Lower Back Pain Episodes Not Influenced by Weather Conditions

Despite popular belief, research published in Pain Medicine has found that weather parameters, including precipitation, wind speed, and humidity do not raise a person’s risk of experiencing an episode of low back pain.¹

Daniel Steffens, PhD, of the George Institute for Global Health at the University of Sydney in Australia, and colleagues, set out to assess the link between various weather conditions — including precipitation, humidity, and air pressure — and the onset of low back pain.

The case-crossover study included 981 participants (mean age: 44.3±15 years; 52.6% male; mean 3.4 days since pain onset), all of whom had a new episode of acute low back pain, defined as “[low back pain] between the twelfth rib and buttock crease, with or without leg pain…for less than 6 weeks’ duration, preceded by 1 month of no pain and of at least moderate intensity.” 

Participants were recruited from 235 primary care centers between 2009 and 2013, with data collected from the placebo-controlled PACE trial (Australian New Zealand Clinical Trials Registry ACTRN12609000966291), which assessed the efficacy of acetaminophen as a treatment for acute low back pain.

Patient exposure to weather parameters was assessed at the onset of pain, and 1 week and 1 month prior to the onset of pain. Meteorology data for precipitation, temperature (Celsius), relative humidity, wind speed, wind gust, wind direction, and air pressure—were collected from the Australian Bureau of Meteorology via 11 weather monitoring stations across Sydney. 

Researchers then assigned participants to 1 of 3 Sydney weather regions, and used postal code data to collect weather information from the station closest to the patient’s residence.

Throughout the study period, the Sydney area experienced mean 1.3 mm precipitation (range: 0-45.7); 17.2°C temperature (range: 5.4°-32.8°); 72% humidity (range: 18.8-100); 11.8 km/h wind speed (range: 1.5-48.1); 16.9 km/h wind gust (range: 2.8-64.9); 167.2 degrees true wind direction (range: 25.4-334.6); and 1017.6 hPa air pressure (range: 995.7-1037.6). 

Over all analyses performed by investigators, only higher temperature resulted in a statistically significant increase in low back pain onset (odds ratio [OR]: 1.20; 95% CI, 1.01-1.42, P =.03).

Summary and Clinical Applicability

“This study provides evidence that common weather parameters, such as precipitation, temperature, air pressure…and humidity, that are believed to be associated with musculoskeletal pain do not have an effect on the risk of a new episode of [low back pain],” the researchers concluded, noting that there are a number of “potential explanations” for patient’s belief that adverse weather conditions trigger pain.

In a press release,² Chris Maher, director of the musculoskeletal division at the George Institute for Global Health, added “Human beings are very susceptible so it’s easy to see why we might only take note of pain on days when it’s cold and rainy outside.” 

Limitations and Disclosures

• Limits in pain recall accuracy may affect pain data. Data were collected in such a way as to limit recall bias.
• Weather data were collected based on the participant’s home address, but did not take into account where the participant spent the majority of their day.
• The study did also not take into account the presence of air conditioning or heating units that may have affected the weather participant’s experienced.
• Results gathered in the temperate Sydney climate may not be applicable to locations with more variable temperature.

This study did not consider patients with chronic low back pain or other long-term musculoskeletal conditions, like arthritis.

References

1. Beilken K, Hancock MJ, Maher CG, Li Q, Steffens D. Acute low back pain? Do not blame the weather—a case-crossover study [published online December 15, 2016]. Pain Med. doi: 10.1093/pm/pnw126

2. The weather’s not to blame for your aches and pains [news release]. Newtown, Australia: The George Institute for Global Health. Published January 11, 2016. Accessed January 12, 2017.

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