Introduction: Musculoskeletal disorders (MSDs) are among the leading causes of global disability. Patients often attribute symptom fluctuations to seasonal or weather changes, but scientific evidence remains inconsistent. Most robust studies are from temperate climates, with limited data from tropical regions .
Methods: We conducted a systematic review guided by PRISMA principles. PubMed, Web of Science, and Scopus were searched through May 2025 using combinations of “seasonal variation,” “weather,” “musculoskeletal pain,” “osteoarthritis,” “rheumatoid arthritis,” “chronic pain,” “temperate,” and “tropical.” Systematic reviews, meta-analyses, longitudinal cohort studies, and observational studies reporting pain intensity variations across seasons or weather factors were eligible. Data were extracted on study design, location, MSD type, meteorological variables, and outcomes, and narratively synthesised by climate zone.
Results: Of 742 records, 23 studies met criteria: 10 systematic reviews/meta-analyses, 9 longitudinal cohorts/time-series, and 4 cross-sectional studies. In temperate regions, modest associations were reported between barometric pressure, humidity, and osteoarthritis pain. Rheumatoid arthritis activity showed seasonal peaks in some registries. Chronic pain studies demonstrated high inter-individual variability, with ~20% of patients showing reproducible weather sensitivity. In tropical regions, evidence was sparse, mostly cross-sectional, with heterogeneous findings and limited meteorological linkage .
Conclusion: Seasonal influences on musculoskeletal pain appear modest but clinically relevant in subsets of patients, especially in temperate climates. Evidence from tropical settings remains insufficient, limiting global applicability. Future studies should employ longitudinal, multi-region designs using symptom diaries, personal exposure sensors, and mechanistic biomarkers. Physiotherapists can integrate season-adapted exercise strategies and patient education into care pathways.