Many people with fibromyalgia report an increase in symptom activity in response to certain weather patterns, such as temperature changes. Common symptoms of fibromyalgia, like widespread pain and fatigue, can flare during these periods, impacting quality of life and causing overall frustration—particularly when symptoms have been largely under control.
While the connection between hot and cold weather and fibro symptoms is still unclear, its reported impact on wellbeing makes it an important factor to understand for both patients and healthcare providers.
This article explores how hot and cold temperatures influence the condition, why fibromyalgia symptoms may be affected by weather, and practical strategies that people with fibromyalgia can use to help manage weather-related symptom flare-ups.
Hot and Cold Weather: How Temperature Affects Fibromyalgia Symptoms
Cold Weather and Fibromyalgia
Cold is the weather-related trigger that is most frequently reported for fibromyalgia flare-ups; several sensory testing studies over the last two decades have shown that people with fibromyalgia experienced unusual sensitivity to cold, even to the point of disablement. 1 Many individuals with fibromyalgia report increased stiffness, pain, and fatigue during colder months.
There are several potential explanations for this relationship:
- Muscle Stiffness: Exposure to cold temperatures can cause muscles to contract and tighten, which may exacerbate the muscle pain and stiffness associated with fibromyalgia. Cold weather can worsen the sensation of “tightness” in the muscles, leading to increased discomfort and difficulty moving.
- Decreased Circulation: When the body is exposed to cold, blood vessels constrict, reducing circulation to the extremities. This decrease in circulation can contribute to increased pain and discomfort in individuals with fibromyalgia, who already experience heightened sensitivity to pain. As the body works to preserve heat, the reduced blood flow to muscles and joints can lead to exacerbated pain levels.
- Barometric Pressure: A drop in barometric pressure, which often accompanies cold fronts or storms, can affect the soft tissues and joints, intensifying pain. This is most often reported in rheumatic conditions like arthritis, but the combination of cold and low barometric pressure may lead to significant flare-ups in individuals with fibromyalgia as well.
A systematic review of the medical literature published in The Journal of Pain in 2020 found that a distinct subgroup of patients with fibromyalgia were more likely to report worsening pain during colder months.2 The researchers suggested that changes in temperature and barometric pressure could be contributing factors in these flare-ups.
Hot Weather and Fibromyalgia
While cold weather may worsen stiffness and joint pain, many fibromyalgia patients find relief in heat or hot weather. This has also been studied in small trials: in a review of various spa therapy techniques from 2012, the authors noted that hot therapies were very well tolerated in people with fibromyalgia overall.3
Why is heat helpful? Besides relieving sore or spasming muscles, heat may also help reverse neuroinflammatory states in fibromyalgia; research on this topic is ongoing and clinical trials are currently underway.
Another answer may lie in the “gate control theory” of pain processing. In this theory, the spinal cord acts as a gate that can allow or block nerve signals from reaching the brain. When the body experiences non-painful stimuli, like pressure from water, the gate closes, inhibiting other, more painful nerve signals from reaching the brain.
This can be especially helpful in fibromyalgia, when the central nervous system is amplifying pain signals through central sensitization, or increased sensitivity of the central nervous system (CNS) to stimuli.
Hot weather may also lead to challenges for individuals with fibromyalgia, albeit in different ways:
- Dehydration: Hot weather can increase the likelihood of dehydration, which can exacerbate symptoms of fibromyalgia, including fatigue, muscle cramps, and pain. Dehydration can make it harder for the body to regulate temperature, leading to overheating and additional discomfort.
- Increased fatigue: High temperatures can cause the body to become fatigued more quickly, and for individuals with fibromyalgia, this can result in added strain on the already-fatigued brain.
- Excessive Sweating: In hot weather, the body works to cool itself by sweating. However, excessive sweating can also lead to skin irritation and discomfort, which may exacerbate the heightened skin sensitivity often reported in fibromyalgia patients.
Why Weather May Affect Fibromyalgia Symptoms
Fibromyalgia is associated with central sensitization; this means that individuals with fibromyalgia may experience amplified pain responses from even mild stimuli, like thumbnail pressure on the skin or even a hug.
This sensitivity to stimuli may extend to environmental changes as well. Individuals with fibromyalgia often report worsening symptoms with weather changes, particularly when transitioning between seasons or experiencing extreme temperatures; the heightened sensitivity in the nervous system could explain why.
Several factors contribute to how weather may affect fibromyalgia symptoms, including:
- Barometric Pressure Changes: Barometric pressure refers to the weight of the air surrounding us, which can fluctuate with weather changes. Studies have shown that barometric pressure changes can affect joint pain and inflammation, which may be more pronounced in individuals with fibromyalgia.4 When barometric pressure decreases, such as during storms or weather fronts, the resulting changes in air pressure can impact the soft tissues, nerves, and joints, potentially intensifying pain levels.
- Temperature Fluctuations: Extreme heat or cold can cause physical stress on the body, leading to muscle stiffness and joint pain. For individuals with fibromyalgia, temperature fluctuations may make muscles and tissues more sensitive, leading to increased discomfort.
- Humidity: Humidity levels can affect how the body regulates temperature and hydration. High humidity can make it difficult for the body to cool down, causing fatigue and discomfort. On the other hand, low humidity in winter can cause the skin to become dry and irritated, which may exacerbate skin sensitivity in some individuals with fibromyalgia.
- Sunlight Exposure: Reduced sunlight, particularly during the winter months, can lead to seasonal affective disorder (SAD), a form of depression linked to lack of sunlight. SAD can worsen symptoms of fibromyalgia, as mood and energy levels are closely tied to pain perception. This makes seasonal transitions more challenging for those with fibromyalgia, particularly during the fall and winter months.
Strategies to Combat Weather-Related Fibromyalgia Symptoms
Since weather-related flare-ups are common in people with fibromyalgia, it’s helpful to have strategies in place to help manage your symptoms. Here are some techniques that can help:
Heat and Cold Therapy
Heat and cold therapy are widely used to manage pain and discomfort in fibromyalgia patients. Both methods offer distinct benefits for alleviating the symptoms that are exacerbated by weather changes, though their effectiveness depends on the individual and the nature of their symptoms.
Cold Therapy:
Cold therapy involves using ice packs or cold compresses to target specific areas of pain or inflammation. Cold therapy can be especially useful for reducing inflammation, which may be more pronounced in hot weather or after physical activity. Cold compresses can help numb areas of discomfort, providing temporary relief from pain and muscle spasms.
For patients with fibromyalgia, cold therapy may be beneficial for reducing swelling and joint pain during flare-ups, particularly when the body is exposed to hot weather or humidity. Applying an ice pack wrapped in a towel (rather than directly on the skin) to painful areas for 15-20 minutes at a time can provide relief.
Heat Therapy:
Heat therapy is particularly effective for muscle stiffness and pain associated with cold weather. Heat helps to relax muscles, improve circulation, and increase blood flow to painful areas. Common forms of heat therapy include heating pads, warm baths or hot tubs, hot water bottles, or warm compresses.
For individuals with fibromyalgia, heat therapy can soothe aching muscles and joints, especially during the winter months when cold temperatures trigger flare-ups. It can be used to relax tight muscles before or after exercise and help reduce pain from muscle spasms. Heat therapy is also known to improve sleep quality by promoting relaxation.
It is important to remember that while heat can help with muscle relaxation, it may not be ideal for everyone with fibromyalgia, especially if it leads to fatigue or dehydration. Use heat therapy for 15-20 minutes at a time.
A 2023 research review on non-drug therapies for chronic pain found that both heat and cold therapy provided short-term relief from fibromyalgia symptoms, through different means.5 Heat therapy was particularly effective for muscle stiffness and neuroinflammation, while cold therapy offered relief from acute pain and activity in the peripheral nervous system.
Maintaining Stable Temperature
During colder months, it is important for individuals with fibromyalgia to keep warm to prevent muscle stiffness. Layering clothing is one way to manage temperature changes throughout the day; thermal clothing, scarves, gloves, and warm socks can help maintain body warmth and reduce the risk of joint and muscle stiffness.
In hot weather, light, breathable fabrics like cotton or linen can help the body stay cool and reduce the risk of overheating. Avoiding tight or restrictive clothing will also help prevent discomfort.
People with fibromyalgia can also benefit from controlling their indoor environment. Using space heaters or air conditioning can help maintain a consistent temperature at home. Having a controlled environment may also help minimize the exacerbation of symptoms due to sudden weather fluctuations.
Regular Movement and Stretching
Regular physical activity, such as walking, swimming, or yoga, can help maintain muscle flexibility and reduce fibromyalgia pain. Stretching is particularly important in cold weather to prevent muscles from tightening. During hot weather, gentle stretches can help keep muscles from becoming too fatigued or stiff.
In a 2007 study, participants with fibromyalgia performed sessions of aquatherapy in warm water three times a week. This group significantly improved their self-reported pain, but also their cognitive function (or reduced brain fog) compared to the control group.6 Combining heat therapy with movement may be a helpful strategy for harnessing the benefits of both temperature and activity.
Summary
The connection between weather and fibromyalgia symptoms is well-established in patient data, with many individuals with fibromyalgia mentioning changes in their symptoms in response to temperature, humidity, and barometric pressure shifts. Whether it is the stiffness and pain that arises from cold weather or the fatigue and discomfort that accompanies heat, the effects of weather can be challenging to manage for those living with fibro.
However, through strategic management of the environment, physical activity, and effective use of heat and cold therapies, you can minimize weather-related symptom flare-ups and enjoy greater comfort year-round.
Sources
1, 2 Berwick RJ, Siew S, Andersson DA, Marshall A, Goebel A. “A Systematic Review Into the Influence of Temperature on Fibromyalgia Pain: Meteorological Studies and Quantitative Sensory Testing.” J Pain. 2021 May;22(5):473-486.
3 Guidelli G, Tenti S, De Nobili E, Fioravanti A. “Fibromyalgia syndrome and spa Therapy: Myth or Reality?” Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders 2012:5 19–26.
4 Fagerlund AJ, Iversen M, Ekeland A, Moen CM, Aslaksen PM. Blame it on the weather? The association between pain in fibromyalgia, relative humidity, temperature and barometric pressure. PLoS One. 2019 May 10;14(5):e0216902. doi: 10.1371/journal.pone.0216902. PMID: 31075151; PMCID: PMC6510434.
5 Shi, Y., Wu, W. Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress. BMC Med 21, 372 (2023). https://doi.org/10.1186/s12916-023-03076-2
6 Munguía-Izquierdo D, Legaz-Arrese A. Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia. Clin Exp Rheumatol. 2007 Nov-Dec;25(6):823-30. PMID: 18173915.
