As the winter chill settles in, people living with MS may face challenges associated with cold weather. It’s more common for heat to exacerbate MS symptoms, but the cold can also have a significant impact. Because MS affects everyone differently, maintaining comfort and wellbeing through the winter can be a delicate balancing act requiring personalised solutions.
How cold affects MS
Research in this area is limited and the mechanisms for how the cold affects people with MS are not fully understood. But damaged nerves can struggle to conduct signals efficiently in hot or cold conditions. Lesions in temperature regulation areas of the brain may also affect how the body regulates core temperature, although a recent study suggested that neuropsychological factors – perceptions of discomfort and fatigue increase – may play a role in increasing a person's sensitivity to changes in temperature.
A range of issues can be triggered during the colder months, including nerve pain and other sensory symptoms, such as numbness and tingling. Mobility can be hampered by muscle stiffness, cramping and spasms. Winter may also contribute to increased fatigue and heightened feelings of depression, potentially linked to Seasonal Affective Disorder (SAD), or simply being less active during the shorter, colder days, which then disrupts normal sleep patterns.
Finding your comfort zone
The effects of cold are mostly short lived, and the best treatment is just to get warm again. But it’s important not get too warm, as this could then trigger symptoms of heat sensitivity, such as problems with balance, vision or concentration, or more fatigue.
Temperature sensitivity is highly individual, so it may take some time to work out your comfortable temperature range and the solutions that work best for you. Here are some tips to get started:
Layering clothing. If you’re often cold, include a moisture-wicking base layer of bamboo or merino wool. If you tend to overheat, wear thinner layers you can remove. Some people with MS find tight fitting thermal underwear helps with tremor, while others find it triggers muscle spasms. So it’s best to experiment with different options.
Personal e-heating. Ideally, you'll have a warm house all winter, but if you’re worried about your heating bill, heated throws, ponchos, jackets, gilets, blankets and pads are a cost-effective way of keeping just yourself warm. Opt for products with a range of temperature and timing options so there’s less chance of overheating.
Keeping the extremities warm. Hands and feet are often the first to feel the cold. Doctors also think MS can cause blood vessels in the hands and feet to overreact to the cold, potentially triggering Rauynaud’s phenomenon. So as well as making sure you have a warm coat, hat, and scarf for the winter, it may be worth investing in quality gloves and insulated footewear.
Internal warming. Hot food and drink can help maintain internal body temperature. So consider keeping a thermos of hot tea by your side, or a swapping the usual sandwich packed lunch for a food flask of warming stew. Avoid too much alcohol, as this lowers body temperature and can exacerbate other MS symptoms.
Staying active. Whether indoors or outdoors, it’s important to move around. Moderate physical activity like walking or stretching will help keep your body warm and should help alleviate muscle stiffness.
Strategic outings. Try to go outside during the warmest hours of the day, especially when the sun is out. This can lift your mood and top up your vitamin D levels – an important consideration as vitamin D deficiency can make symptoms worse. Make sure you can get about safely, and if this is sometimes challenging explore light therapy options.
Consulting healthcare professionals. Whenever your MS symptoms change, talk to your MS healthcare team. They may be able to help with medication for specific problems, such as pain or muscle cramps.
By recognising the effects of cold and experimenting with targeted strategies, people with MS who are sensitive to the cold should be able to navigate the winter months with greater comfort and wellbeing. If in doubt, always consult with your healthcare team.