Is it normal to get more knee pain in cold weather?
Well, over many years my clients have told me that their arthritic knees and the weatherman have one thing in common.
They both can predict the weather.
Let’s look into this in more detail.
Can The Weather Affect Knee Pain?
As a physio, we’re taught the art of history taking from day one, and determining aggravating factors is a key part of the puzzle.
Often the response to my question “what makes your knee pain worse?” is invariably “cold, wet and windy weather”.
On the flip side, the response to “what makes it better?” is “a vacation to sunny Queensland”.
It is a widely held belief that the weather affects joint pain. More often than not cold temperatures being the culprit.
Does that mean arthritic knees should get a one-way ticket to sunnier weather?
Is a deterioration in knee pain in cold weather a scientific fact or a myth?
How Does The Weather Affect Pain?
Various sources of knowledge like physio school (ahem! A few years ago now!), Google and pseudo-scientific journals and blogs, have in the past informed me that:
- Bad weather makes us move less, hence stiffer joints
- Bad weather makes us more depressed, hence we ‘feel’ more pain
- Less sunshine means lower levels of vitamin D affects our bones and joints
These reasons appeal to our common sense, but are they facts?
To answer that question, I looked into research evidence backing these claims.
What Does The Research Tell Us?
Unfortunately, not a lot.
There is a ton of research into knee pain in cold weather, but the inherent complexity of the problem makes it tricky.
The problem defies the simple logic of ‘Does A cause B?’.
For example, study participants with chronic musculoskeletal pain have different underlying pathologies like Rheumatoid Arthritis, Osteoarthritis or Fibromyalgia.
There is variability in the weather being studied. Temperature, humidity, atmospheric pressure, precipitation, wind speed etc.
Even the broad topic of temperature could mean different things to different people, eg: indoor vs outdoor temperature.
Some studies were simple, they just asked “Is your pain affected by the weather? Say yes or no!”.
Some tried to be clever, over 1 month, they compared ED presentations of joint pain in hospitals with the weather at that time.
A review published recently in April 2020 by Beukenhorst et al.,collated information from all the studies done so far on this topic and concluded,
“The association between the weather and pain is not strong”
It is important to note that they are not denying the relationship outright.
They have reported that the studies are of poor quality and have conflicting results, hence at this point, we don’t have a conclusive answer.
What Do I Think About Knee Pain In Cold Weather?
Well, the research has shown that there is no strong positive association between the weather and pain.
I am compelled to take the side of research here.
I believe there are huge biases in our assumption about weather and pain- do we tend to preferentially recall the bad weather days affecting our pain more, thereby confirming our belief?
For now, if you tell me that the weather affects your knee pain, I will empathise with you.
Your pain is your personal experience and no research in the world can recreate it.
What I will tell you is this:
- Evidence shows no strong association between the weather and pain
- Do not fear winter (or any weather for that matter)! Fear and anxiety do not help the pain.
- There is a lot of high-quality evidence behind the treatment of chronic joint pain (link to PEAK?) that is independent of the weather. We do not have to spend the rest of our lifetime bemoaning the weather!
So if you’re suffering from knee pain, and find that it gets worse in the cold weather, let’s work on what we can change.
No, we can’t change the weather, and the research tells us we don’t need to.
An example for knee pain is our PEAK program, where you can treat knee pain effectively with physiotherapy lead interventions at home via telehealth.
So, when it’s cold outside, come and see your physios at PridePlus Health.
It’s nice and warm in the clinic!
Beukenhorst A, Schultz D, McBeth J, Sergeant J, Dixon W (2020) Are weather conditions associated with chronic musculoskeletal pain? Review of results and methodologies. Pain, 161 (4), 668-683.