Come rain or shine: is weather a risk factor for musculoskeletal pain? A systematic review with meta-analysis of case-crossover studies

•Evidence before this studyChanges in weather conditions are often perceived by patients with musculoskeletal conditions as being an important trigger for symptom onset or exacerbation.Case-crossover studies have been recognised as the gold standard methodology to ascertain the transient risk of an event associated with an exposure of interest.Recently, this design has been used to ascertain and quantify the transient risk of musculoskeletal symptoms associated with weather parameters.•Added value of this studyThe current review appraises and summarises, for the first time, the results of case-crossover studies assessing the risk of musculoskeletal symptoms and weather parameters.Despite anecdotal reports from patients, changes in weather factors do not seem to increase the risk of knee, hip, or low back pain symptoms.High temperatures combined with low humidity, however, may double the risk of a gout flare.•Implications of all the available evidenceThis review significantly contributes to the body research challenging the belief that weather will influence musculoskeletal pain or symptoms.Clinicians should exercise caution when recommending musculoskeletal pain management based on weather parameters.Future research should focus on ascertaining the nature and magnitude of modifiable risk factors for musculoskeletal pain and strategies to manage those.