- The temperature inside our muscles and joints varies far less even in extreme cold weather and is unlikely to be the direct source of our pain.
- Exercise can be very good for joint pain and this may be a significant contributing factor to people’s perception of their symptoms being better in the hot months and worse in the cold months.
- Many people feel generally sadder and less optimistic during the winter months. Mood can have a significant impact on pain, and, therefore, this could be another contributing factor to people’s symptoms.
We are in the depth of a wet and cold Kenyan ‘winter’. The temperatures have been low for almost a month. We see many patients every week and one of the common questions we hear at this time of year is ‘why does the cold weather make my pain worse?’
Many patients feel that the cold weather makes their joint and muscle pain worse, particularly knees, hips and lower back. Let us look at some of the science and the evidence to try and explain this phenomenon and give you some tips on how to deal with it.
The body has very efficient insulation. Our skin and subcutaneous fat layer protect the tissues and organs of the body from changes in temperature. The insulation is so effective that the inner core temperature of our bodies only varies to a very small level even with quite extreme external temperatures. This is to protect the body’s cells, which can only function and survive within a relatively narrow temperature range.
DOES THE COLD WEATHER CAUSE DAMAGE TO MY MUSCLES AND JOINTS?
The temperature in our extremities (arms and legs) may vary more than our core. However the depth of joints such as the knee and hip along with the warmth created from muscle activity means that these joints rarely suffer from injury directly from the cold. Almost all cases of direct tissue injury from extreme cold is to the toes and fingers (and nose) which can all get dangerously cold in extreme weather without the right protective clothing. The temperature inside our muscles and joints varies far less even in extreme cold weather and is unlikely to be the direct source of our pain.
Studies that have monitored the temperature changes in the bodies tissue just a centimetre below the surface of the skin show only minimal (less than 4c) changes of temperature after ice has been held on the surface of the skin for prolonged periods (Malanga 2015)
DOES THE COLD TEMPERATURE CAUSE PAIN?
Further to this discussion, if the outside cold temperature is the direct cause of pain, we would expect to see greater levels of reported musculoskeletal pain in colder countries and less in countries with warmer climate. Studies into global prevalence of pain show Australia, America, Spain and Mexico coming highest in overall levels of pain reporting whilst countries with a cooler climate such as Norway, Finland, Poland and the UK showing significantly lower levels of reported pains overall (GSK Global Pain Index 2017 Global Research Report).
SO, WHAT IS IT ABOUT COLDER WEATHER THAT MIGHT MAKE OUR PAINS WORSE?
A number of hypothesis have been put forward.
Cold weather makes people less active.
We know that during the hot months people generally become far more active. Lighter evenings and lighter mornings mean that people are much more likely to go out and exercise. We spend much more time outside and therefore everyone’s activity level tends to be greater. We know that exercise can be very good for joint pain and this may be a significant contributing factor to people’s perception of their symptoms being better in the hot months and worse in the cold months.
We know that the weather and the levels of daylight can have a significant impact on our mood. In most extreme cases, people can suffer seasonal affective disorder (SAD) which means that they suffer from depression during the cold months.
However, even without this, many people feel happier and more optimistic during the summer and they feel generally sadder and less optimistic during the winter months. We know that mood can have a significant impact on pain, and, therefore, this could be another contributing factor to people’s symptoms.