Knee pain in cold weather: why it happens and how to manage it

You’re not imagining it: Cold weather really can make your knees feel more achy or stiff. While people with arthritis or prior injuries may notice it more, even otherwise healthy knees can feel different when temperatures drop.

Cold fronts don’t have to mean giving up movement or dealing with constant discomfort from stiff joints. While you can’t control the weather, there are effective ways to manage symptoms — and staying active is one of the most important. “Consistent activity is crucial in cooler temperatures because the more you move, the more you help keep your joints feeling less stiff and more comfortable,” says Justin DePermentier, PT, DPT, a physical therapist at Hinge Health.

Here’s what to know about why knee pain can feel worse in cold weather — and what you can do to find relief, including gentle exercises recommended by Hinge Health physical therapists.

Why does knee pain get worse in cold weather?

Cold weather doesn’t cause new knee problems. Instead, it can dial up your pain sensitivity, especially if you already have a history of knee pain. “Cold weather creates an environment where soft tissues, including tendons and ligaments, may feel more stiff or sensitive, even in healthy joints,” says Dr. DePermentier. Factors like reduced circulation, muscle stiffness, and changes in joint fluid can all temporarily affect how your knees feel.

Here’s what may be contributing:

• Barometric pressure changes. Drops in air pressure can cause tissues around the joints to expand slightly, which may increase sensitivity. “Cold weather can slow things down and make tissues feel more rigid,” says Dr. DePermentier.

• Thickening synovial fluid. Synovial fluid that lubricates your joints can become slightly thicker in colder temperatures, making movement feel less smooth at first.

• Reduced blood flow. In cooler temperatures, your body directs blood toward your core to conserve heat — which can leave muscles and joints feeling stiffer.

• Muscle and tendon tightening. Cold temperatures can cause the muscles and tendons around your knee to feel tighter and less flexible. This may make movements like bending or straightening your knee feel stiffer than usual — especially first thing in the morning or after sitting for a while. 

• Increased nerve sensitivity. Changes in temperature and humidity can make your nerves more sensitive, so you may notice pain more easily. Shifts in barometric pressure can also affect surrounding tissues, which may contribute to that sensitivity — especially if your knees have been irritated before.

• Less physical activity. Cold weather often leads to moving less. “Many people become less active in the winter months, for example,” says Dr. DePermentier. “You might usually walk your dog for 10 or 20 minutes, but in colder temperatures, you’re in and out.” Less movement can lead to more stiffness and discomfort. “Motion is lotion, so not moving as much can increase joint pain and stiffness,” he says.

Symptoms of knee pain in cold weather

Cold-weather knee pain can show up in different ways, especially if you have arthritis or a previous injury. Common symptoms include:

• Stiffness that worsens with weather changes

• Increased discomfort especially after sitting or inactivity

• Dull, aching pain during or after outdoor activity

• Reduced range of motion

• A feeling of tightness or heaviness

How movement helps with cold-weather knee pain

When your knees are achy, you may feel reluctant to exercise, but movement is one of the most effective ways to reduce stiffness and discomfort.

Movement increases blood flow, helping warm the joint and surrounding muscles. It also strengthens the muscles that support your knee, which can reduce strain over time.

“Getting some movement in — especially before heading outside — can help your knees feel more comfortable,” says Dr. DePermentier. “It’s like letting your engine warm up before driving in the cold.”

Even gentle, consistent activity can help your body adapt to temperature changes and improve how your knees feel day to day. The key is finding your movement sweet spot — enough to stay active without significantly increasing symptoms.

All of these exercises — seated calf raise, seated marches, squats, standing side leg raises, seated clam shells, and seated knee extensions — create a low-impact warm-up for the knee joint. By increasing blood flow to the area, they encourage mobility in stiff areas of your lower body. They also strengthen the muscles surrounding the knee, providing better knee support and reducing pain from conditions like arthritis, which often flare amid really cold temperatures. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for cold-weather knee pain

Cold-weather knee pain doesn’t have to slow you down. A combination of simple strategies, including movement, warm therapy, and activity modification, can go a long way toward keeping joints flexible and comfortable. 

• Try physical therapy and targeted exercises. Targeted exercises strengthen the muscles supporting your knee and improve flexibility and range of motion — all of which can help ease discomfort from temperature changes. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Keep your knees warm. Layer up with long pants, knee warmers, or compression sleeves when going outside. Fabrics with insulating properties, such as wool, fleece, and down, trap and retain body heat, keeping you warmer in cold weather. Avoid sitting in cold spaces for long periods. 

• Stay active indoors. When outdoor exercise feels too uncomfortable, try indoor walking, stationary biking, swimming in a heated pool, or gentle yoga. Generally speaking, it’s always a good idea to modify activities that trigger pain. 

• Apply heat therapy. Heating pads, warm compresses, or warm baths can all help increase blood flow and ease stiffness before movement. Putting heat directly on an arthritic joint may increase inflammation. Instead, Dr. DePermentier recommends targeting the muscles around your knee: try placing a heating pad on your thigh (to warm your quads) and behind your knee (to warm your hamstrings) before you get moving.

• Take over-the-counter (OTC) medication as needed. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have knee pain. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• Make lifestyle modifications. Factors like sleep, stress, nutrition, and certain activities can all play a role in how you feel. In fact, many people are surprised to learn that pain isn’t just about what’s happening physically — your daily habits and overall well-being can have a real impact, too. Staying curious about how your routines affect your muscles and joints can help you identify where small changes might help reduce pain. For example, you might notice your pain is less noticeable on low-stress days.

• Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for knee pain relief, such as massage, acupuncture, or chiropractic care.

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce pain around the knee. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

Tips to manage knee pain in cold weather

Small daily adjustments can make a big difference when temperatures drop. Here are some practical ways to keep your knees feeling more comfortable:

• Time your outdoor activities strategically. Plan walks or errands during the warmest part of the day when your joints are naturally warmer and more flexible. 

• Warm up before going outside. Try doing 5-10 minutes of gentle indoor movement before heading out into the cold to warm up your knees and increase blood flow. Dr. DePermentier suggests simple moves like sit to stand exercises, walking around your home, climbing stairs, or even side-stepping in your kitchen.

• Try compression knee sleeves. These little sleeves can provide warmth, support, and slight compression that helps reduce swelling and adds stability as you move. 

• Stay hydrated. Many people forget to drink water in cooler temperatures. But even though you might not feel as thirsty in winter, proper hydration is crucial to maintaining the volume and viscosity of the synovial fluid in your joints — which is mostly made of water. 

• Check your vitamin D levels. Reduced sunlight in winter months can affect vitamin D, which plays a role in muscle and joint health. Talk to your provider if you’re concerned.

• Adjust your activities as needed. If cold weather makes outdoor movement uncomfortable, break your activities up into shorter sessions or switch to indoor options. The goal is to keep moving in ways that feel manageable for your body.

When to see a doctor

Knee pain in cold weather often improves with at-home treatments like staying warm, staying active, and doing targeted exercises. But if your knee pain is severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get medical care if you have:

• Significant swelling or redness around the knee

• Difficulty bearing weight on the knee

• Sudden pain after an injury

• Fever along with knee pain (could indicate an infection)

PT tip: Keep moving — even in the winter

It’s common to scale back physical activity and social activities in colder months, but staying active can make a big difference. “Don’t let the anticipation of winter or a cold front change your routine,” says Dr. DePermentier. You can always shift your activity indoors — just make sure to keep moving. Even small amounts of movement add up. “You don’t have to do as much as usual,” he says. “Start with something small and build from there.”

How Hinge Health can help you

If you have pelvic pain or symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Peters, H., Rockel, J. S., Little, C. B., & Kapoor, M. (2025). Synovial fluid as a complex molecular pool contributing to knee osteoarthritis. Nature Reviews Rheumatology. doi:10.1038/s41584-025-01271-4

2. Knee pain: MedlinePlus Medical Encyclopedia. (n.d.). Medlineplus.gov. https://medlineplus.gov/ency/article/003187.htm

3. Farbu, E., Anje Christina Höper, Eirik Reierth, Nilsson, T., & Morten Skandfer. (2022). Cold exposure and musculoskeletal conditions; A scoping review. Frontiers in Physiology, 13. doi:10.3389/fphys.2022.934163

4. Duong, V., Oo, W. M., Ding, C., Culvenor, A. G., & Hunter, D. J. (2023). Evaluation and Treatment of Knee Pain: A Review. JAMA, 330(16), 1568–1580. doi:10.1001/jama.2023.19675

5. Ferreira, M. L., Zhang, Y., Metcalf, B., Makovey, J., Bennell, K. L., March, L., & Hunter, D. J. (2016). The influence of weather on the risk of pain exacerbation in patients with knee osteoarthritis – a case-crossover study. Osteoarthritis and Cartilage, 24(12), 2042–2047. doi:10.1016/j.joca.2016.07.016