Preparing Your Body for the Winter Season: Movement, Posture & Injury Prevention for Back Pain in Winter

Introduction

If you find that your back pain in winter seems to flare up as temperatures drop, you’re not alone — and it’s not just “bad luck.” Many of our patients at Unpain Clinic report increased stiffness, discomfort or flare-ups of lower back pain once the calendar turns toward cold weather. In this post, I’ll walk you through why back pain may worsen in winter, what research suggests, how you and we at Unpain Clinic address it, and practical steps you can take to move better, sit better and prevent injury as the season changes. Results may vary; always consult a healthcare provider.

Why back pain may increase in winter

Several factors combine in colder months to make back discomfort more likely:
Cold ambient or ambient-body temperature may lead to increased muscle stiffness and reduced blood flow, making your lumbar region more vulnerable to overload when you move or sit. For example, a Swedish cohort found that occupational ambient cold exposure was associated with incident low back pain (OR ≈1.61) when adjusted for age, BMI, smoking and workload.

Decreased movement: Winter often means more indoor time, more sitting, less walking and fewer breaks — all of which reduce circulation and weaken muscular support around the spine.
Postural changes: Sitting more hours, often in non-ideal chairs or work-from-home setups, means sustained lumbar flexion or shear loads, weak glute and core muscle activation, and increased risk of mechanical overload.

Changing weather conditions: Some patients report increased pain with cold or damp weather. A study measured associations between weather variables and daily back-pain ratings, finding that persons who self-identified as “weather sensitive” had slightly increased pain on colder days.
Comorbidities: For example, a person who smokes or has chronic lung disease (such as Chronic Obstructive Pulmonary Disease, COPD) may already have compromised muscular capacity or systemic inflammation, thereby increasing vulnerability to musculoskeletal loading. Indeed, one review found that pain prevalence in patients with COPD ranged from 32-60 %.
High blood sugar / nerve vulnerability: While less directly studied in the winter/back-pain context, elevated blood sugar (eg, in diabetes) increases risk of peripheral neuropathy, which in turn can alter postural feedback, reduce muscular control and increase susceptibility to back pain.

Why pain persists (and worsens)

Once pain begins, protective muscle guarding often sets in; muscles tighten, movement becomes limited, circulation reduces — a negative cycle.
If posture remains poor (eg, slouched sitting, forward-head posture, weak glutes) the lumbar multifidus and deep stabilisers may remain under-activated, so the spine remains mechanically vulnerable.
Cold + inactivity may delay healing or adaptation from minor micro-injuries (eg, small disc bulges, facet overload).
If you have prior injuries, surgeries (scar tissue) or uncaptured compensations, the winter conditions may unmask dysfunction.
In short: winter conditions amplify mechanical and neuromuscular vulnerabilities in the lumbar region, increasing risk of back pain in winter.

What Research Says

Cold exposure & low back pain
A 2023 prospective study of 3,843 working-age adults in northern Sweden found that high occupational ambient cold exposure (rated NRS 5-7 or 8-10) was associated with incident low back pain (OR 1.61) and radiating low back pain (OR 1.87) after adjusting for age, gender, BMI, smoking and workload.

A 2022 scoping review summarised that associations between cold exposure and musculoskeletal pain (including back pain) were found in several studies, though many were cross-sectional and at risk of bias.
Conversely, a 2020 review found that while many people report increased pain with weather changes, overall the evidence is inconsistent and effect sizes are often small.

Conclusion: the evidence suggests that cold exposure may increase risk of back pain (especially in occupational settings), but it is not conclusive that cold weather causes back pain in every case.

Movement, posture & sitting more

Prolonged sitting is a well-established risk factor for low back pain via deconditioning of lumbar stabiliser muscles, compressive loads on discs and reduced circulation. While few RCTs specifically compare winter vs non-winter sitting, the mechanistic link is robust: weak glutes + tight hip flexors + prolonged lumbar flexion = increased disc/ligament stress.
Heat or cold therapies? A 2023 systematic review looking at superficial heat/cold for low back pain found limited evidence: moderate evidence that heat wraps may provide small short-term pain relief; evidence for cold or heat vs cold was very weak

Patients with COPD: A systematic review found that patients with COPD had a higher prevalence of back pain than the general population, likely due to systemic inflammation, deconditioning and altered posture/respiration mechanics.
High blood sugar / nerve pain: While direct RCTs linking winter/back pain/high blood sugar are limited, the pathophysiology is clear: hyperglycaemia → microvascular damage → nerve dysfunction → altered proprioception/posture → increased risk of spinal loading injuries.

Key take-away for this article
Cold ambient exposure may increase back pain risk, especially when combined with other risk factors (sedentary time, poor posture, prior injury).
Movement, posture, muscle support matter a lot — sitting more in winter increases risk.
Comorbidities such as COPD, smoking history, elevated blood sugar heighten risk via systemic and neuromuscular mechanisms.
Interventions (heat, cold, standard therapies) have some support for short-term relief, but the greatest benefit comes from movement, posture optimisation, and root-cause treatment.

Treatment Options at Unpain Clinic

At Unpain Clinic, our approach to managing back pain in winter is rooted in a whole-body, root-cause-focused model. We don’t just ask “Where does it hurt?” — we ask “Why is it hurting?”

Here are the modalities we may use (with context):
Shockwave Therapy: We use extracorporeal shockwave (ESWT) technology to treat underlying soft-tissue dysfunction, scarring, reduced vascularity and neuromuscular dysfunction associated with chronic back pain. In our podcast Episode #13 “How chronic back pain stopped when C-section was treated” (June 2025) we discussed how scar tissue can alter core stability, leading to lumbar overload, and how targeted shockwave therapy can restore neuromuscular communication.

EMTT (Extracorporeal Magnetotransduction Therapy): This advanced modality is used for neuromodulation, improving blood flow and stimulating muscle/nerve adaptation in challenging cases of back pain — especially when conventional rehab has plateaued.

Manual Therapy + Movement Assessment: We assess posture, lumbar range of motion, movement patterns, glute/core activation, hip mobility, and sitting biomechanics. This may include palpation, orthopaedic testing, muscle testing and gait/movement analysis.

Exercise-Based Rehabilitation: After assessment, we prescribe targeted exercise interventions — glute activation, hip-flexor stretching, lumbar stabilisers, thoracic mobility, ergonomic training for sitting more.

Posture/Sitting Coaching: Especially in winter, we emphasise sitting posture, regular breaks, micro-movements, and adjusting workstation ergonomics to reduce lumbar flexion and overload.

Lifestyle & Comorbidity Management: For patients who smoke, have COPD or elevated blood sugar, addressing these systemic issues supports their back-pain rehab by improving systemic circulation, nerve health and muscular resilience.
By combining assessment, advanced therapies and home-based movement strategies, we aim to reduce the seasonal risk and support your spine through the colder months.

Patient Experience (Anonymized Case Example)
“Jane”, a 52-year-old office worker, presented in November with a six-month history of recurring lower back pain that flared in the morning and after long evening sitting. She reported feeling stiffer when the temperature dropped, and she had a 10-year history of type 2 diabetes (controlled with medication) and a 15-year smoking history (quit 2 years ago).
Assessment at Unpain Clinic revealed weak glute medius activation, tight hip flexors, lumbar multifidus atrophy on ultrasound, and a forward-leaning sitting posture with minimal movement breaks. We used shockwave therapy over the lumbar region and gluteals (3 sessions over 2 weeks), manual therapy for hip flexor release, and a tailored movement programme (glute bridges, bird-dogs, thoracic rotations, seated micro-breaks every 30 min).
After 4 weeks: morning stiffness reduced by ~50 %, fewer pain flares after sitting, improved glute strength. At 12 weeks: She reported being “able to sit through my children’s hockey game without needing to shift every 10 minutes.” We emphasised she did not get a “cure guarantee” but she experienced meaningful improvement.

At-Home Guidance: Movement, Posture & Prevention

Here are safe, practical strategies you can do at home this winter to reduce back pain risk. Always check with your provider before starting new exercises.

Posture & Sitting Tips
Use a chair with lumbar support. Sit with your feet flat, hips at slightly above knee level, back against the chair and shoulders relaxed. Avoid slouched forward posture.
Set a timer: every 30 minutes get up, walk 1–2 minutes, do a light stretch.
When using a laptop or tablet, elevate screen to eye level; avoid looking down for long periods.
Warm up your workspace: if you feel cold, core muscles may involuntarily tighten. Use a small lumbar roll or place a warm pack on your lower back for 5-10 minutes before prolonged sitting (research shows superficial heat may provide small short term relief for low back pain).

Movement & Exercise
Daily warm-up (5-10 minutes):
Pelvic tilts standing: 10 reps.
Glute bridges: 2 sets of 15.
Hip hinge with stick (to teach lumbar/spine neutral): 8-10 reps.
Thoracic rotations seated: 2 sets of 10 each side.
Core & glute activation (3-4 times/week):
Bird-dog (on hands & knees): 2 sets × 12 (each side).
Side plank (modified) with hips elevated: 30 s × 2 each side.
Wall-sits: 30 s × 3, to engage quadriceps and core.
Standing hip flexor stretch: hold 30 s × 2 each side.
Glute medius side-lying abduction: 2 sets × 15 each side.

Movement break (every sitting hour):
Stand up, take 3 deep breaths, arch gently backwards 3 times, then hinge forward 3 times.
Walk 50 m (or march in place) for 1 minute to boost circulation.
Cold-Weather Specific Strategies
Dress warmly (especially lower back region) to keep core and lumbar muscles at comfortable temperature — cold muscles respond slower and fatigue earlier. Research on cold ambient exposure and low back pain supports this.
Avoid sliding into slouched postures while commuting in cold (like leaning forward in a car seat) — take micro breaks to reset posture.

Managing Comorbidities
If you have COPD or a smoking history: focus on upright posture, deep breathing, and core muscle activation (since respiratory mechanics affect lumbar stability).
If you have elevated blood sugar: maintain movement, as insulin resistance and neuropathy can reduce muscle activation/feedback. Even light exercise (as above) helps nerve and muscle health.