Chilled out: cold sensitivity and MS

Some people with multiple sclerosis find that cold temperatures make their symptoms worse. It doesn’t have to be extreme cold, it could be a light breeze or getting caught in the rain on a summer’s day. The effect is temporary and, when you warm up, your symptoms should go back to their usual level.

Sensitivity to cold is not as well-known as heat sensitivity but both occur quite frequently in MS. Just to confuse things, some people are sensitive to both heat and cold so the temperature needs to be just right for them to feel at their best. It can be even harder to explain to others if heat makes some of your symptoms worse but cold makes different symptoms worse. This also seems quite common. These phenomena seem to be another example of everyone with MS being different.

Probably any symptoms can get worse. It’s a very individual thing.

The more common symptoms affected by cold seem to be:

• Different types of nerve pain including trigeminal neuralgia, the MS hug and altered sensations, like numbness or tingling, which may be more troublesome
• Mobility difficulties caused by muscle stiffness (spasticity) and spasms which can get worse. When combined with icy pavements, going out in winter becomes more challenging.
• Fatigue and depression although they may be more closely linked to lack of sunlight than the cold.

There are several possible reasons. In many people with MS, getting cold may affect the speed that messages pass along nerves which have already been damaged by MS and this gives rise to increased symptoms. In some cases, there is a lesion in a part of the brain that controls temperature regulation in the body. Other people might have a lesion in a brain area that should respond to decreased temperature, for example, by initiating shivering so that you warm up again. Without this response, you still feel cold.

Don’t assume that cold sensitivity is always due to MS. There are other conditions like thyroid problems and Reynaud’s phenomenon which can be triggered by cold. If in doubt, consult your MS nurse or GP.

What can you do if cold sensitivity affects you?

• Layers of clothes work well as you can peel layers on and off as needed to keep your temperature just right. Thermal socks and thermal underwear can be a good option if you are often cold. Fleecy gloves, hat, scarf and a good coat can make going out much easier.
• Hot water bottles, electric blankets and heat pads can work well but be careful if MS has changed how you feel temperature on the skin so that you don’t get burnt.
• Move around regularly if possible to improve your circulation and minimise muscle stiffness brought on by the cold. If you are sitting for long periods, a fleecy blanket that you can wrap around you works wonders. Some of them have sleeves which can be really helpful.
• Have hot food and drinks. Avoid too much alcohol which, although it can make you feel warm, increases blood flow to the skin so cooling you even more.
• Keep your home warm by closing windows, shutting internal doors and drawing curtains as soon as it begins to get dark. Get your loft and cavity walls checked out to make sure they are as well insulated as possible.
• Turn up the heating if you need to. If increased fuel costs are a worry, check out the website of the Energy Saving Trust for money saving tips.

If you are affected by both heat and cold, try and strike the right balance by choosing flexible solutions.

First published: 2016

• Brain and Spine Foundation - has cold weather tips for people with neurological conditions
• NHS Choices - has suggestions to keep warm, keep well
• Temperature sensitivity
• Hot and bothered: how heat makes MS symptoms worse
• What's causing my symptoms? tool