Hidden impact of climate change on chronic pain conditions
Source: Chronicle News Service / Nongmaithem Debarani

Imphal, April 20 2025: Every morning around 6.30 o'clock, Nanao (name changed) begins her day with a quiet breakfast which includes green tea and soaked oats with dried dates.

She then takes her medication and spends an hour tending to her garden, before catching up with any work of the previous day.

After that, she gets ready to leave for work.

It is pretty much a simple routine.

However, it was not like this always.

Three years ago, she used to wake up every morning in pain in every part of her body for reasons unknown.

The pain was intermittent, depriving her sleep and ability to concentrate.

During work hours, it would sap her energy and willpower.

Nonetheless, she pushed through with sheer determination, until she could not do so anymore.

After nearly a year of enduring these symptoms and visiting doctors after doctors without any answers, she was finally diagnosed with fibromyalgia.

The diagnosis was a miracle for her and the medications provided partial relief.

But in recent months, Nanao has noticed a troubling pattern.

Her symptoms are flaring-up again, this time more intense, and unpredictable, especially when the weather changes suddenly.

She is not the only one facing this problem.

Around the world, fibromyalgia patients and others with chronic pain illnesses like rheumatoid arthritis and lupus are experiencing similar increase in pain.

Emerging researches and studies have suggested that this is not coincidental.

Extreme weather events brought on by climate change may be playing a critical, and a largely overlooked role.

According to Dr Johnson Nameirakpam, a rheumatologist at JNIMS, fibromyalgia is a complex chronic condition characterised by widespread pain, fatigue, and cognitive difficulties.

It is a condition in which the brain and spinal cord handle pain messages abnormally.

But it should not be confused with inflammatory or autoimmune disorders.

It predominantly occurs in women, particularly those of child-bearing age.

Fibromyalgia is extremely challenging to diagnose because there is no absolute test to confirm it.

"We have to depend on the process of exclusion based on the symptoms reported by the patients such as widespread pain, tiredness, sleep disturbances because of pain, heightened sensitivity, stress, anxiety, depression, etc.," he said.

"This means ruling out every other possible disease first, which takes time and for patients, that time can be arduous," explained the medical professional.

In India, according to an article brought out in 2017, it is estimated that 0.04 per cent to 3.24 per cent of the population in urban and 0.14 to 4.34 per cent of the rural settlers, i.e., approximately seven million individuals suffer from fibromyalgia.

But because of under-diagnosis and lack of proper knowledge about the syndrome, the actual figure may be much higher.

While the root cause of fibromyalgia is not known, it is believed to have a multifactorial etiology.

Physical or mental trauma, stress, gastrointestinal imbalances (dysbiosis), and environmental factors have been known to bring on or aggravate symptoms.

However, evidence has been making it apparent that unusual temperature fluctuations and severe climatic patterns have been aggravating symptoms in sizable numbers of patients.

Patients of fibromyalgia are most likely to develop increased sensitivity towards environmental stimuli.

Temperature changes, especially sudden onset of cold or heat waves, can increase pain through impaired thermoregulation.

A recent meta-analysis of studies maintained that fibromyalgia patients have considerably lower heat-and-cold-evoked pain thresholds.

Also affecting the worsening of symptoms is humidity and barometric pressure.

High humidity is associated with increased fatigue and pain, and low barometric pressure, typically preceding storms, can cause severe discomfort.

These climatic changes are growing more mercurial with global warming.

Still another study has also indicated that air pollution, fuelled by rising temperatures and industrial emissions can heighten the intensity of fibromyalgia symptoms.

Patients tend to complain of sensitivities to airborne pollutants, allergens, and chemical irritants, which may go on to trigger headaches, sinus pressure, and respiratory problems.

Concurrently, chronic stress is one of the causes widely documented to lead to fibromyalgia exacerbations, and the psychological distress of dealing with an increasingly unpredictable climate and worry about environmental decline only increases the body's response to an already challenging condition.

For Nanao, her major triggers were stress and environmental factors.

She used to have a hectic schedule before she was diagnosed with hardly any rest.

She often travelled under the hot sun and exposed to wind and pollutions.

She was under too much pressure and had no means of dealing with her stress or her overall well-being.

She had to quit the job a few months prior to her diagnosis.

Receiving no answers from doctors in the state, she sought help outside the state.

Though she has been able to attain a more effective work life balance since her diagnosis, she must still go in for a check-up every six months to ensure her condition does not worsen.

Although fibromyalgia is incurable, Dr Johnson emphasised lifestyle changes are important in treating the condition.

He suggested having a balanced diet and consistent low-impact exercise like walking, stretching, or yoga.

While these habits would not help eliminate fibromyalgia, they would certainly help in reducing the frequency and severity of the flare-ups, he said.

He also called for further research and clinical trials promptly to learn more about the connection between climate change and persistent pain.

"This is an area which is still largely underexplored," he said.

"If we are going to look after patients properly in the future, we need to increase our knowledge of how varying geographic area, demographics and changing environmental conditions are affecting chronic disease, since the findings derived for one sample population may vary from another," the doctor further stated.

For fibromyalgia patients, maintaining the condition under control under a dynamically changing climate is a question of staying updated, tracking symptoms based on climatic patterns, and maintaining close interaction with healthcare practitioners for adapting effective measures as situations change.

It may involve administering medicines differently at specific seasons, using indoor climatic conditioning, or practicing stress management techniques during high-risk periods.

As Nanao carefully weeds and waters her small garden each morning, she has learned to listen more closely to her body, the wind, and the forecast.

Her life is recognition of a greater truth that, just as the climate change process is natural, human actions have brought it nearer to us than ever before.

With regard to those with long-term illness, its threat is now present, shaping their disease, their misery, and their existence.

(The report is filed under the 5th Media Fellowship Programme on Climate Change Reporting under the sponsorship of Directorate of Environment and Climate Change, Government of Manipur) .

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