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We are Jamie & Anna, researchers at the University of Manchester, and we used smartphones to investigate the link between weather and pain. AMA!

Hi everyone, Anna and Jamie here! We’re here to answer any of your questions around our project. You can read or watch what the study found and ask us any questions you have!

Background: Approximately 75% of people with long-term pain conditions, such as arthritis, believe weather affects their pain. Many report pain is made worse by the cold. Others report pain is made worse by the warm. And others report damp or rainy weather aggravates pain.

What we did: To understand which weather conditions affect pain most, we conducted a 15-month smartphone study called “Cloudy with a Chance of Pain”. Over 13,000 UK residents living with chronic pain downloaded our app, where they could record their daily pain intensity. At the same time, their smartphones' GPS locations would link to local weather data.We then compared, for each participant, what was different in the weather when they had a particularly painful day (compared to a day without such pain increases).

What we found: We found that days with higher humidity, lower pressure, and stronger winds are more likely associated with high pain days. We did not find any link between temperature and pain or rain and pain.

-----------------------------------------------------------------------------------------------------------------

We are Dr Anna Beukenhorst and Dr Jamie Sergeant of The University of Manchester. We went looking for the answer to the age old question of how the weather affects pain, as part of our research project, ‘Cloudy with a Chance of Pain’. Today we are here to answer any questions you have about our research!

Read the paper here: https://www.nature.com/articles/s41746-019-0180-3

Our participants shared their stories here: https://www.youtube.com/watch?v=k6by_IoVwRk

See BBC Breakfast's 2-minute summary here: https://twitter.com/BBCBreakfast/status/1187269996474437633

Learn more about Cloudy with a Chance of Pain on our website: https://cloudywithachanceofpain.com/

Read more on the website of Versus Arthritis, who funded our study, or on the Medical Research Council or watch the take of the Weather Channel.

15:30 BST - EDIT: Thank you all so much for your questions! It was great talking about Cloudy with a Chance of Pain with you, but we now have to dive back into our data...


57
questions
3,508
score
June 29th 2020
interview date
_Ekajata_

For decades, I have been able to predict the rain with ludicrous accuracy as my skin, connective tissues, C1-5 multiple disc ruptures, and related rheumatism issues decide to gang up and just ruin me for days at a time.

Can you tell me if you have any insight on chronic issues affected by barometric pressure changes?

I am going to read/watch your links now.

Thank you in advance for any insight.


UniOfManchester

Thanks for the question. Our study did find a link between pain and higher humidity, lower pressure, and stronger winds. The study was open to UK residents with chronic pain (lasting more than three months) and hence analysis was conducted using data from people with different pain conditions. We hope that further research will enable us to produce findings for specific patient groups, based on their particular condition or other characteristics. For now, these results represent an average effect across our sample.

bulleybeef

Is there a relationship between weather and migraines? I can anecdotally say this happens to me.


UniOfManchester

Our study was open to participants with chronic pain. This included people who experience migraines. In the sample that we conducted our analysis on, 10% of our participants reported experiencing chronic headache (including migraine) when they joined the study. Unfortunately the smaller numbers of people with particular conditions versus the overall sample meant that it wasn't possible to draw conclusions specifically for those conditions.

OversteerCentral

What is your take on season affective depressive disorder? Can it play a mediating or moderating role in pain?


UniOfManchester

We didn't specifically look at SAD. People did report their mood in our smartphone app, and we found that mood had a stronger association with pain compared to the effect of the weather (but it did not explain the association between the weather and pain, so we found an association between weather and pain even beyond mood).

rdgrdmdfld

What's the relationship between the two?


UniOfManchester

Higher humidity, lower pressure, and stronger winds were significantly associated with increased pain.

Our participants had chronic pain, mostly because of musculoskeletal conditions like arthritis, but, as we mentioned in another answer, about 10% because of migraine. Our results suggest that on a humid windy day with low pressure, painful days were 20% more likely compared to a day with 'average weather' (an increase in the risk of a painful day from, say, 5 in 100 to 6 in 100).

whiteboi53

What you guys are doing is really cool! What made you want to study this phenomenon? Also is the sample size that used the app too small to make a theory?


UniOfManchester

Thanks! The study offered a great opportunity to answer an age-old question but using the modern technology of smartphones. We are grateful to our participants who submitted their data so that we could study the link between weather and pain. Hopefully insights from the study can motivate further research to improve our understanding of the mechanisms of pain and potentially new treatments. Also, being able to predict days more likely to be painful might allow people to better manage their activities and hence their pain - a pain forecast to accompany the weather forecast?

distortedtoothbrush

During your research, did you ever look into a situation/scenario in which a patient experiences severe pain in let’s say overcast weather with high humidity percentages but then travels to another part of the world, and encounters a similar climate but doesn’t experience the same pain?

Are there other factors in the weather that can play a role in a situation such as this? Oxygen levels, elevation, etc?


UniOfManchester

Those are really good questions, but unfortunately we only had weather data from the United Kingdom, and only UK residents among our participants. Technology like smartphones and smartwatches have the ability to record location and elevation, so maybe (hopefully!) others will investigate those questions!

3sorym4

Did you take into consideration participants’ belief that the weather affects their pain?


UniOfManchester

Yes! When people enrolled, we asked them how strong their belief was on a scale from 0 to 10 (the average was 7), and what weather conditions they believed to be linked with their pain. The most common beliefs were that rain and cold caused pain.

Our analyses provided some reassurance that our results are not explained by people reporting what they thought their pain ought to be, given that day’s weather:

- If people reported more pain on rainy or cold days because of their belief, we would have expected to see an association with rainfall and low temperature. However, neither rainfall nor cold were found to be associated with pain, meaning this possible bias does not explain our findings.
- We also did not find any differences between those with a stronger or a weaker belief in which weather conditions increase pain.

Huzafa13

What's the main reason a relationship between these two exists?


UniOfManchester

That's a great question, and one that we don't currently have much of an answer to. Our study aimed to improve our understanding of the nature of the association between pain and the weather, but it didn't investigate why any associations exist. It's a great target for future research though. If we can better understand the mechanism through which the weather influences pain, then we may be able to develop ways to disrupt that mechanism and better manage pain. Hopefully our findings give a platform for this future research to be built on.

spyder_victor

Which Manchester campus are you on? I am ex UMIST (2008) is the Sackville Street building still owned by the uni?


UniOfManchester

We're based all over the campus, and actually all over the world. Because we needed experts in different fields: rheumatology (not only clinicians, also people who suffer from chronic pain, as they are the real experts), meteorology, statistics, smartphones/technology. Therefore, people of multiple faculties contributed to the study. We also had external collaborators in London, Israel and Canada - quite difficult to schedule meetings at a time that worked for everybody!

p2pbshmn

So I'm pretty sure I can tell there's some change on weather happening due to a weird feeling where I broke my wrist over 20 years ago, or in my collarbone which was more recent. Is there any evidence for this? How would one test it?


UniOfManchester

Some of the participants in our study had recurring pain because of a previously broken bone! They reported their daily pain level in our app, while it recorded their location, which we could link to the nearest weather station. The results of the above paper - that higher humidity, lower pressure and stronger winds are associated with days with higher pain - are the average of all our participants though, and only a few reported previously broken bones. So to really test your hypothesis, one could make a similar app and then recruit a much larger group of people with pain/weird feelings in their previously broken bones.

dog_in_the_vent

What we found: We found that days with higher humidity, lower pressure, and stronger winds are more likely associated with high pain days. We did not find any link between temperature and pain or rain and pain.

Have you consulted with a meteorologist about these results? Low barometric pressure causes the humidity to rise and can cause strong winds. It's possible the cause of the pain is one of these factors and not all three.


UniOfManchester

Yes, one of our colleagues is a meteorologist. We first looked at four weather variables separately, and then combined them in a model. The model with all four weather variables represents the effect of one weather variable while all else remains constant. So keeping all other weather variables constant, there is an association between low barometric pressure (or: higher humidity/stronger winds) and high pain days.

If you're interested in the meteorology perspective, you might find our other paper interesting: https://journals.ametsoc.org/bams/article/101/5/E555/345596/Weather-Patterns-Associated-with-Pain-in-Chronic (or an article about the article here: https://www.hippocraticpost.com/muscular-skeletal/chronic-pain-mapping-the-weather-patterns/ or this one: https://www.forbes.com/sites/marshallshepherd/2019/11/18/a-40-chance-of-paina-new-study-links-weather-and-discomfort/#6b88cb2c6576

atomsxd

I always get a migraine on the day of a thunderstorm. Any correlation?


UniOfManchester

We didn't specifically investigate thunderstorms, but only the 'main' weather variables (temperature, pressure, humidity and wind speed) plus rain (because so many of our participants believed in a link between rain and pain). Our meteorology expert (see this article) told us that changing pressure occurs with thunderstorms, and we did find a link between lower pressure and painful days.

CamaroBro18

Which climate affects the most in patients and is there any way to prevent climate from affecting the patient?


UniOfManchester

In our study we found increases in pain to be more likely on days with higher humidity, lower pressure, and stronger winds, with humidity having the strongest contribution. Our study was only in the UK and involved comparisons made within individuals as the weather changed day by day. We didn't consider climates beyond the UK or people changing between geographic areas with different climates. Hopefully our results will enable better prediction of painful days for individuals, so that they can better manage their activities and hence their pain, and ultimately better understanding of the mechanisms through which pain acts, so that these can be addressed by treatments.

x32s_blow

Y'all right mayyte?

Translated:

Hello fellow Mancunians!

What have you found from these studies that you didn't expect?


UniOfManchester

We were surprised by our participants and the potential of smartphones for healthcare research! Before launching the study, we hoped that we could get a few hundred people to download our app. Imagine our surprise when, after one week of recruitment, we had more than 6,000 participants.

In total, the app was downloaded by over 13,000 people. We knew from other smartphone apps - whether research apps or apps like Pokémon Go - that it can be difficult to retain app users (I myself often get bored with apps within one week and then delete them). So we didn't expect so many participants to keep using the app and report their symptoms, well-being and behavior more than 5.1 million times. In addition to the analysis mentioned above, where we only analyzed a subset of our participants, we were also able to look at the complete population (see this article).

TotallyFuckingMexico

Any insights gained on fibromyalgia?


UniOfManchester

A quarter of our participants had fibromyalgia or chronic widespread pain! Our findings are the average of all our participants though, but we hope to explore differences in weather-pain relationships between people and subgroups in more detail in future analyses.

Jztherussian

How does pain relate to weather when physical activity is a factor (I.e someone worked out and is sore.)

Follow up: Is there a co variability issue between weather and sleep quality with pain?


UniOfManchester

When people reported their daily pain levels, they also reported their levels of physical activity. So we could actually check whether there was a link between physical activity and pain, and whether it may be that that explains the link between the weather and pain (cold weather > staying indoors without physical activity > more pain, or something like that). We found that there is a link between physical activity and pain, but it didn't explain the link between the weather and pain.

ayihc

If pressure and wind cause pain, is this due to minor pressures on the muscles/tendons/bones, could strapping knees (my issue) on those days simply alter the pressure enough to counter?

Also, as a teacher, I can definitely say that wind affects kids. Makes them nuts. It's so weird!


UniOfManchester

We don't know! We will pass our findings onto other researchers that study the mechanisms of chronic pain, and hopefully they will one day be able to answer that question.

justinbeeba

Just skimmed the paper and watched the BBC feature - great work guys. My dad suffers from Rheumatoid Arthritis and is in constant pain so it's a topic quite close to home.

I'm a bit of a data nerd so I have a few questions on the analysis:

1- how did you guys account for people's health declining and therefore potentially feeling more pain over time, as well as changes in medication/pain relief?

2 - Did you take into account any fallacies when looking into the results? For example if I were to have a 7 out of 10 pain for a week, and then the following week it increased to an 8 of 10. After a few days this would become my new 7 out of 10 as I would have got used to the increase.

Great work guys


UniOfManchester

Thanks for your question. So we analyzed our data with the 'case-crossover analysis'. For each participant, we looked at days where they had big increases in pain ('painful days'), compared them with days where they didn't have those increases ('control days') and asked: what was different in the weather between these days? (for the real data nerds: we used conditional logistic regression to make that comparison)

The analysis had a couple of advantages, and it enabled us to handle the problems you mentioned:

1 - You are right that a participants' health (+ the weather, + many other factors that may be related to pain) may be very different between January and, say, July. So we ensured that we only made comparisons within one month: we compared a participants' painful days in January with control days in January, and the same for February, and for March. By not comparing painful days with control days that were very far apart, we mitigated some of that potential bias.

2 - You are also right that a pain severity of 7 out of 10 may not mean the same to someone a while later (not to mention that you're 7-out-of-10 probably isn't the same as my 7-out-of-10). By defining a 'painful day' as a day that someone had at least a +2 increase in pain compared to the previous day, we didn't have to make any assumptions about the exact meaning of a 7-out-of-10, or what number is the cut-off between a painful day and a control day.

Fun fact: to make sure that people could easily report their pain levels, with one simple swipe, no matter what screen size their phone had, we used a 5-point scale from 1-No Pain to 5-Very Severe Pain.

zaudo

“Approximately 75% of people with long-term pain conditions, such as arthritis, believe weather affects their pain”

If a large proportion of people believe weather affects their pain, then they are more likely to record on the app that they are in more pain on days when the weather matches their preconceived notion. Even if they are not in more pain.

How did you account for this and eliminate this bias?


UniOfManchester

You're very right that this bias could be an explanation for our findings, especially with a study called 'Cloudy with a Chance of Pain'. To eliminate this bias, we asked participants how strong their belief was on a scale from 0 to 10 (the average was 7), and what weather conditions they believed to be linked with their pain. The most common beliefs were that rain and cold caused pain. I realize I just answered this question, so copying from the other answer:

Our analyses provided some reassurance that our results are not explained by people reporting what they thought their pain ought to be, given that day’s weather:

- If people reported more pain on rainy or cold days because of their belief, we would have expected to see an association with rainfall and low temperature. However, neither rainfall nor cold were found to be associated with pain, meaning this possible bias does not explain our findings.
- We also did not find any differences between those with a stronger or a weaker belief in which weather conditions increase pain.

dietderpsy

Is the weather affecting the liquid in the joints?


UniOfManchester

Researchers have suggested why different aspects of the weather may influence pain but few have been conclusively proven. We'll pass our results onto labs that investigate the mechanisms of chronic pain and hope they may be able to tell us more in future.

jillybean310

Oh my god I struggle with this so hard. Last year or so we figured it was more air pressure related. I have turned into a human barometer. I have arthritis and severe nerve damage. Has your study led to any treatment ideas? Have you published your findings that can be shared with a doctor? Thank you for proving I'm not crazy.


UniOfManchester

We'll definitely pass our results onto other researchers that investigate the mechanisms of chronic pain and the treatments for it. You can read the paper with the results here: https://www.nature.com/articles/s41746-019-0180-3. In the post at the top of this page, we put a few links to other resources (the shortest summary is a 2-minute video clip).

TheBonkGoggler

Being a UOM student myself, i can certainly tell you that the rain in Manchester affects my amount of pain, especially when riding home from campus in winter ;)

As a genuine question, what data have you found about local attitudes to the weather and pain? As those in Manchester definitely have a unique view of the rain.


UniOfManchester

We asked participants how strong their belief was that the weather influenced their pain (7 out of 10 on average), and if so, what in the weather influenced their pain. Most people thought the culprit was rain (73%), cold weather (66%, they could choose more than one answer), changes in barometric pressure (35%), changes in temperature (34%), hot weather (18%), and/or something else (3%).

The variety in beliefs is also illustrated in this video contribution of our participants: https://www.youtube.com/watch?v=DXRaF1JTT5E

We didn't specifically look at local differences in these attitudes/beliefs. How do you expect those attitudes to differ locally/regionally?

hsw77

Out of interest, how did Rheumatoid Arthritis figure in the results? I have RA and often get asked if it's affected by the weather, and I've personally never noticed any sort of correlation.


UniOfManchester

About 19% of our participants had rheumatoid arthritis, the biggest group after osteoarthritis. Our results are the average of all the participants groups, and of course it is possible that not everybody have the same experience as that average. We definitely want to look closer at the results for different subgroups (for example by condition) so hopefully we may be able to answer your question about RA specifically in the future!

clockworkspuffnsmoke

Barometric pressure causes me a ton of nerve damage pain. I use Tommy copper compression leggings to combat that. What is the correlation between pain and barometric pressure?


UniOfManchester

We found that lower pressure is associated with painful days (we wrote more about below-normal pressure and high pain in this article, which has nice weather maps showing the pressure.

therealmitzu

Hey guys, I'm from Manchester as well and I have a condition called IIH. I believe the correlation between atmospheric pressure and chronic pain in IIH would be extremely interesting, also given there's little research in both treatment and pain relief for IIH patients.

Have you looked into it? The Eye Hospital in the Royal Infirmary has some very knowledgeable people, such as Dr. Yagan.


UniOfManchester

We found that lower atmospheric pressure was associated with painful days in our participants with chronic pain. I think that our study Cloudy with a Chance of Pain is a proof of concept that smartphones can be used for healthcare research, so maybe the study can be repeated for conditions that we didn't investigate.

myuniquenameonreddit

It's pretty known that heat and humidity affect multiple sclerosis patients. It worsens symptoms to the point some people think they might be having a relapse. The bathtub test used to be the standard test to find out if you have MS. Humidity is my biggest enemy. I get cog fog and crazy fatigue, and am unable to function on any higher level when that happens. For other people, its the pain thay gets worse. Perhaps you have some insight on the MS side of things?


UniOfManchester

I didn't know that, that sounds awful. We didn't have any participants with MS in our study, so we don't have insights on the MS side of things.

qeeryiiojbvxsadf

What degree are you guys doing?


UniOfManchester

Currently we're not doing any degree! Anna did a PhD on Cloudy with a Chance of Pain, recently defended her PhD and Dr. Jamie has been a Dr. for a long time now.

countblah2

Thank you for your work on this. I thought the link between certain kinds of chronic pain (particularly rheumatological issues like arthritis), and weather, especially barometric pressure changes, has been fairly well documented through a number of studies over the last 20+ years. Is the key significance of your work that you're bringing technology to measure results on a wider scale?


UniOfManchester

Correct! There have been more than 40 previous studies investigating weather and pain, but most studied few people (< 100 participants) and over a short period of time (< 1 month). Investigating self-reported pain used to require a lot of fuss with sending people diaries and asking them to post them back. With a lack of sensors, researchers had difficulty determining the weather at participants locations (most assumed that participants always stayed at their home postcode/in their home city).

Like you said, we had all the technology of the 21st century to solve some of these problems, and with more participants, a longer duration and weather data from participants actual locations we had more and better data. Those previous studies taught us a lot about different analysis methods to tackle the data and the challenges of studying weather and pain though (for the links to the specific articles, see our literature review or the summary by the Guardian).

DennisReddit

Did the participants know about what you were studying? Even with this app name, isn't there confirmation bias / placebo?


UniOfManchester

Borrowed from above:

You're very right that this bias could be an explanation for our findings, especially with a study called 'Cloudy with a Chance of Pain'. To eliminate this bias, we asked participants how strong their belief was on a scale from 0 to 10 (the average was 7), and what weather conditions they believed to be linked with their pain. The most common beliefs were that rain and cold caused pain. I realize I just answered this question, so copying from the other answer:

Our analyses provided some reassurance that our results are not explained by people reporting what they thought their pain ought to be, given that day’s weather:

- If people reported more pain on rainy or cold days because of their belief, we would have expected to see an association with rainfall and low temperature. However, neither rainfall nor cold were found to be associated with pain, meaning this possible bias does not explain our findings.
- We also did not find any differences between those with a stronger or a weaker belief in which weather conditions increase pain.

tinkertron5000

How did you control for any pre-existing bias towards the idea that the weather had an effect on their pain?


UniOfManchester

Yes! Allow me to share the answer above:

Yes! When people enrolled, we asked them how strong their belief was on a scale from 0 to 10 (the average was 7), and what weather conditions they believed to be linked with their pain. The most common beliefs were that rain and cold caused pain.

Our analyses provided some reassurance that our results are not explained by people reporting what they thought their pain ought to be, given that day’s weather:

- If people reported more pain on rainy or cold days because of their belief, we would have expected to see an association with rainfall and low temperature. However, neither rainfall nor cold were found to be associated with pain, meaning this possible bias does not explain our findings.
- We also did not find any differences between those with a stronger or a weaker belief in which weather conditions increase pain.

_Bronstein_

What other areas of research have you considered approaching with a similar method as this?


UniOfManchester

In the Centre of Epidemiology Versus Arthritis we do more research into harnessing digital data for arthritis research. On http://www.cfe.manchester.ac.uk/research/projects/ you can read about our other projects. Some of the things we do: finding out how activity is related to knee pain in osteoarthritis with smartwatches (see 'KOALAP'), having people with rheumatoid arthritis log their symptoms with a smartphone app and share it with their clinician (see 'REMORA'), figuring out the link(s) between sleep, fatigue and pain in arthritis with smartphones and wearables (see 'QUASAR'). Anna is now working at the Onnela Lab (https://www.hsph.harvard.edu/onnela-lab/) where she uses the Beiwe smartphone app for research in the motor neuron disease ALS and to understand the nature of suicidal behaviour.

mrs_flibble_

Were any results that surprised you?


UniOfManchester

Allow me to copy from our answer above:

We were surprised by our participants and the potential of smartphones for healthcare research! Before launching the study, we hoped that we could get a few hundred people to download our app. Imagine our surprise when, after one week of recruitment, we had more than 6,000 participants.

In total, the app was downloaded by over 13,000 people. We knew from other smartphone apps - whether research apps or apps like Pokémon Go - that it can be difficult to retain app users (I myself often get bored with apps within one week and then delete them). So we didn't expect so many participants to keep using the app and report their symptoms, well-being and behavior more than 5.1 million times. In addition to the analysis mentioned above, where we only analyzed a subset of our participants, we were also able to look at the complete population (see this article).

MikeAbbsV

Thanks For The AMA it's a fascinating topic! :) I have Osteoporosis at 32 from damage due to Hypercortisolism from Cushing's Disease and on day's like today the pain is unbelievably extreme all throughout both legs (it's grey and weird out not hot not cold just glum) could this be to do with humidity changes or some such thing?


UniOfManchester

So our study found that higher humidity, lower pressure, and stronger winds were significantly associated with increased pain. Those results are the average of all our participants though, so not only people with osteoporosis. In future analyses we hope to learn ore about the variability between people with different conditions.

Doomhammered

Did you have any participants with gout specifically? Did they have stronger correlations to specific weather conditions?


UniOfManchester

Yes, about 4% of our participants had gout. The results we reported above are the 'average' of all our participants though. We did not find evidence for meaningful differences between groups of people with different medical conditions, but that was partially because the subgroups got much smaller, which makes it more difficult to detect those differences. In future, we hope to further explore differences in the weather-pain association between participant groups.

bandofgypsies

Hi Anna and Jamie, that KS for taking the time to do this and for all your life's work! I can only imagine how many people stand to benefit from this.

My question: do you have any data (or sources to which you can point) regarding the connection between barometric pressure and multiple sclerosis? Or perhaps simply to the ways in which pressure-related conditions can impact the relationships between muscular system and CNS (and perhaps even immune system)?

Thank you so much!


UniOfManchester

Hi! You're the second one to ask us about MS. Unfortunately, we didn't have any participants with MS.

Zee_Ventures

People say things like they can feel the rain/cold coming because they feel it in their bones. Is there any correlation between chronic pain and being able to anticipate weather?


UniOfManchester

We looked at the link between lagged weather and pain, whether there was a link between the weather on the previous day and pain, up to five days before the pain report. We didn't find much evidence for such lagged effects, except for significant effects of humidity one and two days before the pain report.

zelet

Any plans to release the app for personal tracking/correlation?


UniOfManchester

Our participants used the app for personal tracking: they could make graphs of their symptoms over time, make notes, set medication reminders etc. (it was developed by https://umotif.com/) Our group at the Centre for Epidemiology Versus Arthritis does a lot of research in digital epidemiology, but those are mainly apps for research purposes and not for personal tracking.

tellmetheworld

Is there any truth to the trope of the elderly person who’s hip hurts before rain?


UniOfManchester

So we did find a link between weather conditions and chronic pain, but actually, rain was one of the variables that was not associated with increased pain. The strongest link was between the same-day weather conditions and pain (rather than yesterday's weather being linked to today's pain).

ocherthulu

Did you study tinnitus at all?


UniOfManchester

People with long-term pain (> 3 months) could enroll in the study - we didn't have anyone with tinnitus. Do you think the weather is linked to tinnitus too?

mrcarrot9

What lind of pain are you reasearching because i can understand that some weather aspects have an effect on a wound or injury for example, when you burn your hand a cold wind can cool it off and make it feel fine but those things are quite logical, what kind of pain or stress are you investigating?


UniOfManchester

People could take part if they were living with long-term pain (> 3 months). Most of our participants had arthritis (e.g. osteoarthritis or rheumatoid arthritis) or fibromyalgia or chronic widespread pain.

PaulTheAdultGamer

I wonder if specializing your research by type or site of injury would yield different result? I'd love to volunteer if you do further studies.

I never believed in the weather thing until nine years ago when I suffered a lumbar injury in a car accident that resulted in scar tissue in and around my spinal cord and sciatic nerves. I now have TERRIBLE pain everyday, all day. Both in my back and terrible neuropathy down either leg and in my groin. I lose strength and feeling and kinesthetic awareness of my feet and legs. I fall often. I have constant ghostly sensations of touch or stabs or crushing or fire or cold. I drag my right foot. It also happens in my genitals and I have various bladder neuropathy. Pain wakes me suddenly most nights and once I manage to sleep I dream of being burned or bitten or stabbed in my lower half. I can only sit up for, at most, twoish hours before having to get flat. Excessive movement saws scar tissue at my nerves and a busy morning can lead to two days flat on my back without sleep and with tears in my eyes.

The weather ABSOLUTELY affects me and I've tracked it myself. I find humidity and low pressure and large swings in pressure are triggers, but also RAIN. Rain, especially storms, are horrible for me now so I'm extremely surprised that your research doesn't bear that out. We play a game here where I guess the weather when I wake in the morning, before opening the curtains or asking Alexa for the forecast. I also place bets against Alexa's forecast and would be rich by now if she'd only pay up.

I have just this month had one spinal stimulator for pain replaced with another company's more modern and capable model. It's helping a bit but still not as much as I had hoped. I rely on narcotics to take enough of an edge off to get up and attempt being productive. I'm mostly housebound except for short trips and some days I am bed or couch -bound.

I DREAD rain.

So, to repeat, I wonder if specializing your research by injury type or site would yield different results? I haven't read beyond your posted verbiage here, so apologize if you've mentioned this in the click-thru.


UniOfManchester

The results described above are an average of all our participants/conditions/injury types/pain sites, but yes, we looked

- by condition (rheumatoid arthritis, osteoarthritis, migraine, fibromyalgia, etc.), and
- by pain site (hip, hand, knee, etc.)

We did not find meaningful differences (maybe [partially] because those subgroups were a lot smaller), but we intend to look further into individual differences in the link between weather and pain.

Dogoncrook

I have nerve damage in my left leg along with some massive tissue injuries and all i can really feel is pressure changes. To me the range in pressure that i feel is roughly the same as a 600mg of aspirin if that makes sense. I feel no pain so im acutely aware of subtle changes in pressure and stiffness in my joints i would equate it with losing other senses the sense i do have is amplified regarding that leg, its the only feedback i get.

So my question is if i can detect a difference in stiffness by the effort it takes to move the joint could you detect a stiffness change in some measurable way just by manipulating the joint? Like a machine that measures how much force it takes to bend the joint? It would of course be a very small difference. I realise there is more to it than just the joint movement itself but i would still expect a measurable difference.

Edit: just a random thought too with tissue damage you see pooling fluids it comes with the territory, scar tissue is not very effective moving things around. Once you have hit a certain level of damage diet plays such a huge part in it i dont know how you cam account for this salt intake can cause massive changes to a damaged area regarding swelling and stiffness even if its well under the daily recommended for a healthy person. Hydration levels and whatnot, its a lot to account for and for me personally it has just as much affect as the weather.

So it strikes me you could tell the difference but only if you account for and track dozens of variables religiously to rule out changes in diet and whatnot. Hell even how long you lay prone a day is gonna have an effect so sleeping would too.


UniOfManchester

Interesting thoughts! I'm not sure how to detect stiffness in such an 'objective' way - I'll have to ask my clinician colleagues. In Cloudy with a Chance of Pain we did ask people to report their stiffness - indeed a common symptom in musculoskeletal disease - on a scale from 1 to 5. As stiffness was not relevant to all participants (e.g. those with migraine), we didn't use it in the primary analysis, but hopefully we can dive into some of your questions in the future.

leannbmxmom

Fascinating study! I have ripped the inside of my hip twice and had it repaired. I also run a construction crew of men (I’m female). If they see me lipping on the job site or can tell that I’m in pain, everyone knows without a doubt it will rain in 2 days. I’ve been accused of ruining everyone’s weekends. Lol. I don’t focus on weather forecasts, I don’t need to. But here’s the crazy thing. There are only two things that stop the pain. A hot bath or wait for the rain. All it has to do is start raining and the pain disappears and does not linger. I’ve never understood why when the rain actually starts, the pain subsided. Did anyone else report that?


UniOfManchester

Most of our participants believed that the weather influenced their pain, and almost three quarters of our participants thought that the culprit was rain, so you're not alone. Our analyses showed that high relative humidity, low pressure and strong winds were associated with painful days, but no direct link between rain and pain.

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UniOfManchester

One reason was that there was so much debate about the weather and pain - it's really an age-old question. As you can see in this video clip from our participants their hypotheses vary widely, and it has been like that for ages.

Another reason was that we were curious about the potential of smartphones for healthcare research. Nowadays we carry a smartphone with us wherever they go, and with one swipe people can report their symptoms, while the phone can record all kinds of things with sensors. When we started Cloudy with a Chance of Pain there where few large smartphone studies that had recruited many participants and kept them engaged for a sustained period of time, so that's what we set out to do.

iamthejubster

I know this is to late, but i figured i'd ask in case you check the comments later. Have you also studied the link between headaches and migraine when it comes to the weather? For a while i was able to tell how bad a storm would be based on how much my head throbbed the day before.


UniOfManchester

From the answer we gave earlier:

Our study was open to participants with chronic pain. This included people who experience migraines. In the sample that we conducted our analysis on, 10% of our participants reported experiencing chronic headache (including migraine) when they joined the study. Unfortunately the smaller numbers of people with particular conditions versus the overall sample meant that it wasn't possible to draw conclusions specifically for those conditions.

Ones_Fate

Dude I predict rain better than the weatherman from my migraines. Since you are studying the link, you should see that people actually pick up and move but how do you decide where? I live in Utah, but Ive also been at sea level. Where do people usually go?


UniOfManchester

British motorcycle legend Barry Sheene moved to Australia to reduce his arthritic pains!

We only had weather data from the UK though, and only UK residents. We analyzed day by day changes in the weather, so we didn't look at climates beyond the UK, or people changing between geographic areas. So that will be one for future research.

00_sieben

Whats the weirdest reaction to weather you saw from an individual in the course of your work? Anything in the vein of that far side comic where three guys predict the weather by various body parts swelling up?


UniOfManchester

The main thing I learnt is that people have such different experiences (see here a video in which our participants share their experiences: https://www.youtube.com/watch?v=k6by_IoVwRk). Doing this AMA confirmed that: the redditors that responded all have different experiences with the weather and pain, including people who report changes in pain that precede changes in the weather (and some have medical conditions that we didn't even include in our study).

As a data scientist, I was mostly working with the datasets, which are quite anonymous: just rows and rows of numbers. At the Centre for Epidemiology Versus Arthritis we got lots of input from our research participants/partners, though, and they really opened my eyes to the reality behind the numbers. One of our participants shared it in this emotional clip: https://www.youtube.com/watch?v=safZ8TSouX4

Pm_me_40k_humor

Would you be interested in checking out the relationship between weather and neurological disturbances (migraine, seizures) is that a thing with a large corpus of literature already?


UniOfManchester

About 10% of our participants had chronic headache (including migraine), so the group was definitely represented. Our main results reflect the average of all our participants, however, so not specifically the link with chronic headaches. We did a preliminary analysis of the various subgroups, including the subgroup of people with migraine, but smaller numbers of people in those subgroups meant that it wasn't possible to draw conclusions specifically for those conditions (yet).

hgaterell

I've never understood why I get a bad headache when it's stormy. Something to do with the pressure? Is this something that has come up in your research?


UniOfManchester

Interesting, you're not the first to mention storms. This was our answer of a previous comment about storms (in the responses you see a meteorologist chip in too)

We didn't specifically investigate thunderstorms, but only the 'main' weather variables (temperature, pressure, humidity and wind speed) plus rain (because so many of our participants believed in a link between rain and pain). Our meteorology expert (see this article) told us that changing pressure occurs with thunderstorms, and we did find a link between lower pressure and painful days.

wackychimp

My wife tends to get migraines right before a big storm. Presumably she's reacting to a barometric change?

Why do we think this happens?


UniOfManchester

Loads of people asked about migraine, pressure and (thunder) storms! Allow me to copy-paste the answer we gave previously (in that thread other redditors shared their experiences, hypotheses and expertise - might be interesting)

We didn't specifically investigate thunderstorms, but only the 'main' weather variables (temperature, pressure, humidity and wind speed) plus rain (because so many of our participants believed in a link between rain and pain). Our meteorology expert (see this article) told us that changing pressure occurs with thunderstorms, and we did find a link between lower pressure and painful days.

peatoire

Interesting study. How do you manage the placebo effect? If people already think the weather affects their pain won’t it skew results?


UniOfManchester

Borrowed from above:

You're very right that this bias could be an explanation for our findings, especially with a study called 'Cloudy with a Chance of Pain'. To eliminate this bias, we asked participants how strong their belief was on a scale from 0 to 10 (the average was 7), and what weather conditions they believed to be linked with their pain. The most common beliefs were that rain and cold caused pain. I realize I just answered this question, so copying from the other answer:

Our analyses provided some reassurance that our results are not explained by people reporting what they thought their pain ought to be, given that day’s weather:

- If people reported more pain on rainy or cold days because of their belief, we would have expected to see an association with rainfall and low temperature. However, neither rainfall nor cold were found to be associated with pain, meaning this possible bias does not explain our findings.
- We also did not find any differences between those with a stronger or a weaker belief in which weather conditions increase pain.

Hungry4havok

What are your takes on the “migraine meteorologist”? Someone who can sense the weather changes through pain


UniOfManchester

From the answer we gave earlier:

Our study was open to participants with chronic pain. This included people who experience migraines. In the sample that we conducted our analysis on, 10% of our participants reported experiencing chronic headache (including migraine) when they joined the study. Unfortunately the smaller numbers of people with particular conditions versus the overall sample meant that it wasn't possible to draw conclusions specifically for those conditions.

swaggler

But humidity is a function of temperature (and dew point)?


UniOfManchester

That's right! We actually had to be very careful in our analysis. We used an analysis method called 'regression', and if you put in three variables where one is a function of the other two, things go horribly wrong (they call it multicollinearity). To solve that problem, we chose to use temperature (in degrees Celsius) and relative humidity (in %) as our measure of humidity (rather than dew point).

znaseraldeen

What are your thoughts on Seasonal Affective Disorder?


UniOfManchester

Ah, you're not the first to ask about seasonal affective disorder! Allow me to copy the answer from above:

We didn't specifically look at SAD. People did report their mood in our smartphone app, and we found that mood had a stronger association with pain compared to the effect of the weather (but it did not explain the association between the weather and pain, so we found an association between weather and pain even beyond mood).

japooki

Where do you think the causality lies?


UniOfManchester

As we only did an observational study, that's not possible to say based on our results. By having people report their mood, their physical activity and their time spent outside, we could do a few sanity checks (there was a link between the weather > mood/physical activity, and also between mood/physical activity > pain, but there was still a weather > pain link after correcting for those).

We'll pass our results on to people in other labs that do investigate the mechanisms of chronic pain, so hopefully there will one day be an AMA on the 'why?'

Megatheorist

When will you investigate the link between cannabis and pain?


UniOfManchester

From a Google search, it looks like loads of people have investigated that link already! The interesting thing about the link between weather and pain was that the majority of people with chronic pain believed it exists, but research was never conclusive. Our participants - even those who didn't believe in the link - really wanted to know the answer (see why in this short video clip of them: https://www.youtube.com/watch?v=ggod3kLv1mI). A second reason to investigate the link between weather and pain was that we expected smartphones to be a game changer: to accurately measure the weather, you need participants' locations. Historically, that was very difficult, but with smartphones we suddenly have Location Services to our rescue.

joe2macker

Do you think if you use Hauwei smartphone would make your job easier?


UniOfManchester

Our app worked on both Android and iOS smartphones, Huawei phones included!

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UniOfManchester