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As temperatures drop in the winter months, many people with multiple sclerosis (MS) begin to brace for cold sensitivity. As one MyMSTeam member stated, “[The cold weather] is brutal on my multiple sclerosis symptoms. Hurry up, summer temperatures!”
Feeling your best and managing your MS symptoms as temperatures change can be a struggle. Read on to learn more about how cold affects MS symptoms and ways to manage the effects of cold sensitivity.
People with MS commonly experience temperature sensitivity — that is, worsening symptoms during temperature changes. As one member put it, “I can’t take real cold or real hot temperatures.”
Although more people with MS tend to experience heat sensitivity, the effects of cold can also impact quality of life for some people with the condition.
A 2022 study found that 58 percent of people with MS reported heat sensitivity, 29 percent experienced both heat and cold sensitivity, and 13 percent reported sensitivity only to cold. In general, respondents reported that temperature extremes worsened their MS symptoms, with worse fatigue being the most common.
In general, people with MS have a normal body temperature, so scientists aren’t sure why some are more sensitive to cold than others. They do have some theories. One theory is, people with MS may develop cold sensitivity due to problems with their neurons, or nerve cells.
In MS, a person’s immune system attacks the protective myelin sheath that surrounds their nerves. This leads to damage known as demyelination. The damaged areas, called lesions, cause nerves to send signals much slower than they should.
Lesions in the hypothalamus — a key area of the brain that regulates body temperature — likely play the largest role in cold sensitivity. If this part of the brain is damaged, it may not be able to effectively control your core body temperature. Lesions may slow down or halt brain-controlled processes that normally help keep the body warm, such as shivering.
Changes in internal body temperature can also affect the central nervous system (CNS), which include the brain and spinal cord. When your CNS cools down too much, it may not be able to send or receive signals efficiently. Keeping your internal temperature within an ideal range allows cells to function appropriately. When a person with MS is exposed to colder temperatures, their CNS has to work harder to control their body temperature and keep their body functioning appropriately, leading to worsened symptoms.
If you have MS and cold sensitivity, you may notice your symptoms respond to even the slightest drop in temperature. You may experience cold hands and feet, chills, stiffening muscles, and generalized pain. These symptoms can last until the environment becomes warm again. While your body is undergoing this cold stress, your typical MS symptoms may feel worse than usual.
One MyMSTeam member stated, “When the temperature is too warm, above 72 degrees or so and humid, the fatigue, weakness, and nerve pain ramp up. When the temperature is too cold, below 55 degrees or so, I get stiff with muscle pain.”
Cold sensitivity may affect various MS symptoms, including the following.
In the 2022 study, respondents reported that fatigue was the most commonly reported symptom to worsen from cold sensitivity. Some MyMSTeam members have this experience as well. One member shared, “It’s cold here in west central Wisconsin. Friday I couldn’t stand or get dressed. Saturday I couldn’t get to my walker to get to the bathroom. I didn’t have the strength to crawl, either.”
“This year, the cold has just drained me,” wrote another member. “My body seems no longer able to regulate my internal temperature.”
Cold sensitivity may cause muscle stiffness or cramping, ranging from mildly tight muscles to severe cramps or spasticity. Cold weather is a common cause of worsening spasticity in MS.
As one MyMSTeam member stated, “[Cold sensitivity] makes my hands and legs really stiff, and I shiver at 65 degrees.”
Another member agreed, saying, “When I get cold, I start to spasm all over and can’t stop.”
Cold weather can impair mobility by causing increased weakness and balance difficulties. One MyMSTeam member described this effect: “My leg doesn’t even like to cooperate, let alone walk, in cold weather!”
Cold sensitivity can be painful in and of itself. It may also exacerbate your existing nerve or muscle pain. “I get so cold, I feel it in my bones,” wrote one member. Another said, “I still have a bad time in the winter. Even my pain levels go way up. When the warmer weather comes, my body does much better.”
Cold sensitivity can cause varying degrees of numbness and tingling in people with MS. These symptoms may include:
One MyMSTeam member commented, “My feet have been ‘cold’ all my life! Now they’re not just cold, they’re numb!”
Cognitive symptoms, including difficulties with attention, memory, and language, commonly worsen in people with MS when the temperature changes. Many MyMSTeam members note an increase in depressive symptoms during the colder winter months. “I have decided that winter depression on top of MS depression really sucks,” one member wrote.
Cold weather can severely impact your quality of life if you’re living with MS. Some MyMSTeam members go as far as relocating to avoid cold weather. “I had to finally move away from the cold, damp weather,” one member shared. “It was terribly hard to keep warm. My core temp has come up a little, but I even have to keep the heat in my room near 80 just to keep warm, or use my electric blanket.”
Following are some to manage worsening MS symptoms from cold sensitivity.
Moving your body regularly is one of the best ways to help with cold sensitivity. Movement generates internal heat, which may help return your body to a temperature that will relieve your symptoms.
Even the simplest movements, such as stretching your arms or doing circles with your wrists and ankles, provide benefits like increased circulation or reduced stiffness. Walking is also a beneficial low-intensity exercise that can help raise body temperature.
Watch the weather forecast and prepare ahead of time for any colder periods. When leaving the house, bring items that can easily help warm you up, such as:
Wearing warmer clothes is a simple preventive way to maintain a comfortable body temperature. Extra layers — especially on the head, hands, and feet — are a great choice to prevent heat loss through the extremities. Additionally, electric blankets can be cozy and provide extra warmth when needed.
Eat and drink warm foods and beverages to help feel warmer. You may want to try nourishing soups or stews as well as herbal teas.
You may experience worsened symptoms from both cold and heat, so it’s very important to find a temperature that feels comfortable for you. Maintain your home thermostat at a temperature that doesn’t worsen your symptoms.
It can help, too, to avoid exposure to dramatic shifts in temperature, such as from cold showers or gusts of cold wind.
In a similar vein, avoid cranking up the thermostat or quickly piling on layers of clothes when you get cold. This can lead to heat sensitivity or Uhthoff’s phenomenon (the worsening of MS symptoms when the body is overheated). Instead, try making gradual changes.
MyMSTeam is the social support network designed to connect, support, and empower people who have MS. On MyMSTeam, more than 198,000 members come together to share stories, tips, and support.
Does cold affect your MS symptoms? Do you have a tip to share on warming up? Start the conversation by leaving a comment below or making a post on MyMSTeam.
Luc Jasmin, M.D., Ph.D., FRCS (C), FACS is a board-certified neurosurgery specialist. Learn more about him here.
Megan Straley, Ph.D., RN has a Doctor of Philosophy in neuroscience, a Bachelor of Science in nursing, and a Bachelor of Science in biology and psychology. Learn more about her here.
