Hot tubs are often used to manage certain types of chronic pain. If you are living with multiple sclerosis (MS), you may wonder whether using a hot tub could be helpful for you. Although a steamy soak may be tempting to help ease muscle stiffness or nerve pain, hot temperatures can actually worsen MS symptoms, even if temporarily.
If you are living with MS, consider carefully if using a hot tub is safe for you, including how it may affect your symptoms. Note that it is important to talk with your health care provider if you are unsure whether hot tubs are appropriate for you.
To understand the potential risks of using a hot tub, it is important to understand the connection between MS and heat.
Multiple sclerosis is characterized by demyelination, or damage to myelin, the protective coating surrounding the nerve cells in the central nervous system. When exposed to high temperatures, demyelinated nerves are further prevented from carrying signals between the nerves and the brain.
Because of this impaired signaling, people with MS experience increased sensitivity to heat, also known as heat intolerance. Exposure to hot weather or hot water or an increased body temperature can directly affect your MS symptoms, particularly fatigue. Becoming overheated may also cause you to experience blurred vision (referred to as Uhthoff’s sign).
The link between heat and MS symptom flare-ups is so well established that before the invention of MRI, doctors would submerge people they believed to have MS in hot baths. If a person’s neurological symptoms suddenly flared during or after this test, the physician presumed the diagnosis was correct.
Although high temperatures cause only a temporary worsening of symptoms and have no lasting effects on MS as a whole, those with MS are advised to avoid high temperatures and take precautions to prevent overheating.
With those factors in mind, it may be wise to avoid hot water or hot tub therapy for managing MS pain, as any brief relief would likely be overshadowed by a worsening of other symptoms. If you still wonder if you might benefit by going into a hot tub, it is best to consult your neurologist. They can give you a thorough explanation and analysis of how the practice might affect your particular MS symptoms.
Many MyMSTeam members have posed questions about using hot tubs to manage MS symptoms. One member asked, “Is it fact or myth that people with MS should not go in hot tubs or stay in the hot sun?” In response, one member wrote, “Fact. If I am in a hot tub, I cannot get out without someone lifting me out. I now take just barely warm showers. In the sun, I have to take something to keep me cool.”
Another member explained that she was always told to stay out of the heat and keep her body temperature down. “Heat and humidity make my symptoms worse,” she said. “When I used to work out, I always had to have a fan on me and drink water to keep me cool.” She also noted, “If I’m at home, I always go into my neighbors’ pool. I tried their hot tub once, but it wasn’t a good thing.”
Not all members report negative experiences with hot tubs. One wrote, that, to her, “It seems as though symptoms and triggers of MS are based on ‘to each their own.’ There is not much rhyme or reason.” Another member noted that some people with MS were affected not by intense heat “but by the cold,” adding, “we all have the same blasted disease, but we all have different symptoms.”
Ultimately, as MyMSTeam members have shared, each person experiences MS differently. What improves or worsens one person’s symptoms may not have the same effect on you. The best thing you can do if you are unsure about trying hot tubs — or other heat therapies, such as saunas or hot showers — is to talk with your neurology team. They have the best understanding of your symptoms and what does (or doesn’t) help. Your doctor can advise you on whether hot tubs are safe or best avoided — and, if you do try them, how to do so safely.
Managing your MS pain can be a challenge, but it’s not one you have to handle alone. With MyMSTeam, you can meet members who understand what it’s like living with multiple sclerosis. Here, you can ask questions, offer support and advice, and connect with nearly 185,000 members from around the world living with MS.
Have you tried hot tubbing with MS? Did it make you feel better or worse? Share your experience or tips in the comments below or by posting on MyMSTeam.