Does Weather Affect Psoriatic Arthritis?by Amy Marturana Winderl Health Writer
Your psoriatic arthritis is flaring: Have you checked in with your meteorologist yet? Yep, along with medication switches and stress—typical triggers for this arthritis-plus-psoriasis condition—temperature changes can affect your PsA. “Weather does, in fact, impact the severity of flare-ups associated with psoriatic arthritis,” says Anand A. Kumthekar, M.D., a rheumatologist at Montefiore Medical Center and assistant professor at the Albert Einstein College of Medicine in New York City. If you notice a difference in your PsA when the mercury tanks or rises, when it rains or snows, here’s what you need to know.
Most People Feel Worse in the Winter
Chilly temps, biting winds, freezing rain: Winter is soooo fun! And if you have psoriatic arthritis, it may also bring joint swelling and pain. While there isn’t scientific evidence to explain why cold weather exacerbates symptoms, many patients report winter flares, according to the National Psoriasis Foundation. And Dr. Kumthekar sees real-world proof: “About 90 percent of my patients say their psoriatic arthritis gets worse in wintertime,” he says.
Cold Weather Can Also Heighten Stiffness
There’s a simple hypothesis about why: When it’s frigid out, it’s harder to keep the joints warm, resulting in prolonged periods of stiffness, says Dr. Kumthekar. For example, if someone already feels achier in the morning and it typically takes them 10 minutes to warm up and feel comfortable, they may report it takes them 30 minutes in the winter. Some patients take more NSAIDs (anti-inflammatory pills) to manage hurting joints when it’s cold, he adds.
Your Best Defense in the Winter: Stay Warm
“Always dress warmly and keep your core temperature warm,” suggests Dr. Kumthekar. It’s especially important to protect the joint or joints that are bothering you. For example, if your hands are a sore spot, never leave the house in the cold without wearing gloves. It’s also important to take note of your personal triggers so that you can work with your doctor on the best ways to prevent flare-ups, says Ana-Maria Orbai, M.D. M.H.S., assistant professor at Johns Hopkins University School of Medicine and director of the Psoriatic Arthritis Program at Johns Hopkins Arthritis Center.
Make Sure to Keep Moving
Continuing to exercise regularly throughout the winter months can help keep your joints warm and loose. Even though it’s tempting to stay curled up inside under a hearty blanket, maintaining some level of physical activity—even if it’s scaled back a bit from what you do in warmer months—can help, says Dr. Kumthekar. “The less you use the joints, the stiffer you’re going to get, so it’s always good to be active.”
Barometric Pressure Might Play a Role
Barometric (or atmospheric) pressure in laypeople’s terms? The weight in the air. A drop in barometric pressure, which typically happens when a storm is coming when winds and rainstorms are coming, has been associated with joint swelling and pain. The theory is that a decrease in pressure may cause fluid in the joints to expand, increasing stiffness, says Dr. Kumthekar.
The Arthritis/Barometric Pressure Link
Research in the American Journal of Medicine has connected changes in barometric pressure with increased osteoarthritis pain, which may be relevant because it’s not uncommon for people with psoriatic arthritis to develop osteoarthritis, says Stanford Shoor, M.D., a rheumatologist at Stanford Health Care and a clinical professor of medicine and rheumatology at Stanford University. Note: All of these studies have been small, and even if they suggest a connection, more research is needed to determine if a true cause-and-effect relationship exists.
Manage Storm-Related Swelling
Having osteoarthritis or other forms of joint damage in addition to psoriatic arthritis will predispose you to weather-related flare-ups, says Dr. Orbai. That doesn’t mean you need to immediately pack up and move to California, though. During stormy weather, ice packs and NSAIDs like naproxen or ibuprofen can help bring down acute swelling, Dr. Orbai says. If you’re experiencing more pain and swelling than normal, she also suggests swapping your regular workout for something gentler and never skipping your warmup.
Psoriasis Seems to Like Warm Weather
“The majority of people have improved psoriasis in the summer,” says Dr. Orbai. That’s because the sun's UVB rays help slow the growth of affected skin cells. That said, in Dr. Kumthekar’s experience, about 10 percent of patients have worsened psoriasis in the summer. Dr. Orbai notes that inverse psoriasis, in particular, often becomes more irritated when the skin gets hot and sweaty. Also known as intertriginous psoriasis, inverse psoriasis typically shows up in skin folds, armpits, groin, and under the breasts. Hot and humid weather can increase rubbing and, consequently, irritation in affected areas. You can manage intertriginous psoriasis by staying dry, avoiding sweating, and bathing regularly (among other things, creams, treatment etc).
There’s No “Best Weather” for Everyone with Psoriatic Arthritis
Since there isn’t research explaining exactly why weather-related flare-ups happen, there’s no way of saying which weather is truly best for everyone with psoriatic arthritis. It all depends on your personal triggers. If you notice that cold, rain, heat, or any other specific type of weather seems to make your skin or joints feel worse, tell your doctor so you can find the best treatment and prevent seasonal flares in the future.