As temperatures drop, many people living with chronic pain begin to notice a familiar and frustrating pattern: their symptoms worsen. Whether it's aching joints, increased stiffness, or flare-ups that seem to arrive without warning, winter weather can take a serious toll on the body—and the mind.
At The Pain Collective, we understand how cold weather impacts chronic pain, and more importantly, how you can take practical steps to manage it. In this post, we’ll explain why pain worsens in winter, which conditions are most affected, and what you can do to stay well and mobile throughout the colder months.
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Why Cold Weather Exacerbates Chronic Pain
There’s more than just anecdotal evidence behind the winter pain phenomenon. Several physiological and neurological factors come into play when temperatures drop:
1. Reduced Blood Flow
Cold weather causes blood vessels to constrict (vasoconstriction), especially in the extremities. This limits circulation, which can lead to increased joint stiffness, muscle tightness, and overall discomfort.
2. Changes in Barometric Pressure
Shifts in atmospheric pressure, common during cold fronts, can affect joint pressure and nerve sensitivity. Lower barometric pressure can cause tissues to expand slightly, which may aggravate already-inflamed joints or compressed nerves.
3. Muscle Contraction and Guarding
Cold temperatures can cause the body to tense up reflexively, especially around painful areas. This muscular contraction adds to the sense of stiffness and can trigger pain flare-ups.
4. Reduced Physical Activity
Shorter days, colder temperatures, and less motivation to move all contribute to less exercise during winter—which in turn worsens stiffness, inflammation, and overall pain levels.
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Common Conditions Affected by Cold Weather
Arthritis
People with osteoarthritis and rheumatoid arthritis are particularly vulnerable in winter. Cold temperatures exacerbate joint stiffness, while reduced movement leads to increased inflammation. Barometric changes can also make joints feel swollen or tender.
Fibromyalgia
Individuals with fibromyalgia often report heightened sensitivity to cold. Cold weather can trigger widespread pain, fatigue, and cognitive "fog." Low light levels in winter also contribute to fatigue and worsening mood symptoms.
Neuropathy and Other Pain Disorders
Those with diabetic neuropathy or post-herpetic neuralgia often feel increased tingling, burning, or electric-like sensations in winter. Nerves already under stress may respond poorly to decreased circulation and ambient cold.
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The Psychological Impact of Winter on Pain
Pain is not purely physical—it is closely tied to emotional and psychological wellbeing. In winter, these links become more apparent.
Seasonal Affective Disorder (SAD)
SAD affects many people in winter, especially in areas with limited daylight. The drop in sunlight exposure can lower serotonin levels, leading to symptoms of depression. Depression and pain have a bidirectional relationship—low mood can heighten pain perception, and persistent pain can worsen emotional health.
Isolation and Reduced Motivation
Winter months often lead to more time indoors, social isolation, and disrupted routines. This reduced engagement can heighten focus on physical discomfort, increase anxiety, and worsen pain.
Tips for Managing Chronic Pain During Winter
The good news? There’s a lot you can do—right now—to feel better.
Staying Active Indoors
Movement is essential to managing chronic pain. Gentle, low-impact exercises:
- Improve circulation
- Reduce stiffness
- Boost mood through endorphin release
Try:
- Yoga or tai chi for flexibility and relaxation
- Stretching routines for morning stiffness
- Short indoor walks or walking on the spot or step counters to stay motivated
- Online classes tailored to chronic pain management like Limber Movement Therapy
Dressing Warmly and Layering Techniques
Protecting vulnerable areas (neck, lower back, knees, hands) from cold exposure can significantly reduce muscular guarding and joint pain.
- Use thermal layers and moisture-wicking fabrics
- Cover extremities with gloves, scarves, and warm socks
- Use heat pads or warm compresses on flare-up zones
Home Heating and Humidity
Dry air and cold surfaces contribute to stiffness.
- Maintain comfortable indoor temperatures
- Use a humidifier to keep air moist and protect joints from drying out
- Consider heated mattress pads or electric blankets to reduce nighttime pain
Diet and Hydration Tips
Dehydration and poor nutrition can worsen inflammation and fatigue.
- Drink warm herbal teas and maintain hydration, even if you're not sweating
- Eat a Mediterranean-style anti-inflammatory diet rich in:
- Omega-3s (e.g., salmon, chia seeds)
- Leafy greens and colourful vegetables
- Whole grains and legumes
- Avoid excessive sugar, alcohol, and processed foods that increase inflammation
Supplementation
Ask your healthcare provider about:
- Vitamin D3 (often deficient in winter)
- Magnesium and omega-3 fatty acids
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Natural anti-inflammatories like curcumin and ginger
When to Seek Professional Help
It's normal for chronic pain to fluctuate with the seasons, but persistent or worsening pain may signal a more serious issue.
You should seek professional input if:
- Pain flare-ups are suddenly more severe or longer-lasting
- You experience new neurological symptoms (numbness, weakness, or balance problems)
- There’s swelling, redness, or warmth around joints
- Your mood has significantly worsened and affects your quality of life
- You are considering new medications or supplements
- Or just because you are worried. You know your body best, if you are worried, seek help
At The Pain Collective, our team of interventional pain specialists, therapists, and interdisciplinary team work together to tailor winter-specific pain management plans for our patients. We help you stay active, feel supported, and remain in control of your pain—even in the coldest months.
Conclusion
Winter can be a challenging season for people living with chronic pain—but it doesn’t have to be a season of suffering.
By understanding how cold weather affects your body, and by implementing small but consistent strategies around movement, warmth, diet, and mental health, you can minimise winter pain flare-ups and regain comfort.
If your pain feels unmanageable or unfamiliar, don’t wait. Reach out to a team who understands the complexity of chronic pain—whatever the season.
FAQs
1. How does cold weather affect chronic pain?
Cold weather can reduce blood flow, increase joint stiffness, and heighten nerve sensitivity. Lower temperatures also lead to reduced activity, which worsens inflammation and pain.
2. Why does my arthritis hurt more in the winter?
Joint tissues may expand slightly with pressure changes, and cold air tightens muscles. This combination makes arthritic joints feel more swollen, stiff, and painful.
3. What are the best ways to relieve pain in winter?
Stay warm, keep moving with low-impact exercise, use indoor heating and humidifiers, eat anti-inflammatory foods, and manage stress or mood changes.
4. Can cold weather trigger fibromyalgia flare-ups?
Yes. People with fibromyalgia often report cold sensitivity and worsening symptoms in winter, especially when combined with low mood or reduced sunlight.
5. Should I change my medication in winter?
You should never change medications without consulting your doctor. However, some adjustments (e.g., vitamin D supplementation or physical therapy) may be helpful seasonally.
About the Author
Dr Willem Adriaan Liebenberg, MBChB, MMed (Neurosurgery), FCS (Neurosurg) SA.
Dr Liebenberg is a neurosurgeon and founder of The Pain Collective, a national network of interdisciplinary pain clinics across South Africa. With over 20 years of clinical experience, he specialises in minimally invasive spine care and holistic chronic pain management. He is also Director of The Health Collective and a Council Member of PainSA.