Back pain in winter, a fatal season for back pain?

Scientific perspectives: myth or reality?

In 2014, a team of Australian researchers published an important study aimed at assessing the relationship between weather conditions and the onset of lower back pain¹.  

Between October 2011 and Nov ember 2012, 993 patients suffering from acute lower back pain took part in this initiative. They were asked to tell the researchers the date on which their pain first occurred. At the same time, the researchers collected data from the Australian Bureau of Meteorology. They then compared the weather conditions at the time the patient first experienced pain with the weather conditions a week and then a month earlier.  

Their conclusions? There was no link between sudden, acute episodes of lower back pain and temperature, humidity, air pressure, wind direction or rainfall. Strong winds may have had a slight influence, but the study considered this effect to be relatively minor.  

In 2016, another team of researchers, again from Australia, studied the medical records of 1,604 patients to investigate the potential links between different weather conditions and the intensity of acute lower back pain².  

They recorded and rated the patients' pain on a scale of 0 to 10 every day for two weeks. By comparing this data with information collected from the Australian Bureau of Meteorology for the period in question, the researchers were unable to observe any relationship between weather conditions and pain intensity.  

They concluded: "Contrary to popular belief, the results showed that meteorological parameters such as precipitation, temperature, humidity and air pressure did not influence the intensity of pain reported by patients during an episode of acute low back pain."  

So why does this belief persist?  

In 2017, two new studies further challenged this long-held myth. The first compared the proportion of visits by patients covered by Medicare¹ (Medicare is a US federal programme that provides health coverage for people over 65 or with severe disabilities, regardless of their income) aged over 65 who consulted for joint or back pain on rainy days and days without rain³. The second, from 2016, compared the weather conditions on the day before the onset of pain, as well as their variation between two and one day before the episode in 981 patients⁴.  

Both studies reached the same conclusion: it is impossible to establish a link between the weather and the onset of lower back pain.  

Nevertheless, some researchers have put forward the hypothesis that the pain has a 'psychological' origin⁵. Others cite contextual reasons, such as reduced activity when the weather is bad6. It is inactivity, rather than cold and damp, that exacerbates the pain. The lack of a link with the weather seems less clear for chronic pain⁴, such as that associated with lumbar osteoarthritis. One thing is certain: the debate is far from over.  

Plausible physical mechanisms for winter aggravation

Although the link between weather and pain has not been scientifically proven, several indirect factors may explain why lower back pain seems to intensify in winter:

• Muscle tension and poor circulation⁷

Cold weather causes muscle contraction, vasoconstriction and joint stiffness, which can increase pain and stiffness.

• Reduced physical activity and loss of muscle tone⁶

In winter, we move less, which leads to a loss of muscle strength, deterioration in posture and an increased risk of back pain.

• Stress, mood and perception of pain^8,9

Lack of light, the festive season and fatigue can contribute to seasonal affective disorder. Stress or depression amplify the sensation of pain, including back pain.

• Specific winter activities

Snow removal, heavy lifting, and falls on ice are concrete factors in back injuries.

Verdict: is there really a link?

Directly (weather and pain) : weakly established. Scientific data does not reveal a systematic link.

Indirectly (through winter conditions): plausible and verified. Muscle cooling, sedentary lifestyle, winter conditions (cold, humidity), stress and winter activities are recognised aggravating factors.