Nature’s wrath—The effect of weather on pain following orthopaedic trauma

  • Author Footnotes
    1 Investigation performed at NYU Hospital for Joint Diseases.
    Brandon S. Shulman
    Footnotes
    1 Investigation performed at NYU Hospital for Joint Diseases.
    Affiliations
    NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1402, New York, NY 10003, USA
    Search for articles by this author
  • Author Footnotes
    1 Investigation performed at NYU Hospital for Joint Diseases.
    Alejandro I. Marcano
    Footnotes
    1 Investigation performed at NYU Hospital for Joint Diseases.
    Affiliations
    NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1402, New York, NY 10003, USA
    Search for articles by this author
  • Author Footnotes
    1 Investigation performed at NYU Hospital for Joint Diseases.
    ,
    Author Footnotes
    2 Investigation performed at Jamaica Hospital Medical Center.
    Roy I. Davidovitch
    Footnotes
    1 Investigation performed at NYU Hospital for Joint Diseases.
    2 Investigation performed at Jamaica Hospital Medical Center.
    Affiliations
    Center for Musculoskeletal Care, 33 East 38th Street, New York, NY 10016, USA
    Search for articles by this author
  • Author Footnotes
    1 Investigation performed at NYU Hospital for Joint Diseases.
    Raj Karia
    Footnotes
    1 Investigation performed at NYU Hospital for Joint Diseases.
    Affiliations
    NYU Langone Medical Center, 380 2nd Ave. Suite 606, New York, NY 10010, USA
    Search for articles by this author
  • Author Footnotes
    1 Investigation performed at NYU Hospital for Joint Diseases.
    ,
    Author Footnotes
    2 Investigation performed at Jamaica Hospital Medical Center.
    Kenneth A. Egol
    Correspondence
    Corresponding author at: 301 East 17th Street, Suite 1402, New York, NY 10003, USA.
    Footnotes
    1 Investigation performed at NYU Hospital for Joint Diseases.
    2 Investigation performed at Jamaica Hospital Medical Center.
    Affiliations
    NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1402, New York, NY 10003, USA
    Search for articles by this author
  • Author Footnotes
    1 Investigation performed at NYU Hospital for Joint Diseases.
    2 Investigation performed at Jamaica Hospital Medical Center.

      Abstract

      Background

      Despite frequent complaints by orthopaedic trauma patients, to our knowledge there is no data regarding weather’s effect on pain and function following acute and chronic fracture. The aim of our study was to investigate the influence of daily weather conditions on patient reported pain and functional status.

      Methods

      We retrospectively examined prospectively collected data from 2369 separate outpatient visits of patients recovering from operative management of acute tibial plateau fractures, acute distal radius fractures, and chronic fracture nonunions. Pain and functional status were assessed using a visual analogue scale (VAS) and the DASH and SMFA functional indexes. For each visit date, the mean temperature, difference between mean temperature and expected temperature, dew point, mean humidity, amount of rain, amount of snow, and barometric pressure were recorded. Statistical analysis was run to search for associations between weather data and patient reported pain and function.

      Results

      Low barometric pressure was associated with increased pain across all patient visits (p = 0.007) and for patients at 1-year follow-up only (p = 0.005). At 1-year follow-up, high temperature (p = 0.021) and high humidity (p = 0.030) were also associated with increased pain. No significant association was noted between weather data and patient reported functional status at any follow-up interval.

      Conclusions

      Patient complaints of weather influencing pain after orthopaedic trauma are valid. While pain in the immediate postoperative period is most likely dominated by incisional and soft tissue injuries, as time progresses barometric pressure, temperature, and humidity impact patient pain levels. Affirming and counseling that pain may vary based on changing weather conditions can help manage patient expectations and improve satisfaction.

      Keywords

      To read this article in full you will need to make a payment
      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • von Mackensen S.
        • Hoeppe P.
        • Maarouf A.
        • Tourigny P.
        • Nowak D.
        Prevalence of weather sensitivity in Germany and Canada.
        Int J Biometeorol. 2005; 49: 156-166
        • Bianchi-Demicheli F.
        • Ludicke F.
        • Spinedi F.
        • et al.
        Association between weather conditions and the incidence of emergency gynecological consultations.
        Gynecol Obstet Invest. 2001; 51: 55-59
        • Kuehn M.
        • Welsch H.
        • Zahnert T.
        • Hummel T.
        Changes of pressure and humidity affect olfactory function.
        Eur Arch Otorhinolaryngol. 2008; 265: 299-302
        • Mizoguchi H.
        • Fukaya K.
        • Mori R.
        • Itoh M.
        • Funakubo M.
        • Sato J.
        Lowering barometric pressure aggravates depression-like behavior in rats.
        Behav Brain Res. 2011; 218: 190-193
        • Kloss-Brandstatter A.
        • Hachl O.
        • Leitgeb P.C.
        • et al.
        Epidemiologic evidence of barometric pressure changes inducing increased reporting of oral pain.
        Eur J Pain. 2011; 15: 880-884
        • Kriszbacher I.
        • Bodis J.
        • Csoboth I.
        • Boncz I.
        The occurrence of acute myocardial infarction in relation to weather conditions.
        Int J Cardiol. 2009; 135: 136-138
        • Meral M.
        • Mirici A.
        • Aslan S.
        • et al.
        Barometric pressure and the incidence of pulmonary embolism.
        Chest. 2005; 128: 2190-2194
        • Kimoto K.
        • Aiba S.
        • Takashima R.
        • et al.
        Influence of barometric pressure in patients with migraine headache.
        Intern Med. 2011; 50: 1923-1928
        • Fletcher B.A.
        • Lin S.
        • Fitzgerald E.F.
        • Hwang S.A.
        Association of summer temperatures with hospital admissions for renal diseases in New York State: a case-crossover study.
        Am J Epidemiol. 2012; 175: 907-916
        • Goldberg M.S.
        • Giannetti N.
        • Burnett R.T.
        • Mayo N.E.
        • Valois M.F.
        • Brophy J.M.
        A panel study in congestive heart failure to estimate the short-term effects from personal factors and environmental conditions on oxygen saturation and pulse rate.
        Occup Environ Med. 2008; 65: 659-666
        • Liu I.F.
        • Chang S.L.
        • Lo L.W.
        • et al.
        Relationship between temperature change and the requirement for a permanent pacemaker implantation in bradyarrhythmias.
        Int J Biometeorol. 2011; 55: 733-739
        • Connelly M.
        • Miller T.
        • Gerry G.
        • Bickel J.
        Electronic momentary assessment of weather changes as a trigger of headaches in children.
        Headache. 2010; 50: 779-789
        • Mireku N.
        • Wang Y.
        • Ager J.
        • Reddy R.C.
        • Baptist A.P.
        Changes in weather and the effects on pediatric asthma exacerbations.
        Ann Allergy Asthma Immunol. 2009; 103: 220-224
        • Jones S.
        • Duncan E.R.
        • Thomas N.
        • et al.
        Windy weather and low humidity are associated with an increased number of hospital admissions for acute pain and sickle cell disease in an urban environment with a maritime temperate climate.
        Br J Haematol. 2005; 131: 530-533
        • de Figueiredo E.C.
        • Figueiredo G.C.
        • Dantas R.T.
        Influence of meteorological elements on osteoarthritis pain: a review of the literature.
        Rev Bras Reumatol. 2011; 51: 622-628
        • Brennan S.A.
        • Harney T.
        • Queally J.M.
        • O'Connor McGoona J.
        • Gormley I.C.
        • Shannon F.J.
        Influence of weather variables on pain severity in end-stage osteoarthritis.
        Int Orthop. 2012; 36: 643-646
        • McAlindon T.
        • Formica M.
        • Schmid C.H.
        • Fletcher J.
        Changes in barometric pressure and ambient temperature influence osteoarthritis pain.
        Am J Med. 2007; 120: 429-434
        • Guedj D.
        • Weinberger A.
        Effect of weather conditions on rheumatic patients.
        Ann Rheum Dis. 1990; 49: 158-159
        • Patberg W.R.
        • Rasker J.J.
        Weather effects in rheumatoid arthritis: from controversy to consensus. A review.
        J Rheumatol. 2004; 31: 1327-1334
        • Yang J.
        • Lu Y.W.
        • Pan H.F.
        • et al.
        Seasonal distribution of systemic lupus erythematosus activity and its correlation with climate factors.
        Rheumatol Int. 2012; 32: 2393-2399
        • Strusberg I.
        • Mendelberg R.C.
        • Serra H.A.
        • Strusberg A.M.
        Influence of weather conditions on rheumatic pain.
        J Rheumatol. 2002; 29: 335-338
        • Redelmeier D.A.
        • Tversky A.
        On the belief that arthritis pain is related to the weather.
        Proc Natl Acad Sci U S A. 1996; 93: 2895-2896
        • Wilder F.V.
        • Hall B.J.
        • Barrett J.P.
        Osteoarthritis pain and weather.
        Rheumatology (Oxford). 2003; 42: 955-958
      1. Wunderground.com [Internet]. Atlanta: The Weather Company, LLC; 2014 [cited 2014 Sept 1]. Available from: http://www.wunderground.com.

        • Gerbershagen H.J.
        • Pogatzki-Zahn E.
        • Aduckathil S.
        • et al.
        Procedure-specific risk factor analysis for the development of severe postoperative pain.
        Anesthesiology. 2014; 120: 1237-1245
        • Fulkerson E.W.
        • Egol K.A.
        Timing issues in fracture management: a review of current concepts.
        Bull NYU Hosp Jt Dis. 2009; 67: 58-67
        • Chung F.
        • Ritchie E.
        • Su J.
        Postoperative pain in ambulatory surgery.
        Anesth Analg. 1997; 85: 808-816
        • Beaussier M.
        • Sciard D.
        • Sautet A.
        New modalities of pain treatment after outpatient orthopaedic surgery.
        Orthop Traumatol Surg Res. 2016; 102: S121-4
        • Urquhart D.M.
        • Williamson O.D.
        • Gabbe B.J.
        • et al.
        Outcomes of patients with orthopaedic trauma admitted to level 1 trauma centres.
        ANZ J Surg. 2006; 76: 600-606
        • Gramke H.F.
        • de Rijke J.M.
        • van Kleef M.
        • et al.
        Predictive factors of postoperative pain after day-case surgery.
        Clin J Pain. 2009; 25: 455-460
        • Roberts M.
        • Brodribb W.
        • Mitchell G.
        Reducing the pain: a systematic review of postdischarge analgesia following elective orthopedic surgery.
        Pain Med. 2012; 13: 711-727
        • Bleakley C.M.
        • O'Connor S.
        • Tully M.A.
        • Rocke L.G.
        • Macauley D.C.
        • McDonough S.M.
        The PRICE study (Protection Rest Ice Compression Elevation): design of a randomised controlled trial comparing standard versus cryokinetic ice applications in the management of acute ankle sprain [ISRCTN13903946].
        BMC Musculoskelet Disord. 2007; 8: 125
        • Funakubo M.
        • Sato J.
        • Obata K.
        • Mizumura K.
        The rate and magnitude of atmospheric pressure change that aggravate pain-related behavior of nerve injured rats.
        Int J Biometeorol. 2011; 55: 319-326
        • Messlinger K.
        • Funakubo M.
        • Sato J.
        • Mizumura K.
        Increases in neuronal activity in rat spinal trigeminal nucleus following changes in barometric pressure–relevance for weather-associated headaches.
        Headache. 2010; 50: 1449-1463
        • Sato J.
        • Aoyama M.
        • Yamazaki M.
        • et al.
        Artificially produced meteorological changes aggravate pain in adjuvant-induced arthritic rats.
        Neurosci Lett. 2004; 354: 46-49
        • Williamson O.D.
        • Epi G.D.
        • Gabbe B.J.
        • et al.
        Predictors of moderate or severe pain 6 months after orthopaedic injury: a prospective cohort study.
        J Orthop Trauma. 2009; 23: 139-144
        • Day M.S.
        • Hutzler L.H.
        • Karia R.
        • Vangsness K.
        • Setia N.
        • Bosco 3rd J.A.
        Hospital-acquired conditions after orthopedic surgery do not affect patient satisfaction scores.
        J Healthc Qual. 2014; 36: 33-40
        • Kahn S.A.
        • Iannuzzi J.C.
        • Stassen N.A.
        • Bankey P.E.
        • Gestring M.
        Measuring satisfaction: factors that drive hospital consumer assessment of healthcare providers and systems survey responses in a trauma and acute care surgery population.
        Am Surg. 2015; 81: 537-543
        • Schmocker R.K.
        • Cherney Stafford L.M.
        • Siy A.B.
        • Leverson G.E.
        • Winslow E.R.
        Understanding the determinants of patient satisfaction with surgical care using the Consumer Assessment of Healthcare Providers and Systems surgical care survey (S-CAHPS).
        Surgery. 2015; 158: 1724-1733