Seasonal Symptoms of Rheumatic Diseases

May 22, 2002

The season of the year does not affect the pain and severity of symptoms

experienced by patients with rheumatic diseases, according to new data.

The Seasonal Pattern Assessment Questionnaire was administered to 1,424

patients with rheumatoid arthritis (RA), osteoarthritis (OA), and

fibromyalgia (FM).

Clinical status was evaluated with standard assessment measures and reported

symptoms were compared with actual seasonal differences measured for periods

of up to 24 years. Approximately 50% of patients with rheumatic disease

reported exacerbation of rheumatic symptoms by seasonal changes.

The presence of seasonal symptoms was not related to the diagnosis or

symptoms of seasonal affective disorder (SAD). These seasonal symptoms were

also less common in older patients and in men.

Using circular statistics, the modal months for worse symptoms were December

and January and for best symptoms it was July.

Bimodal patterns of seasonality were identified for global severity, joint

pain, fatigue, and socialization. Seasonal symptoms differed by the degree

at which they were dispersed around the 12-month circle.

For the pain and global severity measurements that were analyzed during a

24-year period, pain was slightly increased in the summer. However, global

severity was not related to season at all. Even when researchers examined

patients who specifically reported worse symptoms in the winter and best

symptoms during the summer, no effect of season could be found.

" Seasonal rheumatic symptoms are commonly reported across all rheumatic

diseases, but appear to reflect perception rather than reality since

reported symptoms do not agree with measured clinical scores, " the

researchers wrote.

" In addition, regardless of seasonal complaints, measured pain and global

severity scores are not worse in winter. Although patients with FM and

season (positive) patients report more severe symptoms, their pattern of

reporting and their actual scores do not differ according to season compared

to persons without FM or positive seasonality. " (Hawley D, et al. J

Rheumatol 2001;28:1900-9.)

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