Video·3 min read·May 2026

Understanding Cold Exposure: A Path to Resilience and Recovery

Cold Therapy • 3 min read • Based on research by Charlotte Lewis, Albin Stjernbrandt, Jens Wahlström (2023)

Have you ever felt a dull ache in your neck or lower back after spending long hours in a cold environment? You are not alone. Many people experience discomfort that seems to correlate with the chill in the air, especially those who work in cold settings. Recent research sheds light on this connection, suggesting that cold exposure may be more than just an inconvenience—it could be a significant factor in musculoskeletal disorders.

A study conducted by Charlotte Lewis and her colleagues in 2023 explored the association between occupational cold exposure and pain in the neck, shoulders, and lower back. Their findings reveal important insights that can empower us to better understand our bodies and enhance our recovery practices. Let’s dive into the details and uncover how this knowledge can inform our wellness rituals.

The Science Behind Cold Exposure and Pain

The study involved a cohort of 3,843 working individuals in northern Sweden, who reported their experiences with neck-shoulder pain (NSP) and low back pain (LBP) over several years. The researchers categorized cold exposure based on a numerical rating scale, allowing them to analyze its impact on pain levels.

The results were striking. High levels of cold exposure were linked to a 1.59 times higher risk of neck-shoulder pain and a 1.61 times higher risk of low back pain. Furthermore, radiating low back pain was found to be 1.87 times more likely in those exposed to significant cold. This suggests that the body’s response to cold environments can manifest as discomfort or pain, particularly in sensitive areas.

Gender Differences in Pain Response

Interestingly, the study also highlighted gender-stratified differences. Men and women exhibited varying risks related to cold exposure. For instance, men showed a 1.97 times higher risk for NSP, while women experienced a 2.20 times higher risk for radiating low back pain. This indicates that our bodies may respond differently to environmental stressors based on gender, further emphasizing the need for tailored approaches in recovery and wellness.

Understanding these nuances helps us appreciate the complexity of our bodies and the importance of being mindful of our environments. If you find yourself working in cold conditions, recognizing these risks can empower you to take proactive steps in your wellness journey.

Practical Implications for Your Wellness Rituals

So, what does this mean for you? First, it’s crucial to recognize cold exposure as a potential risk factor in your daily life, especially if your work environment requires it. Awareness is the first step toward creating a sanctuary for your body.

Incorporating contrast therapy—alternating between heat and cold exposure—can be an effective protocol for enhancing recovery and resilience. Regular sauna sessions followed by cold exposure can promote circulation, reduce inflammation, and support overall muscle recovery. This simple ritual can help restore equilibrium in your body, allowing you to mitigate the effects of cold exposure.

Additionally, consider integrating mindful movements and stretches into your daily routine. Gentle exercises can help alleviate tension and strengthen the muscles that support your spine and shoulders. Together, these practices can foster clarity and stillness in both body and mind.

Key Takeaways

Be aware of the potential risks of cold exposure, particularly if your work environment is cold.
Incorporate contrast therapy into your wellness rituals to enhance recovery and resilience.
Engage in gentle movements and stretches to alleviate tension and promote musculoskeletal health.

Based on: The association between cold exposure and musculoskeletal disorders: a prospective population-based study
Charlotte Lewis, Albin Stjernbrandt, Jens Wahlström (2023). International Archives of Occupational and Environmental Health

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The association between cold exposure and musculoskeletal disorders a

What This Paper Is Actually Saying

Before we go any further, I want to make something clear: this paper is not about cold plunges. It's not about contrast therapy. It's about workers in northern Sweden — miners, cold store employees, outdoor laborers — spending significant portions of their working hours in ambient temperatures at or below 10 degrees Celsius. We're talking about uncontrolled, sustained, involuntary cold exposure over years. That distinction matters enormously, and I'll come back to it.

The core finding is significant. Lewis, Stjernbrandt, and Wahlström tracked 3,843 working adults from 2015 to 2021 and found that high occupational cold exposure was associated with roughly 1.6 times the risk of neck-shoulder pain and low back pain, and nearly 1.9 times the risk of radiating low back pain. These are meaningful numbers. And this was a prospective study — they measured cold exposure first, then followed up six years later to see who developed pain. That's a much stronger design than the cross-sectional studies that came before it.

How It Fits the Broader Picture

This isn't an isolated finding. The occupational medicine literature has been building this case for years. Cold store workers in Israel showed a nearly threefold higher risk of low back pain. Norwegian seafood industry workers who felt subjectively cold showed extraordinarily elevated risks for both neck and back pain. A Finnish meat processing study found some of the strongest associations yet. This Swedish paper adds a well-controlled prospective design to a body of evidence that, for too long, was dismissed as insufficient.

What's interesting is that cold exposure appears to operate as an independent risk factor — even after controlling for physical workload, awkward postures, mental stress, BMI, and smoking. These are the usual suspects in occupational musculoskeletal disorders. Cold adds something on top of them. The mechanism likely involves sustained muscle tension as the body tries to generate heat, impaired blood flow to peripheral tissues, reduced tissue elasticity, and altered proprioception. Your body in the cold is a body bracing. And bracing, done chronically, breaks things down.

Chronic cold is a stressor without a recovery phase. That's the part that causes harm. The dose is everything — and duration without adaptation is just damage accumulating quietly.

The Nuance That Changes Everything

Here's what I find most fascinating, and what almost never gets discussed when people cite papers like this to argue against cold therapy: the biological difference between chronic ambient cold exposure and deliberate, brief cold immersion is profound. When you step into a cold plunge for three minutes, your sympathetic nervous system activates, norepinephrine floods your system, and then — critically — you get out. You warm up. You recover. The stress is hormetic: brief, controlled, followed by full physiological recovery.

Standing in a cold warehouse for six hours, day after day, year after year, is a fundamentally different stimulus. There's no recovery phase. The vasoconstriction never fully resolves. Muscles never fully relax. This isn't hormesis. It's chronic depletion. The body never gets to adapt — it just endures.

The Practical Take

If you work in a cold environment — construction, agriculture, food processing, outdoor trades — this research should inform how you protect yourself. Layering strategies, scheduled warm-up breaks, core temperature monitoring, and targeted recovery protocols are legitimate occupational health interventions. The evidence base is now strong enough to treat cold exposure as a genuine ergonomic risk alongside posture and repetitive movement.

For those of us using cold therapy deliberately: this paper is a reminder that the protocol matters more than the exposure itself. Get cold. Get out. Warm up fully. The ritual works precisely because it has a beginning, a middle, and an end. Remove the end, and you've changed the nature of the practice entirely.

The association between cold exposure and musculoskeletal disorders: a prospective population-based study

Understanding Cold Exposure: A Path to Resilience and Recovery

The Science Behind Cold Exposure and Pain

Gender Differences in Pain Response

Practical Implications for Your Wellness Rituals

Key Takeaways

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