomSB's excellent article. It's very possible that something in you diet is contributing to the RA. I also believe in moderate aerobic exercise. However if the RA is causing unbearable pain in your hip, I suggest looking into a Trikke, rather than toughing it out with more conventional aerobic exercise.
I mentioned two strength training exercises. One is helpful in the short term; the other in the long term. Unfortunately, I have not seen any scientific studies suggesting that these are helpful for RA sufferers in general. I'm happy to be the first guinea pig.