Do Changes in Atmospheric Pressure Cause Asthma Attacks?

Researchers aren’t quite sure why a drop in barometric pressure may induce joint pain or headaches or asthma. robynmac/iStockphoto

Why do some people experience asthma attacks, joint pain or headaches when a storm passes through? Is there any evidence that changes in atmospheric pressure produce symptoms?

Everything in the human body is affected by air pressure, says Dr. Marc I. Leavey. "After all, our heart pumps blood by creating a pressure in our arteries, the lungs are able to extract oxygen from the air based on the concentration of oxygen in the air and the atmospheric pressure."

So there’s a good reason why people with arthritis, especially elderly sufferers, usually relocate to sunny, warm climates like Phoenix and not, say, Seattle. You might think it has to do with the therapeutic benefits of warm weather, but it's more than that.

No clear proof

Researchers aren’t quite sure why a drop in barometric pressure may induce joint pain or headaches or asthma. There are theories, but the only conclusive reason why sunny, warm weather is better for those with joint pain is simply that warm weather is more pleasant for most people.

One study's findings in the journal Rheumatology did not support the hypothesis that weather is associated with pain. “While some associations were suggestive of a relationship, largely these findings indicate that weather is only modestly, if at all, associated with pain from [osteoarthritis],” concluded the study’s researchers.

But Dr. Donee Patterson, a family physician and director of medical community outreach at Einstein Medical Center in Philadelphia says that “Although there’s not a lot of medical studies supporting the relationship between asthma, arthritis and headaches being directly affected by the weather, I — and certainly many of my colleagues — have seen plenty of anecdotal evidence from our patients supporting the theory that changes in the weather can cause symptoms, including a worsening of mood.”

Why do people become affected when the air pressure changes?

Dr. Dana Simpler, primary care practitioner at Mercy Medical Center in Baltimore, says the reason we are susceptible to barometric changes is because we’re full of air.

“Though we are comprised of approximately 60 percent water, we also have air in our stomachs, intestines, lungs and sinus cavities and middle ear. Both water and air are affected by pressure changes,” says Simpler, who adds that she has a number of patients who get horrendous headaches when a storm arrives and the barometric pressure drops.

In the case of arthritis, one theory for the cause of joint pain is that sensory nerves in the joints respond to pressure. When the air pressure lowers, it causes the pressure and amount of fluid in the joints to change. When a storm arrives and the air pressure decreases, receptors in the joints become more sensitive and the level of perceived pain or discomfort increases.

A classic but extreme pressure-related disease is "the bends," says Leavey. When a diver ascends to the surface too rapidly, nitrogen — which had been dissolved in the blood at the higher pressure of deep water — comes out of solution as a gas within the circulatory system. The result can be fatal, but it can be prevented by ascending slowly, or using a decompression chamber to gradually lessen the atmospheric pressure, he said.

Thunderstorm-induced asthma

Take this convincing anecdotal evidence: In June 1994, within 30 hours of a severe thunderstorm, several London-area hospitals admitted at least 640 asthma sufferers to their emergency rooms with severe reactions. A study of the weather event, published two years after the thunderstorm, in the British Medical Journal, theorized that new episodes of asthma attacks during the thunderstorm were associated with a drop in air temperature and a rise in grass pollen concentration.

The study also observed that asthmatic symptoms, in addition to lightning strikes, increases in humidity and grass pollen concentrations were also associated with higher sulfur dioxide concentrations and high rainfall in the previous day or two before the attacks.

Asthma sufferers, whose conditions manifest when thunderstorms strike, may constitute a different population from other patients with asthma, the BMJ study also hypothesized.

Also, a study in the Annals of Allergy, Asthma & Immunology concluded that emergency room visits of asthmatic children coincided with high concentrations of nitrogen oxide and sulfur dioxide and rising barometric pressure.

The upper respiratory tract is particularly sensitive to changes in barometric pressure, says Leavey. "Taking off in a plane, or traveling up many floors in a skyscraper's elevator can cause ears to 'pop.' If there is congestion of the Eustachian Tube, which equalizes pressure in the middle ear, one can have rupture of the eardrum while traveling in a plane upon landing.

"The sinuses are also sensitive to air pressure. Falling atmospheric pressure often triggers sinus pain, as the contents push out to try to equalize pressure," he said.

What can you do to alleviate symptoms?

Ride out the storm, says Simpler. “There isn't much to do about it, other than usual headache medications. The only thing I can tell my arthritis patients, other than to take their usual arthritis meds and joint rubs is to be comforted that the storm will pass, high pressure will return, and they will feel better when that happens.”

Taking anti-inflammatory drugs taken as soon as a weather event happens may help alleviate symptoms, adds Simpler.