It’s not unusual to have a temporary problem with your knees. But a frequent or persistent extreme cold sensation in your knees can be distracting.

Having “cold knees” isn’t necessarily related to the weather. In these situations, the sensation can’t be relieved with a blanket or more clothing. And if you also have knee pain or range-of-motion problems, it can interfere with your ability to function.

Keep reading to learn some of the causes of cold knees, as well as signs that it’s time to see your doctor.

A variety of things can cause your knees to feel unusually cold. Some involve only the area around your knees or legs. Some are underlying conditions that can make you feel cold over a larger part of your body. These conditions usually have additional symptoms.

Osteoarthritis of the knee

Arthritis is a group of conditions that involve inflammation in your joints. Osteoarthritis is the result of gradual wear and tear of the cartilage in the joint. Knee arthritis is a major cause of disability. The main symptoms are:

  • pain
  • swelling
  • stiffness

Some people with osteoarthritis of the knee experience increased sensitivity to cold. A 2017 study notes that when compared with the control group, these patients also had:

  • decreased physical health
  • lower pressure pain threshold in the knee
  • increased pain
  • greater functional impairment
  • more features of neuropathic pain

These symptoms may point to increased central sensitization of the knee. Women are more likely than men to report that their knees are affected by cold weather.

Peripheral neuropathy

Damage to the peripheral nerves is called peripheral neuropathy. While it mainly affects hands and feet, it can affect other areas of your body, including your knees.

The peripheral nerves transmit messages between your central nervous system and the rest of your body. A disruption in these messages can lead to:

  • freezing, burning, or stabbing pain
  • extreme sensitivity to touch
  • numbness or tingling that begins in your feet or hands and spreads into your arms and legs

Causes of neuropathy include:

Neuropathy can also be due to autoimmune diseases such as:

Or infections such as:

Peripheral artery disease

In peripheral artery disease, there’s a buildup of fat, cholesterol, and other substances in arteries that service vital organs and your legs. This can cause blood to clot, blocking blood flow to your legs. That can lead to:

  • one leg having a lower temperature than the other
  • skin that looks pale or blue
  • no pulse in your leg or foot
  • wounds that don’t heal well
  • poor toenail growth
  • decreased hair on your legs
  • erectile dysfunction

Risk factors for this condition include:

Raynaud’s phenomenon

Raynaud’s phenomenon is a condition in which you have episodes of narrowing of your blood vessels, or vasospasm. These episodes are triggered by cold temperatures or stress.

During a vasospasm, there’s a reduction of blood flow from your heart to the rest of your body. This usually affects your fingers and toes, but it’s possible in your legs and knees as well. Areas of your skin may turn pale, white, or even blue. You might feel cold or numb.

Then, as blood begins to flow freely again, color returns. You might feel a throbbing, tingling, or burning sensation.

Hypothyroidism

Hypothyroidism means you have an underactive thyroid. It’s not making all the hormones you need to function. It can cause many symptoms, including:

  • difficulty tolerating cold
  • joint and muscle pain
  • dry skin
  • fatigue
  • weight gain

There are a variety of causes for hypothyroidism, including:

Treatment for arthritis of the knee may involve:

Because there are several other things that can cause cold knees, it’s important to see your doctor for a diagnosis. That’s especially true if you also have pain or mobility issues.

Once you have a diagnosis, treating the underlying condition may ease your symptoms and help decrease sensitivity to cold.

Since treatment depends on the cause, getting the correct diagnosis is vital. Signs that it’s time to see your doctor include:

  • persistent or frequent coldness of your knee
  • pain that interferes with quality of life
  • difficulty fully extending your knee
  • redness, swelling, tender to the touch
  • problems with multiple joints
  • rash
  • fever
  • thickening or tightening of skin or other obvious deformity
  • worsening condition, such as arthritis or diabetes

And, of course, see your doctor if you have recently experienced a knee injury.

Getting to the root of the problem will probably start with a physical examination. Your doctor will also want a complete medical history. Be sure to discuss any preexisting conditions such as arthritis, diabetes, and autoimmune diseases. Also, mention all other symptoms, even if they don’t seem related.

Tell your doctor if you experience cold in other parts of your body or if you have trouble tolerating cold temperatures in general. This can aid in choosing which diagnostic tests will be most helpful.

You might need imaging tests to check for injury, nerve damage, arthritis, or other problems. Blood tests may be needed to check vitamin and glucose levels, as well as thyroid function.

Results will help guide the next steps.