Saturday

FIBRO FILES: Fibro in the media this week.

Fibromyalgia in the news this week.
I am always fascinated to see what information is being published, in the news media, about Fibromyalgia. I thought you might be interested too.

This week we are travelling around the world from Israel, to Canada and then to Virginia USA to see what is being written about Fibromyalgia (FMS). 
..................................................................................
Fibromyalgia patients to become eligible for state disability stipend.  Chronic condition recognized for purpose of state benefits; rocket-battered southern Israel has seen surge in cases over past few years. TIMES OF ISRAEL. 10 November 2019
SUMMARY: The state will recognize those afflicted with fibromyalgia as disabled especially as the number of people diagnosed with fibromyalgia has increased near the Gaza border.
.................................................................................
Fibromyalgia is a very complex health condition that is not well understood or managed within the current medical paradigm, licensed nutritionist Nonie De Long says. NEWMARKETTODAY. ca 16 November 2019 

SUMMARY: Gladys asks a question about fibro and her search for holistic answers and an orthomolecular nutritionist answers.
..................................................................................

Opioid Use Disorder-Related Hospitalization Rates Have Increased for Patients with Most Common Rheumatic Diseases. NEWSWISE. 6 November 2019

SUMMARY: Report on a study that examined hospitalization rates for Opiod Use Disorder in patients with fibromyalgia, gout, osteoarthritis, rheumatoid arthritis, and low back pain.
..................................................................................

Humor and pain


Humor is a powerful anecdote to pain. 

A 1995 study demonstrated that a significant increase in pain tolerance was seen in the groups being shown a humorous film compared to the other groups that were not.

In 2011 research led by Oxford University’s Robin Dunbar conducted experiments in the lab and at the Edinburgh Fringe Festival to discover laughter's effect on pain. They found that genuine laughter releases endorphins in the brain - chemicals that activate pain-killing effects. There was also  a "dose-related" response to laughter, meaning that people who laughed more felt less pain late on.

In 2013 it was reported, at The European Pain Federation Congress, that humor can increase pain tolerance and improve quality of life. According to Thomas Benz (RehaClinic Zurzach, Switzerland), targeted humor interventions should be part of pain therapy.

So humor activates the release of endorphins and it also helps lessen muscular tension, meaning its effect on pain is both mental and physical.
"As a result, humor helps to reflect pain, thus helping both the patients as well as their carers to deal better with stress," said Professor Willibald Ruch, Zurich University. "Humor can be used specifically as a cognitive technique, for example in terms of a distraction to control the pain and increase pain tolerance."
 For your laughing pleasure we have included a collection of jokes relating to Fibromyalgia. 



















Thursday

What is the best supplement for Fibromyalgia?

The best supplement for Fibromyalgia
Fibromyalgia (FMS) is a widely misunderstood chronic condition that causes pain, fatigue, unrefreshed sleep and cognitive difficulties including taking in and remembering information.

Way back in 2003, a Mayo Clinic study, found that 93% of fibromyalgia patients were vitamin D deficient. But there was no Control Group in the study so it was mainly disregarded. 


In 2014, finally, a randomized placebo-controlled trial was done in Austria. 


Methods

The Control Group (CG) received placebo medication.
The fibromyalgia patients were given oral supplementation of up to 2400 units of vitamin D (cholecalciferol also called D3*) a day for 20 weeks. 

Their vitamin D levels rose up to about 50 and then, once they stopped the vitamin D, levels came back down to match the CG. 

Both groups were re-evaluated after a further 24weeks without cholecalciferol supplementation. 


The main hypothesis, of the research, was that high levels of serum vitamin D would result in a reduction of pain.  

Patients were evaluated using the visual analog scale score, the Short Form Health Survey 36, the Hospital Anxiety and Depression Scale, the Fibromyalgia Impact Questionnaire, and the Somatization subscale of Symptom Checklist. 

Results

A marked reduction in pain was noted over the treatment period in the fibromyalgia patients. Improving the vitamin D levels in FMS had a positive effect on the perception of pain.

Many tests have been carried out since on the value of Vitamin D on widespread pain including:

The results of these tests have all been similar and all say that vitamin D supplementation is able to decrease pain scores and improve pain, musculoskeletal symptoms, level of depression and quality of life of patients.

In my humble opinion this makes vitamin D the supplement that all patients with Fibromyalgia, or undiagnosed widespread chronic pain should trial. 

See the Best Sellers in Vitamin D Supplements on Amazon.

* “D3 mimics the way our bodies make vitamin D from sunlight and it’s more easily absorbed, making it the best option for most people.”

Dr. Joe Feuerstein, Associate professor of clinical medicine at Columbia University and director of integrative medicine at Stamford Hospital in Stamford, Connecticut

RESOURCES:

Effects of vitamin D on patients with fibromyalgia syndrome: a randomized placebo-controlled trial.

Tuesday

Fibromyalgia and foot pain

Fibro and foot pain
Research tells us that 50 percent of people with fibromyalgia report pain in their feet. Here I will discuss some of the reasons, what can be done about them and share my own personal story with fibro and feet problems. 

Fibromyalgia is a long term pain disorder. This means that you live with pain each and everyday and it can be in any part of our body. Today I am talking about the feet. 

The foot has three areas; the ankle, the middle and the toes. They have many muscles, nerves and joints... actually there are 26 bones and 33 joints in each foot. 

The feet bear the weight of our body, so it’s not surprising that we get pain in this area. As well as pain in the feet pain can be referred to our ankles, knees, hips and back from problems in the feet.

If your foot pain is persistent, your doctor can help determine the best treatment.   
Fibromyalgia and feet muscles
The feet are complex as can be seen in this illustration of the muscles.
There are many conditions that cause foot pain. These conditions may not be caused by fibromyalgia but fibro is what amplifies the pain. 


Plantar fasciitis


Osteoarthritis may cause episodes of pain and swelling in one or multiple joints. It can also cause bone enlargement and changes in the shape of feet, which may also cause pain. Between 10-15% of people with osteoarthritis also have fibromyalgia.

Treatment includes:
  • Anti-inflammatory drugs.
  • Taking over-the-counter pain relievers.
  • Wearing pads or arch supports.
  • steroid injection into the foot.
  • Using canes or braces to support the joints.
  • Using an orthotic in the shoes.
  • Physical therapy.
  • Wearing custom shoes.
Plantar fasciitis causes pain in the heel. It is an inflammation of the band of connective tissue on the surface of the foot connecting your heel bone to your toes.

Usually, it hurts the worst in the morning when first getting out of bed. You feel it in your heel or the arch of your foot.

Treatment includes:

  • Resting your foot.
  • Specific heel and foot muscle stretches.
  • Taking over-the-counter pain relievers.
  • Wearing shoes with both an arch support and a cushioned heel.
Heel spurs are a growth of bone on the bottom of your heel. You can be caused by wearing ill-fitting shoes or from postural problems or from running. 

They hurt when you walk, run or stand. They are more common in people with flat feet or high arches.

Treatment includes: 
  • Resting your foot.
  • Wearing a horseshoe shaped pad.
  • Using an orthotic in the shoe.
  • Wearing shoes with shock-absorbing soles.
  • Taking over-the-counter pain relievers.
  • Trying physical therapy.
Morton's neuroma causes a thickening around the nerves between the base of the toes (usually between the third and fourth toes). You may` feel pain, or numbness on the ball of your foot. It can be a result of wearing high heels or tight shoes.

Treatment includes:
  • Wearing shoe inserts to reduce pressure on the nerve.
  • A steroid injection into the foot.
  • Taking pain relievers.
  • Don’t wear high-heeled shoes or ones with a narrow toe box.
  • Avoid activities that put pressure on the neuroma.
  • Ask your doctor about surgery.
Sesamoiditis is the inflammation of tendons near the big toe.  It’s a form of tendinitis, common with runners and ballet dancers.
Treatment includes:
  • Resting your feet.
  • Icing where it hurts.
  • Wearing a pad under the toe.
  • Taping the toe to immobilize the joint.
  • Wearing low-heeled shoes.
  • Asking your doctor about steroid injections.
Flat feet, happen when the arches of the feet flatten. It can cause foot pain

Treatment includes:
  • wearing shoe inserts
  • shoe adjustments 
  • resting 
Neuropathy is nerve damage in the feet. The pain can be burning, stinging, or feel like electricity. It can happen anywhere in the feet. 

Treatment includes:
  • Pain relievers. 
  • Anti-seizure medications. 
  • Topical treatments. 
  • Specific Antidepressants that may block the nerve pain.
Tendinitis is inflammation and irritation of the tendons, the bands attaching the muscles to the bones. 

Treatment includes:
  • Resting your foot.
  • Taking pain relievers.
  • Steroid injections.
My own personal story with fibro and feet problems.
I have a history of fibromyalgia and peripheral neuropathy. I was a ballet dancer for many years so I am no stranger to foot pain. 

Also I have always had a large bone on the heel of both feet which I recently found out is called Haglund's deformity. It has never really caused me a problem until recently except for finding shoes that were soft at the back. 

Haglund's deformity

Switch to lower heels
About seven years ago I decided I would never wear heeled shoes again. I wore them very rarely but the last two times I did they caused so much pain and I went over on my right heel both times. 

I had difficulty just walking in normal shoes but having so much pain, from fibro, in the legs and hips and feet it is hard to work out where the problem is originating from. 

My foot pain did not improve. I started to focus on my feet more.  I have found thick rubber soled shoes very helpful. I prefer lace up walking shoes for the best comfort. I was never a person who even wore shoes around the house so this is a big, and beneficial, change for me.

I also researched and bought support socks which really do give a feeling of extra support. 
Also wearing supportive socks is very soothing and does seem to reduce the tingling. The ones I really like are Thorlos Unisex Walking Thick Padded Crew Sock or any sock that is padded in the foot. I find they really give more support and less pressure on the foot.

My peripheral neuropathy became unbearable, as besides being in the feet and legs, hands and arms it was in my face. The doctor at the pain clinic suggested a small anti-depressant dose which worked brilliantly to block the sensations. 

Once these tingling pain sensations were blocked I could feel other pains in my feet when I walked or stood too much. 

The pain on walking increased and I did develop plantar fasciitis in one foot. I did the prescribed exercises and stretches and after a while the pain subsided. 

I then developed pain in the achilles area and the heel. I also realised that the bone that protudes at the back of my heel, (haglund's deformity) was causing a pulling sensation and also aching a lot of the time. 

See the doctor.
If you are like me it is difficult to work out what is wrong with your own feet and you really need an expert to navigate through all the pain and limping. I am still awaiting my appointment with the specialist and will update this when I find out the official diagnosis.  

How I keep moving.
What I have learnt is it is important to keep my joints moving. However I needed to try different types of exercise because of the painful feet. 

I am exercising in water. The buoyancy of the water takes the  pressure off my ankles and feet and I can move more freely than I can on land. I can also get my heart rate up, for a short while, so this may help with weight loss. 

Support shoes
I went to the Athletes Foot shoe store where they assess your walk and they said my right foot was pronating which means it needs an arch support. I purchased the shoes they suggested and I can feel that they support my feet much better but I still have foot pain. 
I also purchased the shoe inserts they suggested which I can put in my other shoes. These orthotics have a slight arch and extra heel support. 

So my suggestions for reducing foot pain include:
  • Switch to lower heels.
  • Lose weight if you need to.
  • Exercise in water.
  • Wear support socks.
  • Wear support shoes designed for your foot.
  • Wear orthotics.
  • See a foot doctor: a podiatrist or an orthopaedic foot and ankle surgeon.
So you can see that feet problems can be ongoing and complex. I have learnt a lot but am still awaiting professional help. 
Do you have a foot problem that I have not mentioned here? I would love to hear about it. 

RESOURCES:   
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
U.S. National Library of Medicine.
WebMD
Arthritis Australia

Sunday

I'm Taking Back The Power from Chronic Pain.

Taking Back The Power from Chronic Pain.
The chronic pain has taken all my spoons... every single spoon.

It is exhausting, and it can be isolating.

Sometimes I feel like pain takes all my energy, and all my hopes and all my motivation to do anything at all.

It is hard to gather the strength to get up off the lounge let alone make the changes, that need to happen, to help myself feel better.

Taking Back The Power from Chronic Pain.

When every day is the same it is not good. Nothing new, everything the same... less to enjoy about life.

I start to focus on the pain, what else do I have, it is my constant companion.

Having something to look forward to and enjoy gives me a positive focus. Having a goal gives me something to aim for, to work towards.

No matter how small, I need to have a goal, even on a daily basis. This gives me a different kind of focus; one that is helpful on many levels, and one that can be empowering.

Having a goal

Can you relate to my sad little story about living the chronic life?

Do you see the tipping point in yourself where you decide to make a change towards getting back your power?

Do you feel like me that it is a bit like a see-saw, this ride with constant pain?

I am learning that goals need to be smart. SMART is an acronym that stands for Specific, Measurable, Achievable, Realistic, and Timely. 

So a SMART goal incorporates all of these to help keep me focused on the goal. Having cognitive issues, caused by chronic illness, means that I can use all the help I can get. 

I've discovered a helpful site called GoalsOnTrack which has a free newsletter, if you scroll to the bottom of their page. If you sign up for the newsletter you receive access to 4 free ebooks, about goal setting, and other resources. Just click the blue image below to find out more. 

Gray matter volume and pain in Fibromyalgia: A Study

Gray matter volume and pain in Fibromyalgia

This study 'Subtle changes of gray matter volume in fibromyalgia reflect chronic musculoskeletal pain rather than disease‐specific effects' was published in August 2019.

My take on the study
It did NOT show any difference in the 2 groups that were studied:
(a.) those with Fibromyalgia (b). those with osteoarthritis.

BOTH GROUPS had altered gray matter volume (GMV)

Both groups had increased gray matter volumes in the sensorimotor cortex.

Both groups had decreased GMV in the temporoparietal junction.

It was therefore concluded that these changes were from chronic pain in general.
"we did not identify significant and FMS‐specific GMV alterations when adopting a conservative statistical approach of multiple comparison correction. However, with a more liberal approach increased gray matter volumes in the sensorimotor cortex and decreased GMV in the temporoparietal junction in both pain groups in comparison with healthy controls were revealed. Since both pain groups showed nearly identical GMV changes in these areas, cortical GMV changes in FMS should not be interpreted as FMS‐ specific but might rather reflect changes in chronic pain in general."
It was a relatively small study done by a team of researchers at the University Hospital Muenster, in Germany.  25 women with fibromyalgia,  23 patients with osteoarthritis and 21 people with no chronic pain were assessed. 
General pain‐related GMV alterations
The sensorimotor system encompasses all of the sensory, motor, and central integration and processing components involved with maintaining joint stability during bodily movements.
The temporalparietal junction is responsible for sorts through information from the external environment as well as from within the body and processes it into a clear package. 
GMV changes in the frontal cortex near the region of the precentral/sensorimotor cluster have been previously shown in Fibromyalgia (Jensen et al., 2013).
These changes have also been seen in chronic pain in general (Smallwood et al., 2013).
This sensorimotor area, of the brain, is known to be important in pain intensity and repetitive painful stimulation in healthy controls. It causes increased GMV due to the pain input (Teutsch, Herken, Bingel, Schoell,; May, 2008). This has been interpreted as a sign of neuronal adaptation.
The function of the sensorimotor cortex UNIVERSITY OF FRIBOURG
The Temporalparietal Junction (TPJ) might play an interface function between the salience network and the executive control network for response inhibition and interference control (Kucyi, Salomons, & Davis, 2016).
It has been hypothesized to be the key region redirecting attention away from pain and attempting to keep unwanted thoughts about pain out of awareness (Kucyi et al., 2016). Therefore, abnormalities in this area may lead to dysfunctional control of pain such as an increased anxious expectation (Coppola et al., 2017) or altered affective regulation in chronic pain (Liotti et al., 2000).
A recent study showed reduced activity in the TPJ of adolescents compared to adults during an extinction task, suggesting a role for the TPJ in anxiety disorders. (Ganella et al., 2017)
Temporalparietal Junction function
A Nexus Model of the Temporal-Parietal Junction

If you want to read the full report of the study please go here to Wiley Online Library: 

Sundermann B, Dehghan Nayyeri M, Pfleiderer B, et al. Subtle changes of gray matter volume in fibromyalgia reflect chronic musculoskeletal pain rather than disease‐specific effects. Eur J Neurosci. 2019;00:1–10. https://doi.org/10.1111/ejn.14558
Please keep in mind that this is just my interpretation of the study and I am not a medical professional just a person with many health conditions, including fibromyalgia, who has an interest in helping others to understand medical research. Lee Good. 
I have 20+ years of experience helping people with chronic illness to understand research information. I am the WEGO winner, 2018/19 for building the best patient community around Fibromyalgia. You can join our private Fibromyalgia community, FIBRO CONNECT, here. 
RESOURCES: Function of the sensorimotor cortex image. University of Fribourg
Temporalparietal Junction. ScienceDirect
A Nexus Model of the Temporal-Parietal Junction. ResearchGate

Monday

14 reasons it may NOT be Fibromyalgia

14 reasons it may NOT be Fibromyalgia

The symptoms of fibromyalgia are found in so many other illnesses. That's why diagnosis is problematic. Here are 14 reasons why it may NOT be Fibromyalgia...

Fibromyalgia has many, varied and fluctuating symptoms. It should be considered when a patient describes a history of widespread pain, with no evident cause, that lasts three months or more. 


As well as this chronic musculoskeletal pain, whichaffects the bones, ligaments, muscles, nerves and tendons they have fatigue and sleep problems and stiffness. These symptoms are usually accompanied by a number of other conditions such as sensitivity to chemicals, irritable bowel or restless legs and depression or anxiety. The symptoms can often start, or worsen, during a period of severe psychosocial or physical stress.

Fibromyalgia presents a unique medical problem: 
  • Its symptoms are so common, that it is both underdiagnosed and misdiagnosed. 
  • Because there are no blood tests or scans to easily diagnose it, many physicians have trouble detecting the disorder. 
  • It can NOT be easily confirmed or ruled out with a simple blood test. 
  • It can't be seen on an X-ray or MRI. 
  • Instead, fibromyalgia appears to be linked to changes in how the brain and spinal cord process pain signals.
Because there is no test for fibromyalgia, your doctor must rely solely on your group of symptoms to make a diagnosis and rule out other conditions.
The key symptoms of fibromyalgia are also commonly found in many other illnesses, and a thorough examination and investigation needs to be undertaken in order to ensure there is not another pathological cause for the symptoms – particularly if there are any ‘red flags’ in the patient’s history suggestive of another serious pathology (Table 1).
Table 1. Red flags
  • Older age at new symptom onset
  • Weight loss
  • Night pain
  • Focal pain
  • Fever or sweats
  • Neurological features
  • History of malignancy

Doctors need to rule out
:

  1. arthritis 
  2. lupus 
  3. multiple sclerosis 
  4. chronic fatigue syndrome 
  5. polymyalgia rheumatica 
  6. hypothyroidism
  7. depression
  8. polymyositis
  9. hyperparathyroidism
  10. adrenal insufficiency
  11. myasthenia gravis
  12. cushing’s syndrome
  13. sjogren's syndrome
  14. Infection: chronic viral infection, HIV, hepatitis, Lyme disease
So if a doctor asks you about your mood, or skin rashes, or sends you for a blood test of your antibodies or an MRI they are just doing their job. They are ruling out these 14 conditions which have similar symptoms to Fibromyalgia. It is important to do so because these 14 conditions have specific treatments.

reasons it may NOT be Fibromyalgia
Symptoms NOT usually found in Fibromyalgia include:
  1. arthritis: swelling and redness, loss of motion in joints
  2. lupus: butterfly-shaped rash across cheeks and nose, anemia, abnormal blood clotting
  3. multiple sclerosis: brain lesions on an MRI
  4. chronic fatigue syndrome: profound fatigue that is more intense than pain, sore thoat
  5. polymyalgia rheumatica: average age of onset is 70, elevated levels of inflammatory proteins in blood.
  6. hypothyroidism: thyroid autoantibodies are common
  7. depression:
  8. polymyositis: muscle weakness in proximal muscles: upper arms, thighs.
  9. hyperparathyroidism: presence of hypercalcemia
  10. adrenal insufficiency: severe exhaustion, not typically associated with chronic widespread pain.
  11. myasthenia gravis: neurologic signs characteristic of specific disease.
  12. cushing’s syndrome: characteristic facial and skin signs of Cushing’s syndrome
  13. sjogren's syndrome: dry eyes and dry mouth, presence of anti bodies specific to Sjogren's
  14. Infection: chronic viral infection, HIV, hepatitis, Lyme disease
Getting a Diagnosis
I suggest that you keep a diary of your symptoms. This should make it easier to talk to your doctor or specialist. Especially if you have memory problems, writing things down will provide the doctor with the information that they need to make a correct diagnosis.

Fibromyalgia symptoms

When you go to a consultation go with:

  • a list of questions 
  • a list of current medications 
  • a brief medical history including your parents main conditions
  • a list of your symptoms
When writing the list of your symptoms try and remember what were your first symptoms and what year they started and then the next symptoms and the year etc. as many doctors ask these questions.
More clues for fibromyalgia diagnosis (from MayoClinic)

People who have fibromyalgia also often wake up tired, even after they've slept continuously for more than eight hours. Brief periods of physical or mental exertion may leave them exhausted. They may also have problems with short-term memory and the ability to concentrate. If you have these problems, your doctor may ask you to rank how severely they affect your day-to-day activities.

Fibromyalgia often coexists with other health problems, so your doctor may also ask if you experience:

  • Irritable bowel syndrome
  • Headaches
  • Jaw pain
  • Anxiety or depression
  • Frequent or painful urination
Remember that all ongoing pain should be evaluated. I am saying this because after a while of not getting a diagnosis you may start to question whether the pain is all in your head. 

Lee Good has 20+ years of experience helping people with chronic illness to understand research information and is recognized as a leader in patient advocacy. She is the WEGO winner, 2018/19 for building the best patient community around Fibromyalgia and editor at Fibro Blogger Directory, which is a community of fibromyalgia bloggers.

RESOURCES:

Fibromyalgia: Understand the diagnosis process MayoClinic
Diagnostic challenges: Australian Family Physician
Musculoskeletal Pain: Cleveland Clinic

Wednesday

The association between pain in fibromyalgia, relative humidity, temperature and barometric pressure.

FIBROMYALGIA and the weather

Blame it on the weather?

Self-reported pain levels in patients with fibromyalgia may change according to weather conditions.

Previous studies suggest that atmospheric pressure also called low barometric pressure (BMP) is significantly related to increased pain, but that has limited clinical relevance. Some studies report that there is a significant association between pain levels, temperature, BMP and/or relative air humidity in chronic pain conditions, whereas other studies failed to find such relationships

This study examined whether BMP influenced changes in perceived stress, and if stress levels  affected the pain. 

Forty-eight patients with fibromyalgia enrolled in a randomized controlled trail.

They reported their pain and emotional state three times daily for 30-consecutive days before the start of the treatment in the RCT.  .

The patients were unaware that weather data were collected simultaneously with pain and emotional reports. Both the experimenters and patients in the present study were uninformed about the plan to investigate the effects of meteorological variables on pain and stress levels.

The results showed that:
  • both lower BMP and increased humidity were significantly associated with increased pain intensity.
  • only BMP was associated with stress levels. 
  • higher stress was associated with higher pain. 
  • significant individual differences were present shown by a sub-group of patients (n = 8) who reacted opposite compared to the majority of patients (n = 40) with increased pain reports to an increase in BMP. 
  • in summary, lower BMP was associated with increased pain and stress levels in the majority of the patients, and stress moderated the relationship between BMP and pain at the group-level. Significant individual differences in response to changes in BMP were present, and the relation between weather and pain may be of clinical relevance at the individual level.
METHODS
The study included data from the 48 patients  The mean age of the sample was 48.6 years.
The patients had to be 18 years of age or older, diagnosed with fibromyalgia according to the ACR-90 criteria, and a manual examination of the patients’ tender points was performed before inclusion.  If patients were using prescribed medication, the use had to be stable for 3 months before inclusion. 

Depression and anxiety, general symptoms of psychological distress , impact of fibromyalgia on daily functioning and health-related quality of life were measured at baseline (day 1) before the measurement period.

In the morning (9 AM), afternoon (3 PM), and evening (9 PM), the patients received an SMS consisting of the following 4 questions: 
  • “what is your pain level now?,” 
  • “how unpleasant is the pain now?,” 
  • “how tense are you now?,” and 
  • “how anxious are you now?.” 
The response to the questions was delivered through a reply SMS containing the Numeric Rating Scale (NRS) values (0–10).

Meteorological data


All meteorological data were obtained from the Norwegian Meteorological Institute of Tromsø. The station was operated in compliance with the ICO-certified quality control procedure Obskval. 
Air temperature was measured at 2m above ground level using a standard PT100 sensor. Relative humidity was measured at 2 m above ground level using a HMP45D. Atmospheric pressure (BMP) at station ground level was measured using a digital barometer PTB220A .
Both barometric pressure and relative humidity had a significant impact on the individual slopes for pain reports. Increased barometric pressure was the only weather parameter that significantly affected emotional measures. 
Meteorological variables during the period of measurement, obtained at the Norwegian Meteorological Institute of Tromsø, latitude: 69.6537, longitude: 18.9373.
Meteorological variablesMean (SD)Min—MaxMedianMode
Barometric pressure–milibar (mbar)1012.65 (16.06) mbar965–1047.7 mbar1013.3 mbar1031 mbar
Air temperature–degrees Celsius (°C)-1.85 (5.02)°C-18.2–27.4°C-2.6°C-3°C
Relative humidity–percent (%)74.92 (13.99) %22–95%76%92%

DISCUSSION - Pain and emotional data
  • a decrease in barometric pressure was associated with increased pain
  • an increase in relative humidity was associated with higher pain reports 
  • The interaction between BMP by humidity reached significance in the pain intensity data, but was non-significant in the pain unpleasantness data. 
  • Higher BMP and higher levels of humidity were associated with increased pain intensity
  • humidity had no impact on pain intensity levels when BMP was lower. 
  • The interaction between BMP and temperature was significant in both the pain intensity and the pain unpleasantness data. 
  • The combination of lower BMP and reduced temperature was associated with heightened pain unpleasantness compared to when BMP was higher and increased temperature. 
  • No other interactions including the three-way interaction between the weather variables reached significance. 
CONCLUSIONS
The results from the present study showed that data for pain levels, emotional measures and weather conditions were significantly associated. 
In summary, the present study suggests that barometric pressure influences pain in fibromyalgia but on an individual basis that is associated with emotional factors.

STUDY
Blame it on the weather? The association between pain in fibromyalgia, relative humidity, temperature and barometric pressure.
Fagerlund AJIversen MEkeland A,  Moen CMAslaksen PM.

Author information

1
Norwegian Center for E-Health Research, Tromsø, Norway.
2
Department of Psychology, UiT The Arctic University of Norway UiT, Tromsø, Norway.
3
Department of Child and Adolescent Psychiatry, The Regional Unit for Eating Disorders, The University Hospital of North Norway, Tromsø, Norway.

2019; 14(5): e0216902.
Published online 2019 May 10. doi: 10.1371/journal.pone.0216902

PMCID: PMC6510434
PMID: 31075151