The real Reason
You're in pain more in the winter
by Giacomo Kyle Hatanaka, LAc, MAcOM | Hidden Summit Acupuncture
Every year without fail, sometime around November, my neck and traps start talking to me. Not loudly at first, just a dull, persistent ache that takes up residence and makes itself comfortable. Comfortable isn’t a good word for it, though. Maybe day-ruiningly obnoxious (we can say day-ruiningly, right?). Anyway, we all know what it’s like. And through the warmer months I’m more or less fine, partly because Boise summers are genuinely good and partly because Bex keeps me reasonably well maintained when I need it. But when the temperature drops, those same tissues that were perfectly happy in August suddenly require significantly more work to calm down.
I know I’m not alone in this because our clinic gets a lot busier every winter. Not because people are doing anything dramatically different, besides the cultural sado-masochism of the holiday season (more on that soon). Besides that, the cold arrives, the aches arrive with it, and people who were managing fine in July find themselves not managing so fine anymore.
Despite the default answer your doctor might want to give you: no, it’s not in your head. There are specific reasons your body hurts more when it’s cold, and they’re worth understanding.
The Vasoconstriction
Problem
When your body is exposed to cold, it does something very sensible from a survival standpoint: it constricts blood vessels near the skin and extremities to preserve core temperature and protect your vital organs. This is vasoconstriction, and it’s automatic. Your nervous system triggers it before you’ve even consciously registered that you’re cold.
The problem is that vasoconstriction reduces circulation to exactly the tissues most prone to pain: muscles, tendons, ligaments, and joints. These structures, particularly tendons and ligaments, already have relatively modest blood supply under normal conditions. Lovely, right? But reduce that further and you get slower delivery of oxygen and nutrients to the tissue, slower clearance of inflammatory byproducts and metabolic waste, and a muscle that’s operating in a stiffer, less pliable state than it would be at higher temperatures.
Think of it like cold butter versus room temperature butter. The tissue itself hasn’t changed structurally. But its mechanical properties (how readily it moves, how much force it takes to get it there, how it responds to load) change meaningfully with temperature. A neck that moves freely in July requires more effort from the surrounding musculature in January, and that extra effort, sustained across weeks of cold weather, accumulates.
This is also why warming up before exercise matters more in winter than in summer, and why the warm-up that was sufficient in September stops being sufficient in December. You’re starting from a colder baseline, and it takes longer to get tissue to the temperature where it actually moves well.
As if the holidays weren’t enough.
Barometric Pressure and
What It Does to Your Joints
This one surprises people, and it’s the mechanism most often behind the phenomenon of people saying they can feel a storm coming in their knees or their shoulders before it arrives. That’s not folklore. And it’s not just old gramps on the front porch. It’s barometric pressure sensitivity, and it has a real physiological basis.
Your joints are enclosed spaces. They contain synovial fluid, cartilage, and various soft tissue structures, all of which respond to changes in the pressure of the air around them. When barometric pressure drops (as it does before cold fronts, storms, and the general low-pressure systems that dominate winter weather) the tissues inside the joint expand very slightly in response. In a healthy joint with plenty of space and well-lubricated surfaces, this is barely noticeable. In a joint that has any degree of inflammation, reduced cartilage, or existing sensitivity, that slight expansion is enough to increase pressure on already irritated nerve endings.
The same nerve fibers that sense pain in your joints (called nociceptors) also respond to mechanical pressure. A drop in barometric pressure is, from the joint’s perspective, a small but real mechanical event. People with arthritis, old injuries, or chronic joint inflammation tend to feel this more acutely than people without those conditions, which is why weather sensitivity is so common in the exact population most likely to be dealing with chronic pain.
Winter in Boise brings regular pressure fluctuations alongside the cold, which means you’re often getting both mechanisms running simultaneously: reduced circulation from vasoconstriction and increased joint sensitivity from pressure changes. This compounds the effect considerably.
Have I sold you on Winter yet?
Vitamin D, Inflammation, and
the Season Nobody Wants to Talk About
Vitamin D isn’t really a vitamin. It’s a hormone precursor, and it’s involved in an almost absurd number of physiological processes, including the regulation of inflammation and pain sensitivity. Which is a big deal.
Your primary source of Vitamin D is sun exposure. UVB radiation hits the skin and triggers a synthesis process that eventually produces the active form your body uses. In summer, even in Idaho, this happens relatively easily with normal outdoor activity. In winter, the sun angle drops low enough that UVB radiation is significantly reduced, outdoor time decreases, and skin is largely covered when you are outside. Vitamin D levels in the general population drop measurably between October and March, and given that most people are already running lower than optimal going into winter, the seasonal dip matters.
Low Vitamin D has a direct relationship with inflammatory regulation. It modulates the immune system’s production of pro-inflammatory cytokines: the signaling molecules that drive and sustain inflammation. When Vitamin D is insufficient, that regulatory brake is less effective, and inflammatory responses that might resolve cleanly in summer tend to linger and amplify in winter. For someone dealing with chronic muscle tension, joint sensitivity, or recurring pain patterns, that shift in inflammatory tone is often enough to push something from manageable to not manageable.
There’s a mood component here too that’s worth naming. Vitamin D receptors are found throughout the brain, including in regions governing mood and emotional regulation. The seasonal drop in Vitamin D is one of the contributing factors (alongside reduced light exposure) in the increased rates of depression, anxiety, and low mood that reliably accompany winter. And low mood and pain are not independent variables. They share overlapping neurological pathways, influence each other bidirectionally, and are often treated most effectively when addressed together rather than separately.
Your body hurts more in winter partly because you’re running lower on a hormone that regulates both inflammation and mood. Those two things going in the same direction at the same time, during the same season, is not a coincidence.
And Then There Are
the Holidays
I’ll keep this brief because you already know this part: you’re living it.
The last two months of the year ask more of most people than any other stretch on the calendar. More events, more obligations, more family dynamics, more financial pressure, more disrupted routines, more of your kids’ things on the schedule alongside everything else that doesn’t pause for December. The nervous system, running all of that, tends to sit in a higher sympathetic tone than usual: more cortisol, more muscle tension, less recovery, less sleep.
We covered in an earlier blog how chronic sympathetic activation raises resting muscle tone, particularly in the upper traps, the neck, the jaw. Winter combines cold-induced vasoconstriction, pressure sensitivity, reduced Vitamin D, and a nervous system under seasonal load, all at once. It’s a reasonably complete recipe for the specific kind of pain that shows up every November and doesn’t fully leave until March.
The fact that our clinic is consistently busiest in winter is not a coincidence. We’re not complaining. But we do wish more people understood why it happens, because understanding it changes how you manage it. And by managing it, I mean proactively rather than reactively, before it’s fully entrenched rather than after two months of white-knuckling through it.
What Actually
Helps
Keep moving, but respect the warm-up. Cold tissue needs more time to get to a workable temperature before you load it. Ten minutes of genuinely easy movement before you ask anything demanding of your body in winter is not optional the way it might feel in July.
Get your Vitamin D tested and supplement meaningfully if you’re low. The standard sufficiency threshold is set too conservatively, as we’ve written about before, and most people living at northern latitudes are significantly lower than optimal by February. A reasonable maintenance dose through winter is worth discussing with your doctor, ideally based on your actual levels rather than a guess.
Protect the areas that tend to flare. This sounds almost too simple, but keeping your neck and shoulders covered in cold weather (a scarf, a higher collar, not walking to your car with wet hair in December) reduces the vasoconstriction and muscle guarding response in exactly the tissues most likely to be talking to you by January. I still remember when I was going to acupuncture school, and I came to class with wet hair in January. My teacher never treated me the same after that.
One other thing. If you’re already feeling it, come in sooner rather than later. A pain pattern that’s been building since November is a different treatment conversation than one that’s been there since October. Winter is long. There’s no reason to spend most of it aching when the mechanisms driving the pain are addressable.
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Hidden Summit Acupuncture is in Boise, and we see a lot of winter. If your body has started its seasonal commentary and you’d like some help quieting it down, book a visit here. We’re serving patients throughout the Treasure Valley (Meridian, Nampa, Eagle) and yes, we’re busier in winter, but we’ll find you a spot.
Giacomo Hatanaka is a licensed acupuncturist and co-owner of Hidden Summit Acupuncture in Boise, Idaho, where he focuses on pain, nervous system regulation, stress physiology, and helping overwhelmed high-functioning people feel like themselves again. He’s especially interested in why so many intelligent, capable people can function at a high level while feeling terrible almost all the time.