Influence of Seasonal Changes on Rheumatoid Arthritis

Living with rheumatoid arthritis (RA), you know that RA doesn’t go on vacation. And there is growing evidence suggesting RA is less active at certain times of the year and more active at other times due to changes in the weather.

No matter how well-controlled your RA is, you may find some weather patterns might make your RA symptoms worse. You might even feel as if you can predict the weather based on how achy and sore your joints are.

Researchers aren’t sure why weather affects people with RA in the way that it does. However, large numbers of people with RA do report increased pain and stiffness with different weather patterns. Weather changes like atmospheric pressure changes and cold and hot temperature fluctuations have long been reported by people with RA for triggering disease flare-ups.

Keep reading to learn about how RA might affect you during the colder months, as well as during the warmer months, and what you can do to manage RA as the weather changes.       

Atmospheric Pressure 

Changes in atmospheric pressure (also called barometric pressure) seem to affect people with all types of arthritis and chronic pain. That means if significant cold or warm weather changes are coming, you might experience more pain and stiffness in your joints. Once the weather settles in, joint pain and stiffness might even themselves out. 

According to a 2014 report, many people with RA report changes to joint swelling that seem to correlate with changes in air pressure, but researchers haven’t addressed these connections in any type of large-scale study. The report’s authors point to a Japanese study that looked at connections between air pressure and joint swelling and tenderness in people with RA.

The Japanese researchers found negative associations between air pressure and RA disease activity, specifically that drastic changes to barometric pressure in the form of significant weather changes could affect the joint linings (synovial membranes) and lead to swelling, stiffness, tenderness, and pain.

Cold Weather 

When winter weather arrives and temperatures cool down, many people with RA will reach out to their healthcare providers about RA flares. high disease activity, and increased pain, swelling, stiffness, and tenderness of joints. It is unclear why cold weather might affect people with RA, but many studies do suggest cold temperatures do worsen joint pain and stiffness. 

A study reported in 2019 in the journal BMC Musculoskeletal Disorders explored the seasonal effects of weather on RA. For this study, researchers looked at RA disease activity in over 12,000 people over four seasons. They found disease activity in the upper and lower extremities was the highest in springtime, followed by during the winter months.

The researchers recommend healthcare providers consider how seasonal changes might affect people with RA so that treatment can be planned and customized before symptoms worsen as the weather changes.

Risk For RA From Colder Environments 

A cold working environment might increase the risk of developing RA, according to a 2017 Swedish study. In this study, researchers relied on self-reported information on work environments, which included cold indoor and cold outdoor settings, to better understand overall risk and inflammatory markers associated with RA development.

Researchers also investigated how the stress of an occupational physical workload might affect the development of RA in combination with a colder work setting. Based on questionnaires, study participants were categorized by work environment—indoor cold versus outdoor cold presently and in the past.

They also looked at physical workload factors, including bending, lifting, and hand and finger repetitive movements. Researchers found the risk for RA was 1.5 times higher for people who worked in outdoor cold environments and 1.7 times higher for people working in indoor cold environments compared to people who hadn’t worked in these types of settings.

The researchers further suggested the indoor cold environment posed a higher risk than the outdoor cold environment because there wasn’t always a temperature consistency in the indoor setting. They added that differences in how people were affected by cold could also play a part in how these occupational environments might trigger RA.

Vitamin D Deficiency

Research shows a majority of people with RA are also vitamin D deficient, and vitamin D deficiency might worsen RA symptoms. Vitamin D deficiency is more common in places where sunlight is limited during the winter months due to fewer hours of daylight and people avoiding the outdoors because of colder weather.

One study reported in 2015 in the International Journal of Rheumatology, evaluated the vitamin D status of people with RA from 15 countries to determine how low levels of vitamin D might affect people with RA. Among the study participants, 54.6% of people with RA had low vitamin D levels and 8.5% were deficient.

Researchers noted the low levels of vitamin D were associated with higher disease activity in RA, more corticosteroid use, and increased risk of conditions considered comorbidities of RA, including osteoporosis and lung disease. They concluded these findings suggest a need for testing vitamin D levels in people with RA and supplementation to improve vitamin D status. 

Winter Fatigue                           

There is some evidence suggesting people with RA will experience more general and physical fatigue during the winter months. Fatigue affects up to 80% of people with RA and severe fatigue has been reported by up to 50% of people with RA.

A study reported in 2016 in the journal BMC Musculoskeletal Disorders explored monthly and seasonal variations in people with RA between ages 20 to 65. For the study, researchers provided participants with self-assessments of fatigue. 

Researchers found the majority of the study participants had fluctuations in fatigue that were significantly worse during the winter months. The researchers stressed the importance of rheumatology professionals learning and understanding how fatigue affected their patients as they managed the care of these patients. 

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Hot Weather 

Sunny and warmer weather might have a positive effect on RA, while hot and humid weather may not, according to a study reported in 2014 in the journal Rheumatology International that aimed to find out if RA disease activity and changing weather conditions were connected.

In this observational study of 133 people with RA using biologic drug therapies for more than six months, data were collected five different times throughout the study. Data included tender joint counts, swollen joint counts, patient feedback on how study participants were feeling, bloodwork that measured inflammation and disease activity, and DAS28 scores.

In determining how the study participants fared with different weather patterns, the researchers looked at several types of weather, including hot and cold temperatures, air pressure, rainfall, sunshine, humidity, and wind speed.

Upon evaluation of the participants, what they found was that low disease activity was linked to increased sunshine while increased humidity resulted in higher disease activity scores. 

Reducing Flare Risk as Seasons Change

You might not be able to change the weather, but if your RA acts up as the seasons change, there is a lot you can do to manage pain and stiffness and reduce your risk for RA flare-ups. 

Winter Months 

You don’t have to stress about the weather getting colder and making your RA worse. Talk to your healthcare provider about the best ways in which you can manage RA symptoms and pain during the winter months. 

Some ways to keep your RA managed in the winter months include:

• Dressing warmly and in layers to keep your joints protected from the cold
• Wearing outerwear that is easy to put on and take off so you won’t experience pain or injury as you add or remove clothing
• Using heating pads to ease sore and stiff joints
• Asking your healthcare provider about how nonsteroidal anti-inflammatory drugs (NSAIDs) might help you to manage symptoms when winter weather inflames joints
• Staying active with joint-friendly exercises like walking
• Exercising at home to avoid being outdoors when temperatures are below freezing
• Warming up before exercising to avoid injury and protect joints
• Getting your yearly flu vaccine to avoid getting the flu and triggering an RA flare
• Eating an anti-inflammatory diet to reduce RA inflammation
• Following your treatment plan to reduce the risk for a flare
• Managing stress to avoid triggering a flare-up
• Talking to your healthcare provider about your vitamin D levels and taking supplements if your practitioner recommends them

Warmer Weather Months 

If your RA gets worse with hot and humid weather, there are ways in which you can better manage symptoms as the weather warms.

Ways to manage RA and reduce the risk for flares during the summer months include:

• Staying hydrated because dehydration might make you more vulnerable to a flare-up
• Using sunscreen, sunglasses, and hats while outdoors to protect skin and eyes from the sun
• Dressing comfortably and wearing comfortable shoes while outdoors enjoying summer activities
• Avoiding summer activities that put a strain on your joints and could result in injury
• Planning activities for early morning or evening so you are not out when the sun is the hottest and to avoid sun sensitivity, which could trigger a flare
• Being mindful of your limitations—you want to enjoy the summer weather, but don’t let it lead to a flare-up from overdoing things
• Reaching out to your healthcare provider about how to exercise safely during the summer months
• Finding ways to stay cool

If you are finding that summer heat and humidity are affecting your ability to enjoy your life, make an appointment to see your healthcare provider. They can help you to find ways to enjoy the summer months without being stuck inside all time and dealing with flare-ups.

A Word From Verywell

Regardless of the season, rheumatoid arthritis affects people differently. That means you should find out what works for you in managing RA and keeping flares at bay as the seasons change.

One thing you can do to manage your RA throughout the year is to get plenty of sleep. Changes in sleep patterns, especially as the days get shorter or longer can affect how you are feeling and how well-managed your RA is. Keep a consistent sleep schedule and if you find that RA is keeping you up at night, talk to your healthcare provider about the best ways to get a good night’s sleep.