Back pain in cold weather: why it happens and how to manage

Many people notice their backs feel stiff or achy on cold mornings and it’s no coincidence. Cold weather can make muscles feel tighter and joints feel less flexible. If you already have a chronic condition like arthritis or a previous back injury, you may notice the discomfort even more.

“Cold weather can affect your spine and the muscles that support it in ways that increase stiffness and pain,” says Scott Loving, PT, DPT, a physical therapist at Hinge Health.

While cold weather can make it harder to get outside and stay active, it doesn’t have to mean months of discomfort or limited mobility. Staying active is one of the best ways to combat back pain in cold weather.

“Movement helps keep joints and muscles working smoothly,” says Dr. Loving. “When you stay active, it helps reduce stiffness and ease pain all year long.”

Here’s a closer look at why back pain can worsen in cold weather — and what you can do to manage it with simple lifestyle changes and exercises recommended by Hinge Health physical therapists.

Why back pain gets worse in cold weather 

To be clear, cooler temperatures don’t directly cause structural problems in your spine. But they can amplify symptoms of underlying conditions and make the muscles around your back feel less flexible or supportive. Think of your muscles like a rubber band in the cold: they aren’t as elastic or stretchy. 

Several factors can contribute to back stiffness and discomfort during colder months, including:

• Muscle tightness from cold temperatures. When your body gets cold, muscles naturally tighten to conserve heat. Tight muscles are less flexible and can make your back feel stiff or sore. “When muscles stay tight for long periods, they can become fatigued and more prone to spasms,” says Dr. Loving. For people with arthritis in the back, herniated discs, or previous back injuries, that extra muscle tension can place more pressure on already sensitive areas of the spine.

• Reduced circulation. Cold temperatures can slow circulation, or blood flow, to your muscles and joints. When soft tissues and structures receive less blood flow, they may feel stiffer and more sensitive to movement. This can also make existing conditions like arthritis or previously injured areas feel more sensitive.

• Less movement and physical activity. Winter often changes our routines. Shorter days, colder temperatures, and icy sidewalks can lead to fewer walks and more time sitting indoors. The more you move, the stronger your spinal support muscles will be, which can also help prevent back pain. 

• Changes in posture. Many people naturally round their shoulders or tense their bodies when they feel cold, Dr. Loving says. Staying in this posture for extended periods of time can place extra strain on the muscles in your neck and back. If you already have arthritis or have experienced a back injury in the past, that added tension may aggravate symptoms.

• Changes in barometric pressure. Some research suggests that shifts in atmospheric pressure — which often happen before winter weather arrives — may affect how sensitive joints and tissues feel all across your body. For people with arthritis or previous injuries, these pressure changes may make discomfort more noticeable.

Symptoms of back pain in cold weather

Back pain in cold weather can show up in several ways. While it can affect anyone, it tends to be more common in people with arthritis, previous back injuries, or chronic back conditions.

Common symptoms include:

• Stiffness

• Muscle tightness

• Dull or aching pain

• Muscle spasms

• Numbness or tingling if a nerve (such as your sciatic nerve) becomes irritated

How movement can help ease back pain in cold weather

It can feel counterintuitive to move your body when your back hurts. But movement is medicine: gentle activity helps ease discomfort and prevent flare-ups. It helps counter cold-weather effects by increasing blood flow to back muscles, maintaining flexibility, and keeping supporting muscles strong and warm. 

Of course, winter conditions can make staying active a bit more challenging. Shorter days, colder temperatures, and icy sidewalks can all affect your energy levels and motivation to move. The key is to make modifications so you can move more comfortably and safely amid winter conditions and elements. 

In addition, doing targeted exercises that support your mobility and improve both posture and strength can help your back tolerate cold-weather stiffness more comfortably.

These exercises — standing forward bend, standing side bend, back rotation stretch, and standing wall back extension — are gentle ways to warm up your back and surrounding muscles. They help improve circulation, reduce stiffness, and maintain flexibility during colder months. Moves like downward dog also strengthen the muscles that support your spine, which can help reduce strain on your lower back and ease symptoms from conditions like arthritis that may flare up in cold weather.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for back pain in cold weather

Winter back pain doesn’t have to limit your daily life. A combination of movement, heat therapy, and small activity adjustments can help keep symptoms manageable. These strategies recommended by Hinge Health physical therapists include: 

• Try physical therapy and targeted exercises. Targeted exercises, like the ones above,  can help improve mobility and flexibility in the muscles supporting your spine, which can help them build resilience amid temperature changes. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. Targeted exercises are designed to help with recovery, but any type of movement — like walking, stretching, or even household chores — can improve blood flow to the soft tissues and structures in your back. Note: If you have a back condition or have experienced a back injury in the past, it’s always a good idea to check in with your provider or a licensed physical therapist before starting any new exercise program.

• Pace your activities. Modify activities that trigger pain. If winter sports like skiing, ice skating, and snowboarding aggravate symptoms, break up activity into shorter sessions. Similarly, if you like to run outdoors, you may have to use a treadmill or opt for indoor cross-training activities like stationary cycling. “Modify your winter expectations,” says Dr. Loving. “Maybe you won’t go as far or as fast, but the important thing is you’re still moving.”

• Apply heat therapy. “Heat can help soothe stiff muscles and increase oxygen-rich blood flow to tense areas, which supports healing and eases pain,” Dr. Loving says. Consider taking a warm shower or applying a heating pad to your back when your muscles are feeling stiff or after being outside in the cold. 

• Take over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have back pain. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• Prioritize nutrition. Eating a balanced, nutrient-rich diet supports your body’s natural healing processes. Focus on foods like fruits, vegetables, fatty fish, nuts, seeds, and whole grains. These foods help reduce inflammation and offer nutrients that support tissue repair, such as omega-3 fatty acids and vitamins C and D. For individualized guidance, consider working with a registered dietitian.

• Make lifestyle modifications. Factors like sleep, stress, nutrition, and certain activities can all play a role in how you feel. In fact, many people are surprised to learn that pain isn’t just about what’s happening physically — your daily habits and overall well-being can have a real impact, too. Staying curious about how your routines affect your muscles and joints can help you identify where small changes might help reduce pain. For example, you might notice your pain is less noticeable on low-stress days.

• Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for back pain relief, such as massage, acupuncture, or chiropractic care.

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce back pain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

Tips to prevent back pain in cold weather

You don’t have to suffer from back pain during the winter or hibernate indoors until spring. While you can’t always prevent back pain, you can take approaches to help ease discomfort. Follow these practical tips to help keep your muscles warm and flexible during cold weather.

• Maintain your exercise routine year-round. Don’t let winter stop your movement habits. Staying active year-round helps reduce stiffness and keeps your back strong. Consider working out with friends to help you stay accountable and get your mind off the cooler temperatures. 

• Warm up before outdoor activities. Before shoveling snow, playing winter sports, or even just walking outside, it’s important to do dynamic stretches indoors to help warm your muscles and prepare them for activity. “No matter the season, you should always try to warm up enough so that you begin to sweat,” says Dr. Loving. “That’s a good sign that your body is ready for activity.” 

• Create an indoor movement routine. Having backup options — like home workouts or gym sessions — helps you stay consistent with physical activity even when outdoor conditions aren’t ideal.

• Pay attention to winter posture. Notice if you’re hiking up your shoulders toward your ears amid cooler temperatures. Try to relax your shoulders and maintain a neutral posture so you can stay comfortable. 

• Stay hydrated. People often drink less water in wintertime, but hydration remains important for disc health and muscle function year-round. Cold, dry winter air, combined with indoor heating, reduces your body’s moisture — leading to stiff muscles, increased joint friction, and increased risk of injury. 

• Wear layers. When braving the elements, keep your core and back warm to prevent muscle tightening that can contribute to back pain. Wearing layers that conserve your body heat can make a noticeable difference when spending time outdoors.

PT tip: Breathe away muscle tension  

Cold weather can trigger an instinctive response: many people hold their breath or tense their shoulders when stepping into cold air. “Shallow breathing can increase muscle tension,” says Dr. Loving. 

Instead, try diaphragmatic breathing — slowly inhaling through your nose and letting your belly expand as you breathe in. This can help relax your body, reduce tension in the neck and back, and warm the air before it reaches your lungs. As you breathe, check your posture too. If your shoulders have crept up toward your ears, gently let them drop and relax.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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2. Fitness, & Diseases, L. H. and. (n.d.). Tips for Outdoor Exercise in Cold Temperatures. Www.lung.org. https://www.lung.org/blog/outdoor-exercise-winter

3. Wang, L., Xu, Q., Chen, Y., Zhu, Z., & Cao, Y. (2023). Associations between weather conditions and osteoarthritis pain: a systematic review and meta-analysis. Annals of Medicine, 55(1). doi:10.1080/07853890.2023.2196439

4. Low back pain: Why movement is so important for back pain. (2019). In www.ncbi.nlm.nih.gov. Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK284944/

5. Lewis, C., Albin Stjernbrandt, & Jens Wahlström. (2023). The association between cold exposure and musculoskeletal disorders: a prospective population-based study. International Archives of Occupational and Environmental Health, 96(4), 565–575. doi:10.1007/s00420-022-01949-2