Examining the Influence of Weather on Low Back Pain, Knee OA

Weather changes
Weather changes
Weather conditions generally do not influence pain.

Two studies published in December 2016 suggest that weather conditions generally do not influence pain, despite a long-held public perception to the contrary.

In a study reported in Pain Medicine, researchers at Macquarie University and the University of Sydney in Australia investigated the link between weather parameters and low back pain (LBP).1 Up to 20% of the global population will experience LBP, and its causes are numerous.2

Anecdotal reports from patients suggest that certain weather conditions may have an impact on their pain symptoms.3 When a study published in 2014 showed no evidence of this association for LBP, many people expressed doubt regarding the results via social media.4 This prompted the investigators to attempt to replicate the findings in a new set of patients.1 

The sample consisted of 981 patients across 235 primary care clinics with a new episode of acute LBP. The authors used a case-crossover design to examine whether the risk of experiencing these episodes was associated with precipitation, humidity, wind speed, wind gust, wind direction, temperature, and/or air pressure.  

In line with the earlier findings, the results show that weather conditions and changes in the weather do not influence LBP risk. Though higher temperature was found to have a marginally significant association with LBP onset (odds ratio, 1.20; 95% CI, 1.01-1.42; P =.03 for an increase of 5°C), the authors note that it was not clinically important.

Another case-crossover study published in Osteoarthritis and Cartilage revealed similar results pertaining to the exacerbation of knee pain in 345 participants with diagnosed knee osteoarthritis (OA).5 As with patients who suffer from other types of pain, this population has also reported pain exacerbation due to weather conditions.6

The researchers compared patients’ web-based reports of knee pain exacerbation (defined as an increase of ≥2 on a scale of 0 to 10 from their mildest baseline pain level) with changes in the following weather parameters: temperature, humidity, barometric pressure, and precipitation. In the 171 participants who reported at least 1 episode of knee pain exacerbation during the 3-month study period, no link was observed between the risk of exacerbation and weather changes.

Consistent with previous findings, these results suggest that weather conditions do not affect pain symptoms in patients with LBP and OA. Authors of both studies state that future investigation should examine regions with more extreme climates, as different results may be observed in such locations.

Summary and Clinical Applicability

In line with earlier research findings, 2 new studies found no association between pain and weather conditions for LBP and knee osteoarthritis.


The LBP findings may not generalize to patients with other pain conditions. In addition, variables such as time spent indoors or outdoors and exposure to heating or cooling systems should be explored, as well as regions with more extreme weather conditions. 

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  1. Beilken K, Hancock MJ, Maher CGLi Q, Steffens D. Acute low back pain? Do not blame the weather — a case-crossover study [published online December 15, 2016]. Pain Med. pii: pnw126
  2. Meucci RD, Fassa AG, Faria NM. Prevalence of chronic low back pain: systematic review. Rev Saude Publica. 2015;49:1.
  3. Smedslund G, Mowinckel P, Heiberg T, Kvien TK, Hagen KB. Does the weather really matter? A cohort study of influences of weather and solar conditions on daily variations of joint pain in patients with rheumatoid arthritis. Arthritis Rheum. 2009;61(9):1243-1247.
  4. Steffens D, Maher CG, Li Q, et al. Effect of weather on back pain: results from a case-crossover study. Arthritis Care Res. 2014;66(12):1867-1872.
  5. Ferreira ML, Zhang Y, Metcalf B, et al. The influence of weather on the risk of pain exacerbation in patients with knee osteoarthritis – a case-crossover study. Osteoarthritis Cartilage. 2016;24(12):2042-2047.
  6. Ng J, Scott D, Taneja A, Gow P, Gosai A. Weather changes and pain in rheumatology patients. APLAR Journal of Rheumatology. 2004;7:204-206.