It’s cold and wet outside. As you get out of bed, you can feel it in your bones. Your right knee is flaring up again. That’ll make it harder for you to walk the dog or go to the gym. You think it must be because of the weather.

It’s a common idea, but a myth.

When we looked at the evidence, we found no direct link between most common aches and pains and the weather. In the first study of its kind, we found no direct link between the temperature or humidity with most joint or muscle aches and pains.

So why are so many of us convinced the weather’s to blame? Here’s what we think is really going on.

Weather can be linked to your health

The weather is often associated with the risk of new and ongoing health conditions. For example, cold temperatures may worsen asthma symptoms. Hot temperatures increase the risk of heart problems, such as arrhythmia (irregular heartbeat), cardiac arrest and coronary heart disease.

Many people are also convinced the weather is linked to their aches and pains. For example, two in every three people with knee, hip or hand osteoarthritis say cold temperatures trigger their symptoms.

Musculoskeletal conditions affect more than seven million Australians. So we set out to find out whether weather is really the culprit behind winter flare-ups.

What we did

Very few studies have been specifically and appropriately designed to look for any direct link between weather changes and joint or muscle pain. And ours is the first to evaluate data from these particular studies.

We looked at data from more than 15,000 people from around the world. Together, these people reported more than 28,000 episodes of pain, mostly back pain, knee or hip osteoarthritis. People with rheumatoid arthritis and gout were also included.

We then compared the frequency of those pain reports between different types of weather: hot or cold, humid or dry, rainy, windy, as well as some combinations (for example, hot and humid versus cold and dry).

What we found

We found changes in air temperature, humidity, air pressure and rainfall do not increase the risk of knee, hip or lower back pain symptoms and are not associated with people seeking care for a new episode of arthritis.

The results of this study suggest we do not experience joint or muscle pain flare-ups as a result of changes in the weather, and a cold day will not increase our risk of having knee or back pain.

In order words, there is no direct link between the weather and back, knee or hip pain, nor will it give you arthritis.

It is important to note, though, that very cold air temperatures (under 10°C) were rarely studied so we cannot make conclusions about worsening symptoms in more extreme changes in the weather.

The only exception to our findings was for gout, an inflammatory type of arthritis that can come and go. Here, pain increased in warmer, dry conditions.

Gout has a very different underlying biological mechanism to back pain or knee and hip osteoarthritis, which may explain our results. The combination of warm and dry weather may lead to increased dehydration and consequently increased concentration of uric acid in the blood, and deposition of uric acid crystals in the joint in people with gout, resulting in a flare-up.

Why do people blame the weather?

The weather can influence other factors and behaviours that consequently shape how we perceive and manage pain.

For example, some people may change their physical activity routine during winter, choosing the couch over the gym. And we know prolonged sitting, for instance, is directly linked to worse back pain. Others may change their sleep routine or sleep less well when it is either too cold or too warm. Once again, a bad night’s sleep can trigger your back and knee pain.

Likewise, changes in mood, often experienced in cold weather, trigger increases in both back and knee pain.

So these changes in behaviour over winter may contribute to more aches and pains, and not the weather itself.

Believing our pain will feel worse in winter (even if this is not the case) may also make us feel worse in winter. This is known as the nocebo effect.

What to do about winter aches and pains?

It’s best to focus on risk factors for pain you can control and modify, rather than ones you can’t (such as the weather).

You can:

• become more physically active. This winter, and throughout the year, aim to walk more, or talk to your health-care provider about gentle exercises you can safely do at home, with a physiotherapist, personal trainer or at the pool
• lose weight if obese or overweight, as this is linked to lower levels of joint pain and better physical function
• keep your body warm in winter if you feel some muscle tension in uncomfortably cold conditions. Also ensure your bedroom is nice and warm as we tend to sleep less well in cold rooms
• maintain a healthy diet and avoid smoking or drinking high levels of alcohol. These are among key lifestyle recommendations to better manage many types of arthritis and musculoskeletal conditions. For people with back pain, for example, a healthy lifestyle is linked with higher levels of physical function.

Manuela Ferreira, Professor of Musculoskeletal Health, Head of Musculoskeletal Program, George Institute for Global Health and Leticia Deveza, Rheumatologist and Research Fellow, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Swedish climate activist Greta Thunberg describes herself as having Asperger’s while others on the autism spectrum, such as Australian comedian Hannah Gatsby, describe themselves as “autistic”. But what’s the difference?

Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD.

Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.

When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of autism spectrum disorder is made.

Where do the definitions come from?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders.

Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4.

In 2013, the DSM-5 collapsed both diagnoses into one autism spectrum disorder.

How did we used to think about autism?

The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder.

Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress.

Between the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism.

The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech.

Today, as a legacy of the recognition of the autism itself, the majority of people diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability.

What changed with ‘autism spectrum disorder’?

The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term.

It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things.

The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”.

The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in.

Why do some people prefer the old terminology?

Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism.

The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, Tony Attwood and Carol Gray, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges.

What about identity-based language?

A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”.

The neurodiversity rights movement describes its aim to push back against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism.

The movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments.

However the social model contrasts itself against a very outdated medical or clinical model.

Current clinical thinking and practice focuses on targeted supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism.

A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.

Andrew Cashin, Professor of Nursing, School of Health and Human Sciences, Southern Cross University

This article is republished from The Conversation under a Creative Commons license. Read the original article.