Cold Weather: What a pain! Why the cold brings out stiffer joints and backs.

Many people notice the same pattern every winter: joints feel stiffer, backs ache more, and old injuries suddenly make themselves known. While it’s often brushed off as “just the weather,” there are real physiological reasons cold seasons can worsen musculoskeletal pain. Traditional Chinese Medicine (TCM) offers an additional lens and tools for addressing these seasonal flare-ups that can get in the way of our day-to-day.

Biologically, what's happening?

The idea that cold weather exacerbates joint pain is supported by various physiological mechanisms. Cold temperatures may not directly cause arthritis or structural damage to joints, but they do influence pain perception in the body. One primary factor is the viscosity of synovial fluid, which thickens in colder conditions, impairing the smooth movement of joints and increasing stiffness (Jin & Zhang, 2022, Zhao et al., 2014). Muscular and connective tissues tend to contract as the body conserves heat, which can place additional strain on joints, leading to discomfort (Jin & Zhang, 2022, Shi et al., 2021). Falls in barometric pressure, commonly experienced prior to storms, further complicate matters. Research indicates that this drop can cause tissues around joints to expand slightly, which may increase pressure on nerves and heighten pain sensations for individuals with pre-existing joint inflammation (Gao et al., 2012, Li et al., 2020). It has been clinically observed that colder weather can heighten nerve sensitivity, making pain feel sharper, even when inflammation levels remain unchanged (Zhang & Yang, 2025; , (Zhao et al., 2014).

Furthermore, a reduction in physical activity during winter months tends to lead to decreased circulation and weaker muscles, setting the stage for intensified seasonal aches, too (Zhao et al., 2014, Xugang & Cheng, 2023). (But don't worry, you can start that new morning fitness routine with the Lunar New Year!)

What about Chinese Medicine?

Traditional Chinese Medicine (TCM) provides a distinctive perspective on the relationship between cold weather and musculoskeletal pain. According to TCM, external factors such as cold and dampness can penetrate the body, particularly when its internal defenses are compromised due to stress or fatigue (Zheng et al., 2023, Shang et al., 2020). Such environmental influences obstruct the normal flow of Qi (energy) and blood, manifesting as what TCM terms Bi Syndrome or “painful obstruction” (Zheng et al., 2023).

In clinical practice, different manifestations of pain related to cold exposure are recognized: Cold Bi results in pain that improves with warmth, while Damp Bi leads to heavy, aching joints that worsen in humid conditions (Shang et al., 2020, Chen & Yong-hua, 2023). Another presentation, Wind Bi, sometimes called "wandering bi" is characterized by migratory pain.

TCM emphasizes a holistic view, focusing on how environmental changes influence the body's internal state. Despite variances in terminology, both biomedical and TCM frameworks converge on the key insights that increased sensitivity, reduced circulation, and tightened tissues contribute to pain perception (Zhao et al., 2014, Shang et al., 2020).

How We Treat

Where TCM becomes especially helpful is in how it approaches treatment. Acupuncture, for instance, is frequently applied to improve circulation, relax tight muscles, and modulate pain signaling (Jin & Zhang, 2022, Zhang, 2023). It stimulates the release of endogenous opioids, influences inflammatory processes, and enhances localized blood flow, providing meaningful relief for conditions like chronic low back pain and osteoarthritis, particularly when integrated within comprehensive treatment plans (Zheng et al., 2023, Zhang, 2023).

Moxibustion, or "moxa," is the gentle heating of acupuncture points using mugwort, often employed alongside acupuncture during colder months. This technique is especially valued in TCM as it dispels cold and improves circulation. Evidence from recent studies indicates that techniques such as warm acupuncture and moxibustion have been effective for managing osteoarthritis pain (Zheng et al., 2023, Luo et al., 2019). Incorporating warming herbs like ginger and cinnamon into herbal medicine also complements these physical therapies (Jin & Zhang, 2022, Chen & Yong-hua, 2023).

TCM presents a variety of therapeutic approaches that address these seasonal challenges. Acupuncture, for instance, is frequently applied to improve circulation, relax tight muscles, and modulate pain signaling (Jin & Zhang, 2022; , Zhang, 2023). It stimulates the release of endogenous opioids, influences inflammatory processes, and enhances localized blood flow, providing meaningful relief for conditions like chronic low back pain and osteoarthritis, particularly when integrated within comprehensive treatment plans (Zheng et al., 2023; , Zhang, 2023).

Things You Can Do at Home

In addition to professional treatments, self-care strategies can significantly mitigate winter-related pain. Maintaining warmth, especially in joints susceptible to cold-induced discomfort (such as knees and lower back), is crucial (Zhang & Yang, 2025; , Xugang & Cheng, 2023). Gentle movement through activities like tai chi, qigong, or mild stretching keeps joints lubricated and muscles engaged, which are essential for maintaining health and alleviating stiffness (Zhang & Yang, 2025; , Chen & Yong-hua, 2023). Consuming warm, nutritious foods and ensuring adequate hydration are important aspects of sustaining circulation and promoting tissue health during colder periods. The overarching message is clear: cold weather does not create pain but rather highlights pre-existing vulnerabilities. An integrative approach that combines modern physiological understanding with the principles of TCM can provide effective strategies for individuals suffering from seasonal joint and back pain (Zheng et al., 2023; , Zhang et al., 2020).

"Okay, great, but I don't have time!"

No judgement! Swing by the herbal pharmacy. On top of moxa products, we have some great liniments and over-the-counter formulas that can help you get back up and running and feeling better while you're on the go!

References:

• Chen, C. and Yong-hua, Z. (2023). Comparative Study of the Clinical Efficacy of Manipulation and Acupuncture in the Treatment of Knee Osteoarthritis. Frontiers in Medical Science Research, 5(6). https://doi.org/10.25236/fmsr.2023.050608Gao, X.,

• Chong, C., Zhang, S., Cheng, K., & Zhu, B. (2012). Temperature and Safety Profiles of Needle-Warming Techniques in Acupuncture and Moxibustion. Evidence-Based Complementary and Alternative Medicine, 2012, 1-6. https://doi.org/10.1155/2012/168393Jin,

• M. and Zhang, R. (2022). Research Progress of Acupuncture and Moxibustion on Knee Osteoarthritis. Frontiers in Medical Science Research, 4(8). https://doi.org/10.25236/fmsr.2022.040810Li,

• Y., Wu, F., Wei, J., Lao, L., & Shen, X. (2020). The Effects of Laser Moxibustion on Knee Osteoarthritis Pain in Rats. Photobiomodulation Photomedicine and Laser Surgery, 38(1), 43-50. https://doi.org/10.1089/photob.2019.4716Luo,

• L., Liao, M., Peng, J., Ma, Q., Zhou, J., Zhu, L., … & Yu, S. (2019). Comparison of the Efficacy between Conventional Moxibustion and Smoke-Free Moxibustion on Knee Osteoarthritis: A Randomized Controlled Trial. Evidence-Based Complementary and Alternative Medicine, 2019, 1-8. https://doi.org/10.1155/2019/1291947Shang,

• J., Fan, W., Dou, Z., Wu, L., Lu, B., & Qian, J. (2020). The efficacy and safety of warming acupuncture and moxibustion on rheumatoid arthritis. Medicine, 99(34), e21857. https://doi.org/10.1097/md.0000000000021857Shi,

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