Research shows a connection with chronic pain and cold weather
Those with chronic pain may especially feel the effects of cold weather.
Clint Austin | Duluth News 2019
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You’ve probably been feeling the chill with that cold air returning this week. The transition to cold weather can be hard on all of us, but those with chronic pain may especially feel the effects of this seasonal weather change.
Some research shows an association between increased pain and low barometric pressure. Dr. Clarence Shannon is an anesthesiologist and professor at the University of Minnesota School of Medicine. He joined MPR News host Cathy Wurzer to talk about the potential connection between cold weather and chronic pain conditions — and how we can manage it.
Use the audio player above to listen to the full conversation.
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Audio transcript
CATHY WURZER: I'm thinking there are probably a number of you listening right now who are in some kind of physical pain. It could be a headache, it could be arthritis, back pain, maybe it's a stomach ulcer. Whether the pain is caused by inflammation or dysfunctional nerves, the pain could be short lived or you've been living with it for years. You might hurt especially this time of the year when the temperatures drop. Some research shows an association between increased pain and low barometric pressure.
Dr. Clarence Shannon is an anesthesiologist and professor at the University of Minnesota School of Medicine. He's on the line right now to talk about the potential connection between cold weather and chronic pain conditions. A pleasure Dr. Shannon. Welcome to Minnesota Now.
CLARENCE SHANNON: Thanks for having me. Nice to meet you.
CATHY WURZER: Likewise. So I understand that more than 20% of Americans suffer with chronic pain. That seems like a pretty pervasive problem.
CLARENCE SHANNON: That's right. It's not a very small problem. In fact, approximately 50 million Americans have chronic pain. And 6.9% of Americans probably have what we call high impact pain, which will affect their ability to work, their ability to have relationships with people, and their ability to just enjoy life.
CATHY WURZER: Who is most affected by chronic pain?
CLARENCE SHANNON: People who are affected by chronic pain-- people whose the architecture of their being has derangements, so that could be physical, neural, mental. So people who might have a systemic illness, an acute illness, or even some psychological illness. And when I say systemic illnesses, things like diabetes or cancer or acute illnesses like injuries, a sprained ankle, or an infection. And psychological issues, and we might not think about that all the time, but stress and anxiety can actually manifest as pain.
CATHY WURZER: More men than women, or more women than men are in chronic pain?
CLARENCE SHANNON: Usually more women than men. And we're not sure why.
CATHY WURZER: Interesting. So I was talking to another physician friend who deals with folks who are in chronic pain. And she said, gosh, chronic pain patients can operate at a level of pain that would bring most people to their knees. Do you find that to be true?
CLARENCE SHANNON: That is the truth. I think they have to operate at that level, otherwise they would just be debilitated and they wouldn't be able to function at all. They do that though I think begrudgingly because they do have a lot of pain and go through life with a pain level of 9 out of 10, as whereas you and I might have 1 out of 10 pain on a daily basis.
CATHY WURZER: It is so hard to deal with. Of course, and as I said in the introduction, it gets worse for many people this time of the year. I mean, cold weather is not easy for anybody, as long as we stay warm, we tend to feel OK. But how is that different for some folks with chronic pain?
CLARENCE SHANNON: Yeah, I think you're right. I think all of us as Minnesotans have a little PTSD when it comes to be October and they talk about the winter is coming. But I think people who have chronic pain know that there is a change in really the architecture of their being, namely changes in their physical status, their neural status, and even their psychological or mental status.
So things like cold weather can cause vessels to constrict, and so those blood flow does not go greatly to certain organs and so they can have pain secondary to that. And certain systemic illnesses can cause neural problems like diabetes, and those can be worsened with cold weather.
CATHY WURZER: So in terms of cause and effect, I mean, how strong is this cause and effect in terms of research?
CLARENCE SHANNON: There's not a great amount of research that shows that there is a causative effect, but we do know that as it gets colder, the barometric pressure decreases and that pressure that is put on our bodies and our joints decreases. This allows the joints and the ligaments to swell, and as a result, patients might have pain secondary to that.
We do know that as the pain gets worse with cold, so people who have Raynaud's disease or peripheral vascular disease, if there's constriction to vessels and constriction to end organs, we can have increased pain secondary to that. And that can be significant.
CATHY WURZER: So what's the treatment here? It sounds like you need to keep moving or do you keep the extremities warm in some way?
CLARENCE SHANNON: So there should be a comprehensive approach. And really you need to think about treating the root cause. And some of the things that I think about are to warm up, so stay warm so you can reduce that vasoconstriction. You want to wrap up. So if you have joints that are swelling, you can wear compression stockings that will help decrease the swelling and decrease the pain.
You want to get up. So in the wintertime, we may not want to go for a walk because it's snowing outside, but we need to still move, stretch. Have some friends over, so we need to get out. Maybe have a monthly breakfast club with the cool kids and so that you can stay connected with all of your friends.
And if those things are not effective, if we need to actually treat some of the symptoms, as you mentioned in the introduction, anti-inflammatory medications and muscle relaxants might help. I like to use a more conservative treatment and we move up as the pain gets worse. If we need to, we can do some spinal injections or joint injections, and maybe that can tide us over until the meteorologist tells us that spring is on the way.
CATHY WURZER: So I wonder-- those are all, of course, they can be workable therapeutics, but I'm also wondering about integrative medicine. I don't know, something like, say, acupuncture. Does that tend to help at all?
CLARENCE SHANNON: Acupuncture is very helpful when it comes to myofascial pain or pain that involves the muscles and the fascicles, and so that's something that we can use. Sometimes it's prohibitive because of the cost. Massage therapy is also very helpful.
CATHY WURZER: So when you looked at some of the research that has been done on cold weather and pain as an anesthesiologist who deals with trying to tamp down pain when you're in surgery specifically, what are you going to be looking for? What do you really want to see from research?
CLARENCE SHANNON: What I'm trying to look for is what is the patient's functional status? So it's great to have a patient that says that they're not in pain, but we want to make sure that patients are continuing to move and to be able to function. We want them to be able to get out because, as I said, improving blood flow, increasing their movement is helpful, but also staying connected to their friends and their social activities is very helpful.
CATHY WURZER: Just a foregone conclusion that when you get older you're just going to be in pain, not really. I hope not anyway.
CLARENCE SHANNON: Well, there's going to be a little pain. It's going to be more than when you were in your 20s, but I think if we stay active, we can keep it at bay.
CATHY WURZER: All right. Dr. Shannon, it's been a pleasure. Thank you so very much.
CLARENCE SHANNON: The pleasure is all mine. Thank you for having me.
CATHY WURZER: We've been talking to Dr. Clarence Shannon, a professor at the University of Minnesota School of Medicine.
Dr. Clarence Shannon is an anesthesiologist and professor at the University of Minnesota School of Medicine. He's on the line right now to talk about the potential connection between cold weather and chronic pain conditions. A pleasure Dr. Shannon. Welcome to Minnesota Now.
CLARENCE SHANNON: Thanks for having me. Nice to meet you.
CATHY WURZER: Likewise. So I understand that more than 20% of Americans suffer with chronic pain. That seems like a pretty pervasive problem.
CLARENCE SHANNON: That's right. It's not a very small problem. In fact, approximately 50 million Americans have chronic pain. And 6.9% of Americans probably have what we call high impact pain, which will affect their ability to work, their ability to have relationships with people, and their ability to just enjoy life.
CATHY WURZER: Who is most affected by chronic pain?
CLARENCE SHANNON: People who are affected by chronic pain-- people whose the architecture of their being has derangements, so that could be physical, neural, mental. So people who might have a systemic illness, an acute illness, or even some psychological illness. And when I say systemic illnesses, things like diabetes or cancer or acute illnesses like injuries, a sprained ankle, or an infection. And psychological issues, and we might not think about that all the time, but stress and anxiety can actually manifest as pain.
CATHY WURZER: More men than women, or more women than men are in chronic pain?
CLARENCE SHANNON: Usually more women than men. And we're not sure why.
CATHY WURZER: Interesting. So I was talking to another physician friend who deals with folks who are in chronic pain. And she said, gosh, chronic pain patients can operate at a level of pain that would bring most people to their knees. Do you find that to be true?
CLARENCE SHANNON: That is the truth. I think they have to operate at that level, otherwise they would just be debilitated and they wouldn't be able to function at all. They do that though I think begrudgingly because they do have a lot of pain and go through life with a pain level of 9 out of 10, as whereas you and I might have 1 out of 10 pain on a daily basis.
CATHY WURZER: It is so hard to deal with. Of course, and as I said in the introduction, it gets worse for many people this time of the year. I mean, cold weather is not easy for anybody, as long as we stay warm, we tend to feel OK. But how is that different for some folks with chronic pain?
CLARENCE SHANNON: Yeah, I think you're right. I think all of us as Minnesotans have a little PTSD when it comes to be October and they talk about the winter is coming. But I think people who have chronic pain know that there is a change in really the architecture of their being, namely changes in their physical status, their neural status, and even their psychological or mental status.
So things like cold weather can cause vessels to constrict, and so those blood flow does not go greatly to certain organs and so they can have pain secondary to that. And certain systemic illnesses can cause neural problems like diabetes, and those can be worsened with cold weather.
CATHY WURZER: So in terms of cause and effect, I mean, how strong is this cause and effect in terms of research?
CLARENCE SHANNON: There's not a great amount of research that shows that there is a causative effect, but we do know that as it gets colder, the barometric pressure decreases and that pressure that is put on our bodies and our joints decreases. This allows the joints and the ligaments to swell, and as a result, patients might have pain secondary to that.
We do know that as the pain gets worse with cold, so people who have Raynaud's disease or peripheral vascular disease, if there's constriction to vessels and constriction to end organs, we can have increased pain secondary to that. And that can be significant.
CATHY WURZER: So what's the treatment here? It sounds like you need to keep moving or do you keep the extremities warm in some way?
CLARENCE SHANNON: So there should be a comprehensive approach. And really you need to think about treating the root cause. And some of the things that I think about are to warm up, so stay warm so you can reduce that vasoconstriction. You want to wrap up. So if you have joints that are swelling, you can wear compression stockings that will help decrease the swelling and decrease the pain.
You want to get up. So in the wintertime, we may not want to go for a walk because it's snowing outside, but we need to still move, stretch. Have some friends over, so we need to get out. Maybe have a monthly breakfast club with the cool kids and so that you can stay connected with all of your friends.
And if those things are not effective, if we need to actually treat some of the symptoms, as you mentioned in the introduction, anti-inflammatory medications and muscle relaxants might help. I like to use a more conservative treatment and we move up as the pain gets worse. If we need to, we can do some spinal injections or joint injections, and maybe that can tide us over until the meteorologist tells us that spring is on the way.
CATHY WURZER: So I wonder-- those are all, of course, they can be workable therapeutics, but I'm also wondering about integrative medicine. I don't know, something like, say, acupuncture. Does that tend to help at all?
CLARENCE SHANNON: Acupuncture is very helpful when it comes to myofascial pain or pain that involves the muscles and the fascicles, and so that's something that we can use. Sometimes it's prohibitive because of the cost. Massage therapy is also very helpful.
CATHY WURZER: So when you looked at some of the research that has been done on cold weather and pain as an anesthesiologist who deals with trying to tamp down pain when you're in surgery specifically, what are you going to be looking for? What do you really want to see from research?
CLARENCE SHANNON: What I'm trying to look for is what is the patient's functional status? So it's great to have a patient that says that they're not in pain, but we want to make sure that patients are continuing to move and to be able to function. We want them to be able to get out because, as I said, improving blood flow, increasing their movement is helpful, but also staying connected to their friends and their social activities is very helpful.
CATHY WURZER: Just a foregone conclusion that when you get older you're just going to be in pain, not really. I hope not anyway.
CLARENCE SHANNON: Well, there's going to be a little pain. It's going to be more than when you were in your 20s, but I think if we stay active, we can keep it at bay.
CATHY WURZER: All right. Dr. Shannon, it's been a pleasure. Thank you so very much.
CLARENCE SHANNON: The pleasure is all mine. Thank you for having me.
CATHY WURZER: We've been talking to Dr. Clarence Shannon, a professor at the University of Minnesota School of Medicine.
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