Why Does My Knee Hurt When It’s Cold? | 3 Potential Causes

Written By on September 5, 2022 — Medically Reviewed By Mich Torres (PT)

Written by on — Medically Reviewed By: Mich Torres (PT)

a person holding their knee while in winter clothes.

As a physical therapist, patients with bad knees often ask me: “Why does my knee hurt when it’s cold?” Well, there are 3 plausible causes for this bizarre phenomenon.

They have to do with joint fluid consistency, inactivity, and changes in atmospheric pressure. We’ll discuss each one in-depth, along with tips to manage this weirdly specific type of knee pain.

These are the topics covered, tap any of the bullets below to easily navigate through the contents:

3 Reasons for knee joint pain during cold weather

The following scenarios can worsen the symptoms in your sore and achy knees during colder months:

1) Drop in barometric pressure

anatomical image of a knee joint plus its surrounding capsule.

This is also known as “atmospheric pressure.” It’s basically the weight of the air around us and it can change depending on the temperature.



When the barometric pressure plummets down – like when a storm is coming -, the natural gasses inside our knees expand. This increases the pressure inside the joint. (1)

This doesn’t cause problems in healthy knees. But for those with injury, the increased pressure irritates the tissues and can make your joints ache, leading to pain in cold weather. (1)

2) Thickening of synovial fluid

Synovial fluid is a lubricating liquid inside our joints. It helps us move our limbs freely as it reduces friction between the end of our bones.

However, it can become more viscous and thicker during cold temperatures. (1) This often leads to stiff joints, which could ultimately contribute to knee pain.

3) Lack of activity

I know it’s tempting to remain indoors and binge-watch movies during cold weather conditions.

But the inactivity for long periods means we use our knee joints less often. This can stiffen them up and cause pain when we try to move.

3 Conditions that make you vulnerable to knee pain during cold weather

These are the most common knee injuries that can increase your risk of knee pain in colder climates:

1) Knee osteoarthritis

This is the wearing down of your knee cartilage. Knee osteoarthritis is considered an overuse injury, as the years of daily friction on the joint degenerate the tissues over time. The result is often knee pain and stiffness.

Now, cold weather thickens the synovial fluid. This stiffens the knee joint even more, increasing friction and causing more pain. (2)

2) Patellar tendonitis

This overuse injury affects the tendon between your kneecap and shin bone, causing pain and soreness in that area.

In theory, cold weather could also stiffen your tendons. This can make your patellar tendon less flexible, increasing your symptoms.

3) Runner’s knee

This is an overuse injury of the kneecap, caused by the excessive grinding of your kneecap on the lower end of your thigh bone.

Cold weather could increase the pain due to the drop in barometric pressure, as it could increase the pressure on your already irritated tissues.

5 Tips to manage knee pain during cold weather

Don’t let your painful knees stop you from enjoying the cold weather. Mix and match any of the tips below to maximize their effectiveness:

1) Use a heating pad

If the cold is making your knee joints hurt, then keeping them warm could improve the symptoms.

Just apply a heating pad to your knee for 20 minutes at a time to improve blood flow and ease your stiff joints. A warm water bag or bath can also do the trick if a heating pad isn’t available.

2) Wear a thermal knee sleeve

This is a wearable heating device that can relieve knee pain on the go. It can also act as additional joint support as its snug fit can enhance your sense of balance.

We recommend: The Cocoon Knee Flex Pro thermal sleeve.

3) Take painkillers

Pain medications offer a quick solution to numb the pain. Milder forms, like ibuprofen, are usually available over the counter. Stronger drugs require a doctor’s prescription.

There are also pain relieving ointments available. They may not be effective as oral medications, but they tend to also have fewer side effects. (3)

Learn more: What to take for knee pain?

4) Stay active

“Motion is lotion” is a common saying from us physical therapists. This means that movement helps keep your synovial fluid flowing, making your knee joint easier to move.

So, make it a habit to have a daily exercise routine – even with the cold weather. Squeezing in those 30-minute walks or exercises daily will do wonders for your joint health.

5) Stay hydrated

Water makes up most of our joint fluid and cartilage. So even though you sweat less when it’s cold, you need to keep up with your water intake to maintain healthy knees. (4, 5)

Research shows that the daily fluid average should be about 3000 mL for men and 2000 mL for women. (6)

Using a measured water jug or setting an hourly reminder on your phone are some ways to help you keep track.

For more tips: 8 easy ways to relieve knee pain in cold weather

FAQs

Does cold weather affect bad knees?

Yes, cold weather does affect bad knees.

How does colder weather affect my knee injury?

The colder weather can affect your knee injury by making your joints stiffer and a little more painful than in hot weather.

Why does my knee hurt when it’s cold?

Your knee can hurt when it’s cold because of a drop in barometric pressure, increased joint stiffness, and/or inactivity.

Conclusion: Why does my knee hurt with cold weather?

Experiencing knee pain in cold weather is mainly due to how your knee joint reacts to the cooler climate.

But any of the tips above will help you recover. However, if your knees hurt frequently or they affect your daily life, get them checked by a doctor or physical therapist.

Resources

  1. McAlindon, Tim et al. “Changes in barometric pressure and ambient temperature influence osteoarthritis pain.” The American journal of medicine vol. 120,5 (2007): 429-34. DOI: 10.1016/j.amjmed.2006.07.036
  2. Timmermans, Erik J et al. “The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis: Results from the European Project on OSteoArthritis.” The Journal of rheumatology vol. 42,10 (2015): 1885-92. DOI: 10.3899/jrheum.141594
  3. Cross, Pamela L et al. “TOIB Study. Are topical or oral ibuprofen equally effective for the treatment of chronic knee pain presenting in primary care: a randomised controlled trial with patient preference study. [ISRCTN79353052].” BMC musculoskeletal disorders vol. 6 55. 7 Nov. 2005, DOI: 10.1186/1471-2474-6-55
  4. LaPrade, Robert et al. ” Evidence-Based Management of Complex Knee Injuries.” Elsevier. 17 Dec 2020. https://www.sciencedirect.com/book/9780323713108/evidence-based-management-of-complex-knee-injuries
  5. Sophia Fox, Alice J et al. “The basic science of articular cartilage: structure, composition, and function.” Sports health vol. 1,6 (2009): 461-8. doi: 10.1177/1941738109350438
  6. Meinders, Arend-Jan, and Arend E Meinders. “Hoeveel water moeten we eigenlijk drinken?” [How much water do we really need to drink?]. Nederlands tijdschrift voor geneeskunde vol. 154 (2010): A1757. https://pubmed.ncbi.nlm.nih.gov/20356431/

Author
Paolo Sarmiento (PT)
Paolo is a physical therapist, educator and fitness enthusiast. He shares his knowledge and experience in helping people deal with health issues, especially with the knee. As health-conscious as he can be, he enjoys long bicycle rides, early morning runs, and a good slice of pizza with extra pepperoni.

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