Combined temperature sensitivity is a type of temperature sensitivity that can be experienced by people with MS. It describes the temporary worsening of MS symptoms in response to an increase or decrease in temperature. These effects are temporary and should reverse when the body temperature returns to normal.
On this page we look at what combined temperature sensitivity is and the MS symptoms that may be affected. We also look at some practical approaches for managing combined temperature sensitivity.
It is a type of temperature sensitivity that some people with MS experience. If you experience combined temperature sensitivity, you are affected by both heat sensitivity (Uhthoff’s phenomenon) and cold sensitivity. Your symptoms can flare up in response to your core or skin temperature going up or down by even a small amount. Around 30 in 100 people with MS report experiencing both heat and cold sensitivity. This is less than the number who only experience heat sensitivity. But it is more than those who only experience cold sensitivity.
Common heat triggers include warm weather, exercise and infections. Common cold triggers are cold weather and long periods of inactivity.
Read more about triggers of heat sensitivity.
Read more about triggers of cold sensitivity.
An increase in temperature can affect symptoms such as:
Read more about heat sensitivity (Uhthoff’s phenomenon).
When the temperature decreases, the symptoms most likely to worsen are:
- increased stiffness and spasticity
- nerve pain – especially altered sensations such as burning, numbness or pins and needles
- mobility – movement might be slower or tasks that rely on fine motor skills, like eating or brushing your hair, are more difficult.
The following can also be affected:
- fatigue – keeping warm uses more energy adding to fatigue
- depression – especially if the cold coincides with poor weather and less sunlight.
Read more about cold sensitivity.
The increase in symptoms is not usually due to new MS damage. It is a temporary response triggered by an external factor. Once your temperature returns to normal, the symptoms should settle back down within a few hours.
You will likely need to adopt strategies to manage both heat and cold. The main aim is to try and keep your core temperature as stable as possible. Try to avoid rapid temperature changes or extremes of heat or cold if possible. Aim for stable, moderate temperatures.
- Programmable thermostats or smart heating systems can help you keep your home at a steady temperature.
- Wear layered clothing that can be taken on and off easily. This will allow you to respond quickly to temperature changes before symptoms escalate.
- Use pre-cooling or pre-warming strategies where appropriate.
- Choose food and drink appropriate to your external environment. This will help you to maintain a stable core temperature.
- Move and pace yourself according to the conditions.
Read more about strategies to manage heat sensitivity.
Read more about strategies to manage cold sensitivity.
Sometimes, what appears to be temperature sensitivity can be a sign of something else. This might be a fever, another underlying medical condition or a relapse.
Read more about when to check in with your GP or MS team.
