Nature's wrath-The effect of weather on pain following orthopaedic trauma.
BACKGROUND
Despite frequent complaints by orthopaedic trauma patients, to our knowledge there is no data regarding weather's effect on pain and function following acute and chronic fracture. The aim of our study was to investigate the influence of daily weather conditions on patient reported pain and functional status.


METHODS
We retrospectively examined prospectively collected data from 2369 separate outpatient visits of patients recovering from operative management of acute tibial plateau fractures, acute distal radius fractures, and chronic fracture nonunions. Pain and functional status were assessed using a visual analogue scale (VAS) and the DASH and SMFA functional indexes. For each visit date, the mean temperature, difference between mean temperature and expected temperature, dew point, mean humidity, amount of rain, amount of snow, and barometric pressure were recorded. Statistical analysis was run to search for associations between weather data and patient reported pain and function.


RESULTS
Low barometric pressure was associated with increased pain across all patient visits (p=0.007) and for patients at 1-year follow-up only (p=0.005). At 1-year follow-up, high temperature (p=0.021) and high humidity (p=0.030) were also associated with increased pain. No significant association was noted between weather data and patient reported functional status at any follow-up interval.


CONCLUSIONS
Patient complaints of weather influencing pain after orthopaedic trauma are valid. While pain in the immediate postoperative period is most likely dominated by incisional and soft tissue injuries, as time progresses barometric pressure, temperature, and humidity impact patient pain levels. Affirming and counseling that pain may vary based on changing weather conditions can help manage patient expectations and improve satisfaction.
NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1402, New York, NY 10003, USA. Electronic address: Brandon.Shulman@nyumc.org.
Brandon S
BS
Shulman
NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1402, New York, NY 10003, USA. Electronic address: ale.marcano@gmail.com.
Alejandro I
AI
Marcano
Center for Musculoskeletal Care, 33 East 38th Street, New York, NY 10016, USA. Electronic address: Roy.Davidovitch@nyumc.org.
Roy I
RI
Davidovitch
NYU Langone Medical Center, 380 2nd Ave. Suite 606, New York, NY 10010, USA. Electronic address: Raj.Karia@nyumc.org.
Raj
R
Karia
NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1402, New York, NY 10003, USA. Electronic address: Kennth.Egol@nyumc.org.
Kenneth A
KA
Egol
D000553:Ambulatory Care; D005260:Female; D005599:Fractures, Ununited / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011885:Radius Fractures / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013696:Temperature; D014481:United States / Q000453:epidemiology; D014887:Weather
Barometric pressure; Orthopaedic trauma; Outcomes; Pain; Pain after trauma; Post-operative pain; Weather