Why Winter Is Harder When You Have MSby Lisa Emrich Patient Advocate
The start of a New Year is often a bright moment — a chance to look ahead and make grand resolutions and promises to ourselves for the months to come. For me, the new year brings excitement that days will continue to lengthen as the sun sets one minute later each evening. However, the temperatures will also continue to drop and it’s about to feel like winter very soon.
While some people with multiple sclerosis (MS) are heat intolerant and have trouble during the summer, others are sensitive to cold temperatures. Some people, like myself, may be bothered by both extremes as it can become difficult to regulate body temperature due to impaired neural control of autonomic and endocrine functions. The part of the brain that senses core body temperature and regulates it to about 98.6°F can be affected by MS, allowing for atypical fluctuations in body temperature.
The cold of winter can aggravate a number of MS symptoms, particularly nerve pain and spasticity. For me, cold weather affects my sensory symptoms, such as numbness or tingling, spasticity, fatigue, and circulatory problems, including Raynaud’s phenomenon. It doesn’t even need to be winter — summer air conditioning can turn my fingers a ghostly white color.
Research into the influence of cold on MS symptoms is limited. Similar to how pain was once thought not to be part of MS, but is now more commonly accepted among neurologists as a MS symptom, cold sensitivity is recognized as a feature of MS. A small case study report published in 1987 highlighted the effect of cold on the symptoms of six patients with relapsing-remitting MS. Some of the symptoms that were aggravated included paraesthesia (abnormal sensations), motor function, visual function, and bladder control.
But you can do something to protect yourself. Here are 7tips for going outside in cold weather or staying warm at home when you have MS:
1. Wear clothing in layers that you can remove or add to keep your body at a steady internal temperature. Extra layers, such as thermal underwear and socks, can be very helpful if you tend to be cold most of the time. Soft fleece wrist warmers may help to keep your hands warmer when you are inside.
2. Cover up with the essentials — winter coat, hat, scarf, and gloves — when you are out and about. If you experience nerve pain in a frequently exposed part of the body, such as trigeminal neuralgia, keep your face warm with an extra scarf or balaclava.
3. Keep your home warm. Insulate the walls and attic, seal up drafty windows, and draw curtains as the sun goes down. Heat living areas to between 68°F and 72°F, or within a range that you find comfortable.
4. Hot water bottles, electric blankets, and heating pads may be helpful, but be careful to avoid fire hazards and never sleep with an electric heating pad or blanket that is turned on. If MS has changed the way your skin feels temperatures, be extra careful to avoid getting burned by hot water, radiators, or electric heat sources.
5. Stay active and move around regularly to improve circulation, generate heat, and reduce muscle stiffness. If you must sit immobile for long periods of time, wrapping yourself in warm blankets may help keep you warmer.
6. Eat nutritious meals with plenty of fruits and vegetables to keep your energy levels up. Stay hydrated by drinking water and limit alcohol. If you will be braving the weather for any length of time, bring a thermos filled with a hot beverage to drink to help keep you warm from the inside out.
7. Avoid going outside when the weather is particularly bad if it’s not absolutely necessary. Pay special attention to icy conditions that can increase the risk of falls and injury. If you need assistance with snow removal or errands, ask a neighbor or friend for help.
Not everybody with MS will feel negative effects from the cold or heat; some people may actually feel better in one extreme or the other. I am not one of those people. But this reinforces how MS is unique to the individual and affects each of us differently.
Note that not every negative response to the chill of winter can be traced back to MS. While MS may interfere with your ability to regulate body temperature, other conditions, such as thyroid disease or connective tissue disease, can also interfere. Don’t presume that all cold sensitivity is related to MS. If in doubt, consult your primary care doctor.
Davis SL, Wilson TE, White AT, Frohman EM. Thermoregulation in multiple sclerosis. J Appl Physiol. 2010;109:1531–1537. doi:10.1152/japplphysiol.00460.2010.
Honan WP, Heron JR, Foster DH, Snelgar RS. Paradoxial effects of temperature in multiple sclerosis. J Neurol Neurosurg Psychiatry. 1987 Sep;50(9):1160-4.