Winter Wellness: Managing Arthritis and Joint Pain in Winter - A Physio’s Guide

5 June

When winter arrives, people living with arthritis may notice their joints feel stiffer, sorer, or harder to get moving. If that sounds familiar, you’re not imagining it.

While research hasn’t identified a single direct cause linking cold weather to arthritis flares, studies suggest that factors such as temperature changes, shifts in barometric pressure, reduced physical activity, and changes in sleep patterns may influence pain sensitivity and joint stiffness (Arthritis Australia, 2023; Kolasinski et al., 2020).

The good news? There are practical, evidence-based strategies that can help you stay mobile and comfortable through winter - and physiotherapy plays a key role in that plan.

Why Do Joints Feel Worse in Winter?

Winter often changes our daily habits. We may tend to move less, spend more time indoors, and sit for longer periods. Colder temperatures can also make muscles and soft tissues feel tighter, while reduced sunlight may affect mood and energy levels (Arthritis Australia, 2023). For people living with osteoarthritis (OA), these changes may worsen symptoms.

Osteoarthritis involves degeneration of joint cartilage and changes in surrounding tissues, which can lead to stiffness, particularly after periods of rest or inactivity (Australian Commission on Safety and Quality in Health Care [ACSQHC], 2024). That’s why many people with arthritis notice their joints feel stiff first thing in the morning or after sitting for long periods. When winter reduces activity levels, stiffness can increase - creating a cycle of moving less and feeling worse.

Movement Is Medicine (Even in Winter)

One of the most important messages in arthritis care is simple:

- Movement helps joints.

Australian clinical guidelines consistently recommend exercise as a first-line treatment for knee and hip osteoarthritis, ahead of many passive treatments (The Royal Australian College of General Practitioners, 2018; Kolasinski et al., 2020).

Regular movement helps by:

Reducing joint stiffness

Strengthening muscles that support joints

Improving mobility and balance

Supporting long-term joint function

A physiotherapist or exercise physiologist may recommend a tailored program that includes:

Low-impact aerobic exercise such as walking, cycling, or swimming

Strength training targeting key muscle groups like the quadriceps and glutes

Range-of-motion exercises to maintain joint mobility

Balance exercises to reduce fall risk

Research consistently shows that structured exercise programs can reduce pain and improve function for people with osteoarthritis (Kolasinski et al., 2020). The key is finding exercises that are appropriate for your body and sustainable long-term.

Warmth Helps - Use It Strategically

Cold muscles and joints can feel stiffer, especially first thing in the morning. Heat therapy can help ease this stiffness by:

Increasing blood flow

Reducing muscle guarding

Improving comfort before movement

Clinical guidelines suggest that heat can be a helpful adjunct strategy for symptom relief alongside exercise and activity (RACGP, 2018).

Simple winter strategies include:

• Taking a warm shower before activity

• Using a heat pack on stiff joints before exercise

• Wearing layered clothing to keep joints warm

• Gradually warming up before longer walks or activity

Heat doesn’t treat the underlying arthritis itself - but it can make movement more comfortable, which supports better long-term outcomes.

Strength Protects Joints

Muscle strength plays a crucial role in protecting joints. When muscles are weak, joints are exposed to higher mechanical loads during everyday activities like walking, standing, and climbing stairs. This is particularly important for knee osteoarthritis, where weakness in the quadriceps muscles is strongly linked to worse pain and functional limitations (ACSQHC, 2024). Australian care standards emphasise the importance of individualised strengthening programs guided by trained clinicians (ACSQHC, 2024).

Examples of helpful strengthening exercises include:

Sit-to-stand practice

Step-ups

Resistance band exercises

Controlled squats

Winter can actually be an ideal time to focus on structured indoor strength training, helping build resilience around affected joints.

Weight Management and Joint Load

For people with knee osteoarthritis, body weight can significantly influence joint loading. Research suggests that for every ~0.45 kg (1 lb) of weight lost, knee joint load during walking decreases by approximately 1.8 kg (4 lb) per step (Messier et al., 2005). Over the course of thousands of daily steps, this reduction can meaningfully decrease stress on the joint.

Winter routines, such as reduced activity or comfort eating, can sometimes lead to weight gain, which may worsen symptoms. If weight management is relevant, physiotherapists can often work collaboratively with GPs and dietitians to support a sustainable approach.

Pacing and Managing Flare-Ups

Arthritis symptoms naturally fluctuate, and winter may increase the likelihood of temporary flare-ups. When pain increases, the instinct can be to stop activity completely. However, long periods of rest can worsen stiffness and deconditioning.

Instead, clinicians often recommend pacing strategies, such as:

Temporarily reducing activity intensity

Continuing gentle movement

Gradually building activity back up as symptoms settle

Guidelines strongly emphasise ongoing activity and self-management, rather than prolonged rest or over-reliance on medication (ACSQHC, 2024).

When Should You See a Physiotherapist?

It may be helpful to seek physiotherapy advice if:

Winter stiffness is lasting longer than usual

Pain is limiting your daily activity

Your mobility is declining

You’re unsure what exercises are safe

Early support can help you maintain activity levels, reduce pain, and prevent long-term decline in function.

The Winter Takeaway

Cold weather may increase joint stiffness, but it doesn’t have to stop you from staying active.

The most effective winter strategy isn’t complete rest. It’s:

✔ Staying active

✔ Keeping joints warm

✔ Strengthening muscles regularly

✔ Managing flare-ups with confidence

With the right physiotherapy guidance, winter can be a season of maintaining strength and independence, not losing it. Contact your local physiotherapist today to get started.

References

Arthritis Australia. (2023). How cold weather impacts arthritis. https://www.arthritis.org.au/arthritis/arthritis-insights/living-well-with-arthritis/how-cold-weather-impacts-arthritis/

Australian Commission on Safety and Quality in Health Care. (2024). Osteoarthritis of the knee clinical care standard. https://www.safetyandquality.gov.au

Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L. F., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W., Hawker, G., Herzig, E., Kwoh, C. K., Nelson, A. E., Samuels, J., Scanzello, C., White, D., Wise, B., & Altman, R. (2020). 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care & Research, 72(2), 149–162. https://doi.org/10.1002/acr.24131

Messier, S. P., Gutekunst, D. J., Davis, C., & DeVita, P. (2005). Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis & Rheumatism, 52(7), 2026–2032. https://doi.org/10.1002/art.21139

The Royal Australian College of General Practitioners. (2018). Guideline for the management of knee and hip osteoarthritis (2nd ed.). https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/knee-and-hip-osteoarthritis

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