What You Need To Know about Living with Chronic Pain in the Winter

There are an estimated 100 million Americans living with chronic pain, which can be anything from having a general “bad back” to specific illnesses like endometriosis. The official time limit that determines if pain is chronic or acute is about 6 months, and depending on the person it can be constant or daily but not every minute of every day.

As you can imagine, living with chronic pain affects your life a lot. And while the exact effects can be different from person to person, those effects are also stronger in the winter for many people living in pain. A lot of chronic pain patients claim that they feel weather changes and/or they feel worse in the cold. I’m going to get into the science behind that shortly, but I can say that as someone with chronic pain that I fully believe them.

Before we really get into it, I want to clarify that this is a post for people who aren’t the ones with chronic pain but for people who know those with chronic pain. If you are a chronic pain patient, you might find this helpful – particularly the first section on on the science behind how winter affects living with chronic pain – but the primary audience isn’t pain patient themselves. You already know a lot of this stuff! (If you find it helpful, share this post with the people in your life.)

I am not a medical authority or professional. I include sources when applicable and I share my advice!

Is It True That Cold Weather Makes Pain Worse?

Anecdotally? Sure! And that’s not news; people have been saying it for probably millennia. But it isn’t necessarily true for everyone. For me personally, it’s not about the cold itself but instead big changes in temperatures, like if the high temp for the day drops 30 degrees from one day to the next. But for plenty of other people, it is cold weather specifically that makes their pain worse.

How about scientific answers?

Dr. Chakour, an orthopedic surgery at at University of Chicago, says, “There is no one explanation for why dropping temperatures affect your joints. One theory relates to drops in barometric pressure, which cause tendons, muscles and the surrounding tissues to expand. Because of the confined space within the body, this can cause pain, especially in joints affected by arthritis” (x).

But scientific studies aren’t clear.

One 2012 study decided “weather influences rheumatic pain in middle aged patients” (x).

A 2014 study said “Temperature, relative humidity, air pressure, wind direction, and precipitation showed no association with onset of back pain” (x).

A 2013 Swedish study determined there’s “an increased risk of developing low back and neck pain with decreased outdoor temperature” (x).

A different 2013 study said, “There is more evidence against than in support of a uniform influence of weather on daily pain and fatigue in female patients with fibromyalgia. Although individuals appear to be differentially sensitive to certain weather conditions, there is no indication that specific patient characteristics play a role in weather sensitivity” (x).

To me, it basically looks like the scientific community can’t decide on a one-size-fits-all answer on cold weather affecting pain within specific conditions – ie rheumatoid arthritis patients – let alone whether cold weather affects chronic pain patients in general.

At the end of the day, though, whether the scientific community agrees that temperature changes affect my pain doesn’t change the fact that I am in more pain when there are big temperature drops. They can argue all they like – they don’t have to live in my body! If they did, they would know the truth.

That being said, let’s get into what you should know.

What is the difference between osteoarthritis and rheumatoid arthritis?

What You Need To Know about Living with Chronic Pain in the Winter

Living with chronic pain is already trickier than most people understand. But it can be even trickier in the winter for a couple of reasons. Some of these might be familiar to you, depending on how close you are to people with chronic pain. But some of these might be surprising! I hope this helps you understand what we’re dealing with. To cover as much as possible, I’ve asked other chronic pain patients for how chronic pain affects them in the winter, and I’ve included those answers here.

Living with pain is not straight forward, and it varies from person to person – Every day is not the same. One day (or hour, even) we’re walking down the street completely fine, and the next we can hardly get out of bed. Sometimes we know exactly why it happens, and other times we have no idea. Plenty of times, I learn that we will have temperatures jumping or dropping because I feel bad and then I check the weather.

But while I respond generally the same to weather changes, it’s never exactly the same. For example, if our temperatures slowly drop over a week or two, I’ll feel fine, especially compared to if they drop a lot from one day to the next.

Beyond that, how winter weather affects pain patients varies depending on the cause for the pain. How I, an arthritis patient, react to winter weather is different from someone with nerve pain. To illustrate that, I’ve asked some other chronic pain patients to share how cold weather impacts them.

Alexa from Love, Alexa lives with chronic pain from a traumatic brain injury. For her, “Cold weather tends to give me goosebumps and with that comes excruciating pain. Goosebumps give me the feeling of wanting to rip my skin off and that is never fun for anyone” (x). So getting goosebumps itself causes nerve pain, but goosebumps are a body’s automatic reaction to the cold. There’s not much you can do about that other than staying warm!

Laura from Creating Your Own Sunshine explains that “When you have Raynaud’s disease and you get cold, your body has an overreaction to it and your blood vessels restrict more than they need to. This can be painful or at the very least very uncomfortable” (x). Plus, “Toes and fingers are the most commonly affected and they can change colour to white or blue and become very numb and stiff!” (x). In this case, even if you’re nice and toasty in your house, if you go outside and get cold, your body is going to react negatively.

Claire from Through the Fibro Fog also has Raynaud’s. She says, “When I warm back up [from being cold] the blood returns to my fingers and toes, which causes pain, throbbing and a hot feeling” (x). That cold-warm transition does not sound fun. She also says, “Come winter it feels as though everything will affect my circulation and lead to unhappy fingers and toes. While I have the heating on at home I can still get an attack, and sometimes have no idea what sets it off” (x).

Pain affects how much energy we have in a day – It takes a lot of energy to be in pain all the time, and doing normal things takes more out of us than it does for a healthy person. So if we’re someone who has worse pain in the winter, the winter might also be tough for us energy-wise. I’m sharing this not only because you should know it but also because it’s so important to actually rest when you take breaks.

When I make plans, I factor in the needed rest time as well as blocking off the time that I’ll be at the event itself. For example, pre-COVID-19, my sister visted Boston. We as a family planned to go out to dinner the Saturday she was here, so when my parents and sister took the dogs to Castle Island that afternoon, I stayed home and rested so that I would be okay to go out to dinner. I needed to make sure that I wasn’t just sitting on the couch working on this blog; I needed to fully rest so I could hold onto as much mental and physical energy as possible.

While I feel fatigue because of pain that can be caused by winter weather, other people feel fatigue more directly from being cold.

Pippa from the blog Life of Pippa has ME/CFS, and she says, “Once I feel cold, it’s as though my entire system begins to shut down. My muscles and joints seize up, every one of my movements slow down, I struggle to form coherent thoughts and find the strength to voice them, even my eyes and ears seem to function at a reduced level. And once that sensation has begun, it takes hours or even days of endurance before things begin to ease; even with the temperature on full blast and wrapped in approximately 37552974 blankets.” (x).

Leah from A Pain in the Butt has chronic nerve pain from surviving cancer. She says, “The whole winter basically becomes one big flare up I seriously struggle with staying active and being social, i cant do much at the best of times but the cold literally zaps all my pain tolerance and energy because i have to work even harder to complete the simplest of tasks like getting dressed or having a bath” (x).

How is chronic pain different from acute pain?

We hate how our pain affects our lives (and yours) – I hate that I often have to cancel plans, and even more so if that means that they’re with you or you’re affected by them. I am not doing things like that without caring about how it affects you – truly. So please don’t take it personally if I cancel or am hesitant to make plans. But I have to mentally juggle so much in my life. There’s work and there are all the things I need to do to manage my health and then there’s fun. It often feels like I spend all my time managing my illnesses and pain.

I’m sharing all of this not so you feel sorry for me or the pain patient in your life. I’m sharing it so that you understand that what we’re going through. If it helps, earlier this year I shared what a day in my life is like as a chronic illness/pain patient and as a part-time blogger. I’m fully aware that my life is not normal and it absolutely sucks. Honestly, I try not to think about it too much, but it’s hard not to when you’re making small talk at a holiday party and someone asks what you’ve been up to lately. And even if in-person parties don’t happen this year, the same sort of thing happens in holiday phone calls or when you see holiday cards with family updates.

So someone you know was diagnosed with inflammatory arthritis

We don’t always get a heads up that the weather is going to turn – Sometimes, we know days in advance that there’s going to be freezing rain because the barometric pressure changes. Sometimes, we find out when we wake up the morning of the rain because our pain is so much worse. This applies to people like me who are sensitive to barometric pressure, as since we react to the pressure changes in general, if the pressure doesn’t change until the day of the bad weather we won’t have a heads up. Of course, sometimes we do! But just because something happens sometimes doesn’t mean that it’s like that always.

Sarah from My Migraine Life is someone else who reacts to barometric pressure changes, as she has migraines. She says, “I feel like a human barometer most days feeling it increase and decrease” (x). But she also says that “I have no ideas on how to even prepare for the swings when I know it is coming,” as her migraines can be triggered by so many things that she would constantly be taking her trigger medicine (x).

But if the person you know reacts to cold itself and not the changing weather, they might not always know that they’re going to have problems. Personally, when I look at the weather for a week, I’m not looking at the hourly temperature predictions but at the high and low temperatures and what type of weather is expected. Some days, the temperature is its highest earlier in the day and then it drops over the course of the day. If you know someone who reacts to cold weather itself, don’t be mad at them if they suddenly feel worse because they didn’t realize it would be cold in the afternoon so they didn’t bring a sweater. While it’s easy to be mad at someone for a choice they made, we do a lot to try to manage our pain and stay on top of it. We’re not going to be on top of it 100% of time!

Slipping and falling can be so much worse for us – First and foremost, if we struggle to walk and use something like crutches, there’s a high chance we could fall. I speak with a lot of experience – I spent all of December 2004 on crutches after my first ankle surgery; most of January, all of February, and most of March 2006 on them before and after another foot surgery; and all of January through February 2009 on crutches due to another foot surgery. While living in Maine, which has a way more intense winter than even Boston. So I’m an expert on telling you that it’s tricky using crutches on icy ground.

Plus, while anyone can break their wrist by slipping and falling on ice, we might be more likely to break it. For example, if we have osteoporosis – something I’ll have very early due to long-time steroid use, but that’s a conversation for another day – we are more likely to break a wrist. And even if we don’t break our wrist, we might feel a fall way worse than someone without our condition, as a fall could also trigger a flare of our condition.

Basically, falls and injuries are very likely to cause bigger problems for us than for someone without chronic pain.

What to do when chronic pain becomes too much

Now that we’ve talked about different ways our lives are affected by chronic pain in the winter, let’s talk about how you can help us.

What You Can Do for Us This Winter

Keep inviting us to things – Even if we can’t go, and you know we can’t go, we like to be invited. So keep inviting us to your events and don’t assume that we can’t go because we usually can’t. Personally, the fact that most things have shifted to be virtual now actually means that I can attend more than I could pre-COVID-19! I’m not spending the time commuting from place to place, which means more energy for me.

At the same time, though, please don’t take it personally if we decline events. Unless you are a jackass, declining invitations isn’t about you, and we don’t want to spend our valuable time convincing you about that.

But don’t assume that because you’ve invited us to a virtual event we can go – Yes, I am more likely able to attend if an event is virtual. But that doesn’t change the fact that I feel worse at the end of the day and am generally unable to attend anything that is in the evening. I think that people are starting to understand the idea of “Zoom fatigue,” which is something that many people experienced at the beginning of the pandemic when suddenly everything was virtual. Basically, it’s fatigue from constant video calls, both for work and for your personal life. If you experience(d) Zoom fatigue, imagine feeling that as well as fatigue from just existing, which is what chronic pain patients experience.

Offer specific ways to help us (bring dinner, run errands, etc.) – If you just say, “Let me know how I can help!” we may feel uncomfortable asking for things. We don’t know if you actually mean it or if you’re just saying it. Offering specific ways you can help makes it more likely for us to accept your help. And this is especially true if you know someone with a suppressed immune system. I truly don’t feel safe leaving my apartment when I’m in Boston, which means that I’m relying on my parents to do grocery shopping and pick up my prescriptions. So one thing you could offer to do is pick up things that we might need.

Another specific way you can help is to keep us supplied with things that keep us warm if you know someone whose pain is affected by the cold itself. This, of course, depends on the person; while cold weather drops make my pain worse, I love being cold due to POTS. Alternatively, if you live with someone who has worse pain in the cold, don’t use our things that help us stay warm!

Don’t automatically suggest things you’ve read about helping with chronic pain – I have been in pain since 2001 and goodness gracious do people assume they have the magical tool that will make my pain better and that I haven’t heard about it or tried it. I have. Trust me. It’s gotten so bad that I get annoyed when people suggest things that I actively use that do help me! It’s the presumption that gets me.

Don’t rely on us for information just because we have a condition – I am very aware that this is a confusing juxtaposition with the previous point! But what I’m saying is you shouldn’t assume that because I have arthritis I know everything about arthritis. You have Google! If you’re wondering something about a condition we have, instead of waiting until you’re on a holiday video call to ask us about it or texting us to ask, Google it.

Now, going back to the previous point, you shouldn’t come to me assuming that because you read about meditation helping pain you think that I should know about it aka you think that I haven’t heard about that. And if you’re having a conversation with us and you think of a question, feel free to ask! But I am only an expert on rheumatoid arthritis, and really I have a PhD in my personal RA experience and not another person’s experience. Google is your friend!

What do you want to know about living with chronic pain?

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And if you like this post, and want to read more, check out:

What Does Arthritis Pain Feel Like?, Describing Pain Levels to a Doctor, Answering Questions about Being Chronically Ill, What You Need To Know about Arthritis