Weathering Chronic Pain

A Surprising Relationship between Chronic Pain, Connective Tissue, Sexual Function, and the Weather. 

My pain is named Frank, and he’s an asshole.  He lies – he complains – he disrupts shit.. constantly, and if the weather is *just right*, he’ll keep me horizontal.  He’s with me all the time, reminding me of his existence. All. The. Time.

My experience is not unique.  Chronic Pain occurs beyond a threshold of time – generally 12 weeks.  It can result from injury, as you’ll hear folks identify their ‘bad knee’. It can result from illness, and it can result from trauma. 

In this article, I’ll be sharing some thoughts about the impact of weather on chronic pain within the contexts of fascia, hormones, and sexual function (I’ll discuss trauma in a future post).

The Impact of Weather Changes on Chronic Pain

Several studies have shown that weather conditions can have an impact on the daily symptoms of pain and fatigue in individuals with Fibromyalgia, which has an intimate relationship to connective tissue (Bossema et al., 2013; Smedslund et al., 2014). In a multilevel regression analysis, researchers found that fluctuations in weather patterns could directly influence the severity of symptoms experienced by female patients with fibromyalgia. This highlights the importance of considering the role of external environmental factors, such as weather, in the management and treatment of fibromyalgia similar chronic pain symptoms.
Multiple Sclerosis(MS) is a condition in which an individual’s immune system damages the mylean sheath that encases nerves, and this occurs in the brain and spinal chord.  A 2016 study analyzed data from over 500 MS patients in Spain and found that patients reported more pain during periods of high solar and geomagnetic activity (Clinical Neurology and Neurosurgery, 2016) The researchers suggested that these changes in the Earth's magnetic field could affect the immune system and trigger inflammatory responses, exacerbating MS symptoms. While further research is needed to fully understand the relationship between space weather and MS, these findings suggest that environmental factors such as space storms may play a role in the severity of MS symptoms.

Space Weather

Space Weather refers to the impact solar storms and the like have on us here on Earth. While the mechanisms behind this relationship are not yet fully understood, one theory is that changes in the magnetic field can affect the body's ion channels, which play a role in transmitting pain signals. Another possibility is that space weather events can trigger inflammation, which is known to be a key contributor to chronic pain. One group used a smartphone app to collect pain data from over 9,000 participants with chronic pain, and analyzed the data to determine whether changes in weather patterns affected pain levels. The study found that participants reported higher levels of pain on days with low atmospheric pressure, high humidity, and stronger winds. The study also found that participants with osteoarthritis and fibromyalgia were particularly sensitive to changes in weather patterns. I’ve included a table from an article, which you can find here.

Chronic Pain and Fascia Dysfunction

One area of the body that may be particularly affected by these changes in weather is fascia, the connective tissue that surrounds and supports muscles and organs. According to the Mayo Clinic, fascia has a potential role in fibromyalgia (Mayo Clinic Staff, 2018), because it is often involved in myofascial pain syndrome, a condition with symptoms similar to fibromyalgia. Other research suggests that dysfunction in the fascia can contribute to the development of myofascial trigger points, which are tender areas in the fascia that can cause referred pain and other symptoms (Travell & Simons, 1999).

Fascia and Emtotions

Dr Robert Schleip is one of the world’s leading researchers in fascia, and I’ve had the pleasure of attending some of his courses.  One of his theories is that fascia may act as a sense organ or a contributor to the body's proprioception (Schleip, Jäger, & Klingler, 2012). Fascia contains a high density of sensory nerve endings, which contribute to proprioception and pain perception (Schleip et al., 2012). Some experts suggest that fascia operates as a sense organ that provides information about the body's position, movement, and overall well-being – this relates to the concepts of proprioception and interoception. (Stecco & Hammer, 2008). The sensory functions of fascia have important implications for the body's overall sensory function and well-being. By providing information about the body's position, movement, and overall health, fascia may play a critical role in the prevention and management of chronic pain conditions such as fibromyalgia and myofascial pain syndrome. Additionally, the sensory functions of fascia may contribute to the body's overall proprioception and balance, helping individuals maintain stability and coordination in everyday movements and activities.

I am always communicating with fascia when I’m facilitating somatics and offering sound healing.  Meaning --- it’s subtle and meant to give gentle assistance in the experience of more comfort in the body, rather than meant to correct anything in the immediate.  Both approaches are valuable, of course.

Estrogen and the Experience of Pain

Estrogen, a hormone that plays a role in modulating pain perception and sensitivity, may also affect the quality and quantity of fascia in the body (Lesondak, 2017). The book Myofascial Pain and Dysfunction: The Trigger Point Manual by Janet G. Travell and David G. Simons describes the impact of hormonal changes on the musculoskeletal system and pain experience. Hormone changes contribute to the development of myofascial trigger points, which are tender areas in the fascia that can cause referred pain and other symptoms (Travell & Simons, 1999). For example, women may be more susceptible to the development of trigger points in the neck and shoulders during certain phases of their menstrual cycle.
I bring this into the conversation, because female-bodied individuals’ experience of pain – ESEPCIALY when it occurs within a context of hypermobility, autoimmune disease, and other chronic conditions – is extraordinarily complex. Additionally, AFAB individuals are routinely gaslit by providers. Did you know that most women aren’t offered pain control for IUD insertion?

YES – but I digress…

Impact on Sexual Function

Myofascial pain can have a significant impact on sexual function and satisfaction. In fact, research has shown that women with chronic pain are more likely to experience sexual dysfunction than women without pain (Maugars et al., 2021). 

My personal experience has been that strategic application of BDSM techniques can assist with pain management and can even disrupt this.

Some studies have shown that women (using the studies’ term) with fibromyalgia experience greater pain during sexual activity than women without fibromyalgia, which can lead to avoidance of sexual activity and decreased sexual satisfaction (Miro & Martinez, 2015). In addition, the impact of hormonal changes on pain perception and sensitivity may also contribute to sexual dysfunction in women with chronic pain conditions. For example, women may experience more pain during certain phases of their menstrual cycle due to hormonal fluctuations that affect pain sensitivity (Nappi et al., 2016). Hormonal changes during pregnancy and menopause may also impact pain levels and sexual function in women with chronic pain.

Overall, chronic pain can significantly impact sexual function and satisfaction in women. Addressing both the physical and psychological aspects of chronic pain through targeted interventions such as physical therapy, medication, and counseling can help improve sexual function and overall quality of life (Nagoski, 2015).

As you can see in this overview of concepts and connections , Chronic pain can have a significant impact on our lives, and weather is a genuine factor in how many of us experience it.  Fascia and hormones both have roles in nociception, which is the experience of pain, and if the individual is estrogen-dominant, this will impact pain pathways further.

References:

Bossema, E. R., van Middendorp, H., Jacobs, J. W., Bijlsma, J. W., Geenen, R. (2013). Influence of weather on daily symptoms of pain and fatigue in female patients with fibromyalgia: a multilevel regression analysis. Arthritis Care & Research, 65(7), 1019-1025. DOI: 10.1002/acr.21978
Dixon, W.G., Beukenhorst, A.L., Yimer, B.B. et al. How the weather affects the pain of citizen scientists using a smartphone app. npj Digit. Med. 2, 105 (2019). https://doi.org/10.1038/s41746-019-0180-3

Smedslund, G., Eide, H., Kristjansdottir, Ó. B., Nes, A. A., Sexton, H., & Fors, E. A. (2014). Do weather changes influence pain levels in women with fibromyalgia, and can psychosocial variables moderate these influences? Pain, 155(10), 1900-1907. doi: 10.1016/j.pain.2014.06.008

Travell, J. G., & Simons, D. G. (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual (Vol. 1). Lippincott Williams & Wilkins.

Lesondak, D. (2017). Fascia: What it is and Why it Matters. Handspring Publishing.

Maugars, Y., Berthelot, J. M., Le Goff, B., & Darrieutort-Laffite, C. (2021). Fibromyalgia and Associated Disorders: From Pain to Chronic Suffering, From Subjective Hypersensitivity to Hypersensitivity Syndrome. Frontiers in Medicine, 8, 666914. doi: 10.3389/fmed.2021.666914

Mayo Clinic Staff. (2018, July 31). Mayo Clinic Q and A: Understanding myofascial pain syndrome and fibromyalgia. Mayo Clinic News Network. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-understanding-myofascial-pain-syndrome-and-fibromyalgia/

Miro, E., & Martinez, M. P. (2015). Sex differences in pain-related psychological variables and quality of life in patients with fibromyalgia syndrome. Pain Research and Treatment, 2015, 1-9. doi: 10.1155/2015/561462

Nagoski, E. (2015). Come as You Are: The Surprising New Science that Will Transform Your Sex Life. Simon & Schuster.

Nappi, R. E., Terreno, E., Cucinella, L., & Polatti, F. (2016). Hormonal contraception and pain. Best Practice & Research Clinical Obstetrics & Gynaecology, 34, 5-14. doi: 10.1016/j.bpobgyn.2015.09.004

Schleip, R., Jäger, H., & Klingler, W. (2012). What is 'fascia'? A review of different nomenclatures. Journal of Bodywork and Movement Therapies, 16(4), 496-502. doi: 10.1016/j.jbmt.2012.08.001

Stecco, C., & Hammer, W. I. (2008). Functional Atlas of the Human Fascial System. Churchill Livingstone.

Willard, F. H., Vleeming, A., Schuenke, M. D., Danneels, L., & Schleip, R. (2012). The thoracolumbar fascia: Anatomy, function and clinical considerations. Journal of Anatomy, 221(6), 507-536. doi: 10.1111/j.1469-7580.2012.01511.x