"My knee knows it's going to rain"
It is one of the most common things people say in a clinic during a British winter: the knee aches more when it is cold and damp, the hands are stiffer on frosty mornings, and an old injury "plays up" before the weather turns. Cold weather joint pain is a belief shared across countries and generations.
So is it real? The honest answer is more interesting than a simple yes or no. Large studies have found that the weather has, at most, a modest effect on pain for some people. What happens around the weather, such as moving less, sleeping worse and feeling low, may matter just as much.
What people with joint pain report
In a European study of older adults with osteoarthritis in six countries, about two thirds described themselves as weather sensitive. Those who did reported more joint pain on average than those who did not (Timmermans et al., 2014).
So the experience is widespread and real for the people who feel it. The question researchers have tried to answer is whether measured changes in the weather actually line up with changes in pain.
What the large studies found
Weather and the start of back pain
An Australian study of almost 1,000 people with a new episode of low back pain compared the weather when the pain started with the weather a week and a month earlier. Temperature, humidity, air pressure and rain showed no link with the onset of back pain. Only stronger wind and gusts were associated with slightly higher odds (Steffens et al., 2014).
The UK smartphone study
The most detailed study comes from the UK. In "Cloudy with a Chance of Pain", 2,658 people with long-term pain recorded their symptoms daily on a smartphone for up to 15 months, while the phone recorded local weather. The researchers found significant but modest links between pain and higher relative humidity, lower air pressure and stronger wind, even after accounting for mood and physical activity (Dixon et al., 2019).
Rain and visits to the doctor
A US study linked more than 11 million doctor visits by about 1.5 million people aged 65 and over to local rainfall. There was no meaningful link between rainy days and visits for joint or back pain (Jena et al., 2017).
Put together, the picture is this: weather is not a major driver of joint pain for most people, but small effects are possible, especially on damp, windy, low-pressure days.
Why winter can still feel worse
Even if temperature itself plays a small role, winter changes many things that do affect pain:
- We move less. Dark evenings, cold mornings and icy pavements cut walking and exercise. Joints with osteoarthritis tend to stiffen and hurt more when they are not used.
- We sit more. Long periods in one position make the first steps afterwards stiff and uncomfortable.
- Sleep and mood change. Shorter days affect sleep and mood for many people, and both strongly influence how sensitive the nervous system is to pain.
- We expect it. If you believe the cold will make your knee ache, you are more likely to notice and remember aches on cold days. This is normal human attention, not imagination.
None of this means the pain is "in your head". Pain is always real. It means that the factors that turn pain up or down are often things we can influence.
How to keep your joints moving well in winter
Keep exercise in the plan
NICE recommends therapeutic exercise as a core treatment for osteoarthritis, tailored to the person, and encourages people to stay active (NICE, 2022). Winter is the time to protect that routine, not abandon it.
- Swap outdoor walks for indoor options on icy days: a gym, a pool, a class or exercise at home.
- Keep two or three strength sessions a week for the muscles around painful knees and hips.
- Break up long periods of sitting every 30 to 45 minutes with a short walk or a few sit to stands.
Warm up before you go out
Five minutes of gentle movement indoors, such as marching on the spot, knee bends and ankle circles, can make the first part of a cold walk feel easier.
Dress for the conditions
Layers, gloves and warm, grippy footwear help you stay comfortable and steady. Many people find warmth soothing for stiff joints, and a warm shower or bath before exercise can help you get going.
Look after sleep and mood
A regular sleep routine, daylight exposure when you can get it and time with other people all help your body cope with pain.
Keep a simple diary
If you are convinced the weather affects you, write down your pain, your activity and the weather for a few weeks. Many people find that activity and sleep explain more of their bad days than the forecast does.
When to get your joints assessed
Get same day medical advice (your doctor or NHS 111) if a joint is suddenly hot, red and swollen, especially with a fever or feeling unwell. This can be an infection or gout and should not wait for a booking.
Speak to your doctor or book an assessment if:
- morning stiffness lasts more than about 30 minutes, or several joints are involved
- pain wakes you at night and does not ease with a change of position
- your walking or daily activities are becoming limited
- pain has not improved after a few weeks of staying active
Frequently asked questions
Is heat or cold better for stiff joints in winter? Many people find warmth more comforting for stiffness, such as a warm shower before exercise. Use what feels better for you, and keep moving.
Should I exercise on days when my joints ache? Usually yes, at a gentler level. Movement tends to ease stiffness, while long rests tend to make it worse.
Would moving somewhere warmer fix my joint pain? The research suggests the weather plays only a small part, so a warmer climate is unlikely to make a big difference on its own.
The bottom line
Cold weather joint pain is a real experience, but research shows the weather itself has, at most, a small effect. Damp, windy, low-pressure days may nudge pain up slightly for some people. The bigger and more changeable factors are activity, strength, sleep and mood, and winter tends to affect all four.
If winter stiffness is holding you back, create an account at bpr.clinic and book an assessment with one of our therapists. At the assessment we listen to your history, look at how your joints move, and give you a plan of exercises you can do at home to keep you moving all year.
References
- Timmermans EJ, van der Pas S, Schaap LA, et al. Self-perceived weather sensitivity and joint pain in older people with osteoarthritis in six European countries: results from the European Project on OSteoArthritis (EPOSA). BMC Musculoskeletal Disorders. 2014;15:66. https://doi.org/10.1186/1471-2474-15-66
- Steffens D, Maher CG, Li Q, et al. Effect of weather on back pain: results from a case-crossover study. Arthritis Care and Research. 2014;66(12):1867-1872. https://doi.org/10.1002/acr.22378
- Dixon WG, Beukenhorst AL, Yimer BB, et al. How the weather affects the pain of citizen scientists using a smartphone app. npj Digital Medicine. 2019;2:105. https://doi.org/10.1038/s41746-019-0180-3
- National Institute for Health and Care Excellence. Osteoarthritis in over 16s (NG226). 2022. https://www.nice.org.uk/guidance/ng226
- Jena AB, Olenski AR, Molitor D, Miller N. Association between rainfall and diagnoses of joint or back pain: retrospective claims analysis. BMJ. 2017;359:j5326. https://doi.org/10.1136/bmj.j5326
