In our last blog, we discussed why neck pain can feel worse during winter. Recently, we have also noticed more people coming into the clinic with lower back pain, stiffness and tightness during the colder months.
Many people feel that their aches and pains are worse when the weather is cold, rainy or damp. This is a common experience, particularly for people with ongoing musculoskeletal pain such as osteoarthritis, inflammatory pain, fibromyalgia or chronic lower back pain. But does the cold actually cause the pain, or is something else going on?
What does the research tell us?
- Steffens et al. (2014) tracked close to 1,000 people from the moment their back pain started, then checked the weather on that day against records from a week and a month before. No real pattern emerged linking pain to temperature, humidity, air pressure, wind or rain.
- Duong et al. (2016) had over 1,600 people rate their pain every day for two weeks, then matched those scores to daily weather conditions. Once again, no consistent relationship surfaced.
- Jena et al. (2017) analysed millions of medical visits compared rainy days against dry ones and found no rise in people seeking treatment for back or joint pain when it rained.
- Beilken et al. (2017) followed close to 1,000 people with new back pain and likewise couldn’t tie its onset to any weather pattern.
When researchers reviewed all of this evidence together in 2020, the takeaway was the same: no single weather factor consistently predicts pain, and different studies often contradict each other.
If it’s not the weather, what’s behind it?
- Tighter muscles and reduced blood flow: cold temperatures can cause muscles to contract and vessels to narrow, which often leaves the back feeling stiffer and more reactive.
- Less daily movement: winter usually means less walking, less exercise and more time sitting, and that drop-in activity weakens supporting muscles and affects posture over time.
- Lower mood and added stress: shorter daylight hours, tiredness and a busier season can dampen mood, and a lower mood tends to make pain feel more intense.
For lower back pain, this is especially important because symptoms are rarely caused by one single issue. Pain can be influenced by strength, mobility, workload, sitting habits, previous injuries, stress, sleep and activity levels. This is why evidence-based physiotherapy looks beyond the painful area and considers the whole person.
Current low back pain guidelines support a person-centred approach that includes education, self-management strategies, exercise and appropriate physical therapies. In practice, that means learning to move safely, building strength step by step, and having a plan for flare-ups instead of avoiding activity altogether. Sleep, stress and mood deserve just as much attention as the physical side.
Staying Comfortable This Winter
- Keep moving, even in short bursts
- Break up sitting with a walk or stretch
- Warm up before lifting or exercising
- Stick to your usual exercise routine
- Build strength gradually rather than stopping
Weather itself doesn’t appear to be the trigger, but that doesn’t make winter back pain any less real. If your back is giving you trouble this winter, it is worth seeking help. A physiotherapist can help you understand what may be contributing to your back pain and provide tailored advice, exercises and strategies to keep you moving comfortably throughout this winter.
References
Beilken, K., Hancock, M. J., Maher, C. G., Li, Q., & Steffens, D. (2017). Acute low back pain? Do not blame the weather-A case-crossover study. Pain Medicine, 18(6), 1139–1144. https://doi.org/10.1093/pm/pnw126
Beukenhorst, A. L., Schultz, D. M., McBeth, J., Sergeant, J. C., & Dixon, W. G. (2020). Are weather conditions associated with chronic musculoskeletal pain? Review of results and methodologies. Pain, 161(4), 668-683. https://doi.org/10.1097/j.pain.0000000000001776
Duong, V., Maher, C. G., Steffens, D., Li, Q., & Hancock, M. J. (2016). Does weather affect daily pain intensity levels in patients with acute low back pain? A prospective cohort study. Rheumatology International, 36(5), 679-684. https://doi.org/10.1007/s00296-015-3419-6
Jena, A. B., Olenski, A. R., Molitor, D., & Miller, N. (2017). Association between rainfall and diagnoses of joint or back pain: Retrospective claims analysis. BMJ, 359, j5326. https://doi.org/10.1136/bmj.j5326
Steffens, D., Maher, C. G., Li, Q., Ferreira, M. L., Pereira, L. S. M., Koes, B. W., & Latimer, J. (2014). Effect of weather on back pain: Results from a case-crossover study. Arthritis Care & Research, 66(12), 1867-1872. https://doi.org/10.1002/acr.22378
World Health Organization. (2023). WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. https://www.who.int/