4 Ways Spring Can Be Challenging for People With Rheumatoid Arthritis

The chill of winter has finally passed, and spring is in full bloom. Pink and white flowers dot the landscape, along with green, leafy trees. Breezes are light, and it’s mild, but not hot.

Though spring is usually cause for celebration after a long, cold winter, for people living with rheumatoid arthritis (RA), the season can bring challenges. Environmental and lifestyle triggers may exacerbate RA symptoms, causing added pain and fatigue.

“Spring has sprung! And with it, more allergies and possibly increased RA disease activity,” says Irina Litvin, DO, a rheumatologist at Northwell's Staten Island University Hospital. “Day-to-day weather changes have been associated with increased joint pain and tenderness.”

Here are four health hurdles people with RA may encounter in the spring, and some possible solutions.

1. Barometric Pressure and Humidity Shifts

Springtime may be pretty and pleasant, but it’s also notoriously moody weather-wise.

But is there any evidence to back up those claims? Experts say yes.

“The relationship between weather and joint pain is one of the most common things my patients bring up,” says Diana Girnita, MD, a rheumatologist with her own practice called Rheumatologist OnCall in Irvine, California. “There is evidence suggesting that drops in barometric pressure can cause the fluid in the joints to become thicker, increasing pressure and discomfort in already inflamed spaces. The rainy, low-pressure days will also increase pain levels.”

“The study tested the relationship between pain and four weather variables: relative humidity, wind speed, atmospheric pressure, and temperature,” Dr. Liao says. “Temperature had no relationship with reported pain. … Relative humidity had the strongest association with pain, where higher humidity was associated with higher odds of pain.” She says the findings align with what her patients tell her.

If you suspect atmospheric pressures and changes may affect your RA symptoms, Dr. Girnita has some easy-to-incorporate tips.

“Stay warm and layer up during temperature swings,” she says. “Keep joints moving with gentle range-of-motion exercises on damp days rather than resting completely, which can increase stiffness.”

It can also help to take notes. “If you notice a pattern with weather changes, track your symptoms alongside the forecast,” Girnita suggests.

2. Spring Allergies

Both rheumatoid arthritis and seasonal spring allergies involve the immune system. RA is an autoimmune disease, and spring allergies happen when the immune system overreacts to allergens.

Some people with RA say that dealing with both their condition and seasonal allergies can make their fatigue more pronounced.

“This is a really important overlap that doesn’t get enough attention,” says Girnita. “When your immune system is already working overtime managing joint inflammation, adding an allergic response on top of it genuinely does compound fatigue.”

Nondrowsy antihistamines like cetirizine (Zyrtec), fexofenadine (Allegra), and loratadine (Claritin) are effective and safe to take with most RA medications, according to Girnita and Litvin, as are nasal corticosteroid sprays like fluticasone. But always check with your doctor before taking any new medications that haven’t been prescribed to you.

3. The ‘Spring Cleaning’ Trap

Spring often brings on the urge to go walking, do a little gardening, and clean house. But for people with rheumatoid arthritis, those bursts of activity can lead to unwanted aftereffects, including:

• Overuse Injuries After a sedentary winter, jumping into heavy physical activity too quickly can strain joints. This "weekend warrior" approach can lead to increased swelling and pain in the wrists, knees, and ankles. “I see this every April and May — patients who did beautifully through winter come in with flares from overdoing it over a single enthusiastic weekend,” says Girnita.
• Vulnerability Tendons and ligaments are often tighter in the early spring if you’ve been less active during the winter months, making them more susceptible to injury.

How do you get active safely if you have RA? Follow these tips.

• Take it slowly. “Start at 50 percent of what you think you can do,” Girnita says. “If you’re planning to garden for two hours, do one. Your joints will tell you the next morning whether that was right.”
• Warm up first. “Five to 10 minutes of gentle movement gets synovial fluid circulating and reduces injury risk,” explains Girnita. Dr. Liao says that “stretches can help reduce pain and lower the risk of muscle injury.”
• Protect your joints. Carry heavy loads close to your body, use ergonomic tools, and avoid any sustained grip position that could cause flare-ups. “Gardening kneelers, jar openers, and long-handled tools help,” Girnita says.
• Follow the “two-hour pain rule” and make sure to rest. Take note of how you feel two hours after you’re finished. If your pain is worse, you likely did too much. “Scale back next time,” Girnita advises, and “alternate activity with rest.”

4. Sleep Disruptions

Spring brings longer days and shifting light patterns, which can disrupt your circadian rhythms and your sleep. The result can be an increased sensitivity to pain in those with RA. Your pain threshold can drop if you're restless at night, making existing joint symptoms feel more intense.

Liao says that some RA medications can also interfere with a good night’s sleep. “Individuals with RA who are on glucocorticoid therapy should try to take their dose in the morning,” she advises. “Glucocorticoids are known to cause insomnia.”

Girnita recommends these strategies.

• Block out the evening light with blackout shades or eye masks so your sleep isn’t compromised because of longer days.
• Keep your wake-up time consistent, even on weekends.
• Pay attention to your stiff joints. “Keeping a heating pad or electric blanket nearby to warm joints before you get up can reduce that wake-up pain that fragments sleep,” Girnita says.

If you’re struggling more with your RA symptoms in the spring, be sure to talk to your doctor. By following some simple strategies, you can look forward to a more pain-free season in the future.

The Takeaway

• The rain, humidity, and fluctuations in barometric pressure of spring weather may make joint pain and stiffness worse for people with RA. Wearing layers, moving joints gently, and tracking symptoms alongside weather patterns can help.
• Seasonal allergies, sleep disruptions due to longer days, and overdoing it on physical activity can also worsen RA symptoms. Some lifestyle modifications can help.
• If the season seems to aggravate your symptoms, check in with your doctor.