Temperature sensitivity

clasped hands in fingerless gloves

People with MS can be sensitive to extremes of temperature, and may find that either heat or cold makes their MS symptoms worsen.

Some people can find they experience problems with both extremes of temperature. This can be hard to explain to people around you, as different symptoms may be affected by heat and cold. You may find you need to monitor the temperature and situation around you and take steps to keep yourself at a comfortable temperature. 

What causes temperature sensitivity in MS?

Temperature sensitivity could be caused a number of ways. Extremes of heat and cold may affect the speed at which nerve impulses can travel along your nerves, particularly where there has been demyelination or nerve damage. Alternatively, MS may have caused a lesion in the part of the brain that controls or responds to body temperature. Your brain may not trigger sweating or shivering responses that keep your body at the best temperature for comfort.

Although unpleasant, the effects of heat and cold are temporary and do not cause any permanent damage to your nerves. Your symptoms are generally quickly reversed when body temperature returns to normal. If they do not, then discuss it with your doctor or MS team.

Heat sensitivity

Between 60% and 80% of people with MS find that heat can cause their symptoms to worsen. This might involve a build up of fatigueblurred vision, loss of balance or a worsening of cognitive symptoms such as concentration or memory. The effect of temperature changes on your visual symptoms is known as Uhthoff's phenomenon.

Summer weather, excessive central heating, vigorous exercise or having a fever can all raise your core body temperature. You might also find environments with lots of people crowded together uncomfortable. If you have MS, just a small rise in core body temperature can make a difference to how you might feel. 

Being heat sensitive may affect the activities you choose to do. If you are sensitive to heat, you could opt for strength or resistance exercise rather than endurance exercise, as this tends not to raise your core temperature so much.

Dealing with the heat

  • Have regular cold drinks or suck an ice cube or frozen pineapple chunks.
  • Spray your face and wrists with a plant mister filled with iced tap water
  • There are also commercially available sprays available from high street pharmacists that will stay cool throughout the day.
  • Some people find eating makes them warmer, and so it may be an idea to choose salads and sip iced water while eating. A cooling dessert can help.
  • When you take a bath or shower, start with tepid water and reduce the heat gradually.
  • A floor or desk fan can help to keep the temperature down and the air flowing in a room. A hand held fan can be useful when moving around.

Useful equipment to keep cool

There are many different options for cooling equipment. Wearable options include hats, scarves, ties and wrist bands that can be worn during day to day activities and are relatively inexpensive. These contain a gel or other substance that can be pre-cooled before wearing, usually by soaking in water. Depending on the product, the cooling effect can last from a few hours to several days.

More expensive options may involve active cooling technology that requires a battery. Cool vests incorporate cooling packs fitted into the lining of a waistcoat-like garment, keeping the torso cool. Many of these are designed for athletes and are styled to be comfortable when active.

If you get hot at night, a cooling pillow may help, and there are plenty of options available. You can find regular pillows designed and made with cooler materials, but also pillows with cooling gel pads attached, or gel pads that you can put on top of your existing pillow. Memory foam can be heat-retentive and uncomfortable in hot conditions, so you may wish to save that for winter, or select a reversible option with a cool side and a warm side.

Some people find equipment to cool rooms a great help during hot periods of the year, though there are a few points to think about before making a purchase.

Air conditioners use a refrigerant to lower room temperature. Permanent devices can be expensive, but there are cheaper, portable models available that can be set up where needed. Although very effective, air conditioners can be noisy, take up space and use a lot of electricity. As the process creates hot air, the device needs to be set up near a window so that this can be expelled.

Air coolers work by drawing air through water. Whilst these are much quieter than air conditioners and are also much cheaper to run, the cooling effect is less, particularly in humid conditions. To get the best from an air cooler it is worth investing in a more expensive model.

Cold sensitivity

Cold sensitivity is less common with MS than heat sensitivity, and it tends to affect different symptoms. The symptoms most likely to be affected are nerve painmobility and spasmsDepression and fatigue may also be triggered by the cold, particularly if it coincides with poor weather and less sunlight. Having increased spasticity or stiffness due to low temperatures can make walking in icy conditions harder.

If you have this sensitivity, you may find cold weather, cold draughts or having a fever affects you considerably. You may even find that driving with the window open triggers your symptoms.

Dealing with the cold

  • Choose clothing that you can layer up easily. This will help you stay comfortable, particularly if you are moving between places at different temperatures, such as in and out of shops on a cold day.
  • Scarves or hats with ear or neck protection will protect you from chilly draughts and may reduce nerve pain in the face and neck. A lightweight tube scarf can be pulled up or down as needed. You may find you use scarves all year round, not just winter, so look for something washable and compact.
  • Make sure you are eating well. Hot food and hot drinks will help keep you warm and give your body the fuel it needs to generate internal heat. Avoid too much alcohol, as it has the overall effect of cooling your body by causing your skin to flush and give off heat.
  • Try to ensure that your home is well insulated and heated. Simple tips like drawing the curtains at dusk and bleeding your radiators can help maintain the warmth in your home without extra cost.
  • Space heaters can be useful for keeping individual rooms warm, but they can be more expensive than central heating in terms of energy costs. Use space heaters safely at all times. Position them on a hard surface and keep bedding and furnishings well away. Many space heaters have safety features such as automatic cut-outs if they overturn or overheat.
  • Blankets, electric blankets and hot water bottles are useful to keep you cosy at home without all the other occupants having to sweat. Use electric blankets and hot water bottles safely, and be careful if your MS means that you don't detect heat well to avoid burns or scalds.
  • Don't forget to move around frequently to prevent muscle stiffness and improve your circulation.

Useful equipment to keep warm

There is a huge variety of clothing and equipment designed to keep you warm. An online search will provide you with lots of options, but as with any purchase, ensure that they are a reputable company, keep your banking and personal information safe, and seek personal recommendations where you can. Outdoor activity or clothing companies can also be a good source of heating and cooling products.

You may wish to ask other people with MS what products they have found useful, or ask your MS team for advice. Our Facebook peer support group has a large community you could ask.  

If you struggle to stay warm at times, then you will likely be looking for clothing and heating solutions. It can be more efficient to ensure that you don't lose heat, than to warm yourself up again if you have got cold, so prepare ahead each day. Dressing in thin, comfortable layers that you can add or remove easily allows you to adjust your temperature as needed. Hands, feet, head and neck are often especially sensitive to cold. 

Personal heat sources such as hot water bottles, electric blankets or chemical heat packs can be helpful, but take care if you have reduced sensation or numbness in your skin, as you could damage your skin without being aware of it.

Your home will be less expensive to heat if it is well insulated and free from draughts. Blankets, thick curtains and draught excluders can help in older homes. You may also like to use additional plug-in space heating for your key rooms. Some space heaters are cheaper to run than others, so look for reviews that give the power output and electricity draw for items you are considering. It may be more cost-effective to turn up your main heating a degree or two instead. 

Davis SL, et al.
Thermoregulation in multiple sclerosis.
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Full article (link is external)
Christoganni, A. et al.
Temperature sensitivity in multiple sclerosis: An overview of its impact on sensory and cognitive symptoms
Temperature (Austin). 2018 Sep 5;5(3):208-223
Summary (link is external)
Davis SL, et al
Thermoregulatory dysfunction in multiple sclerosis.
Handb Clin Neurol. 2018;157:701-714
Summary (link is external)
Christoganni, A et al.
Heat and cold sensitivity in multiple sclerosis: A patient-centred perspective on triggers, symptoms, and thermal resilience practices
Mult Scler Relat Disord . 2022 Jul 25;67:104075. doi: 10.1016/j.msard.2022.104075.
Full article (link is external)
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