Multiple Sclerosis and Cold Feet

Causes and management tips

Wearing Wool Sock to Combat Your Cold Feet in MS
Jamie Grill/Getty Images

 

Despite thick, warm socks and a cozy blanket wrapped around your legs, do you still find yourself battling uncomfortable, ice-cold feet? While burdensome and uncomfortable, the one upside is that, like other painful symptoms of multiple sclerosis (MS), there are ways to combat cold feet.

Cold Feet: A Type of Pain Called Dysesthesia

While MS used to be labeled a painless neurological disease, experts now know this is far from the truth.

In fact, up to half of all people with MS experience ​pain at some point in their disease course, with many developing chronic pain.

And there are different types of pain a person with MS may experience, like the excruciating facial pain of trigeminal neuralgia or the eyeball pain of optic neuritis. When it comes to cold feet, MS experts call this pain a dysesthesia.

Dysesthetic pain refers to abnormal sensations that are unpleasant, potentially painful, and may occur anywhere on the body, although they are most commonly experienced in the legs and feet. Dysesthesias can occur on their own or may be triggered by something in the outside world, often by a change in the temperature or weather. They also tend to be worse at night and intensified with exercise.

Of course, these observations about dysesthesias are not hard and fast rules, and so they may not be the case for you, which is okay. Just as the symptoms of MS are unique to each person, so are the timing and characteristics of those symptoms.

Sensitization of Your Nervous System

You or your loved one may note that your feet are warm to touch, despite the fact that they feel cold to you. This is because in MS the protective coating around the nerve fibers in your brain and spinal cord, called your central nervous system, is damaged. This damage leads to faulty nerve communications which can cause erroneous pain messages to be sent to your brain.

In other words, your feet are actually warm, but you think they're cold because your nervous system is telling you they're cold.

Nervous System Sensitization Can Lead to Chronic Pain

It's worthy to mention too that with dysesthesias and other types of pain, sensitization of your nervous system may develop and can lead to chronic pain in some people. More specifically, with sensitization of the nervous system, two phenomena may develop called allodynia and hyperalgesia.

Allodynia means that a benign stimulus like a light touch or cool breeze triggers pain. Hyperalgesia refers to an increased sensitivity to pain. For instance, a pinprick on your foot, which is normally a little painful, may feel like a sharp knife cutting into your foot.

Cold Feet Doesn't Necessarily Mean Your MS Is Worsening

It's important to note that cold feet and other sensory symptoms are often not signs that your MS is getting worse, especially if the symptoms come and go. But if you experience cold feet for the first time, it's important to talk with your doctor because it could be a sign of an MS relapse or another medical problem altogether.

Other Conditions That Can Contribute to Cold Feet

Examples of other health conditions that may cause cold or painful feet include:

Tips to Manage Your Cold Feet

Besides warming your feet with blankets or tucking your toes under your partner's leg or your pet's body, here are some other techniques, both medical and behavioral, to help you manage your discomfort.

Remember, to discuss treatments with your doctor first. As an aside, too, when attempting to warm your feet, be wary of sticking them in hot water or using a heating pad as you don't want to cause any burns.

1. Distraction. Distraction is a great psychological intervention for managing pain as it forces your brain to focus away from your pain and onto the activity at hand, especially if that activity is cognitively demanding.

If your feet are bothering you, consider trying one of these distraction techniques. Remember, though, depending on the intensity or nature of your discomfort, you may have to go through a couple different techniques before finding the one that works for you:

  • Reading a book
  • Calling a friend on the phone
  • Playing a video game
  • Listening to music or a podcast
  • Coloring or painting
  • Completing a puzzle
  • Journaling

2. Complementary therapies. Complementary therapies like hypnosis, cognitive-behavioral therapy, and mindfulness meditation can be especially useful in managing your pain, as well as potentially other symptoms of your MS like fatigue or cognitive problems.

3. Medications. Of course, if your cold feet are significantly affecting your quality of life or impairing your functioning (for example, if you are falling or not going to work or seeing your friends and family), be sure to speak to your doctor.

There are medications that can soothe your discomfort like the tricyclic antidepressant Elavil (amitriptyline) or serotonin-norepinephrine reuptake inhibitor Cymbalta (duloxetine). Sometimes antiseizure medications used to treat neuropathic pain can also be helpful like Neurontin (gabapentin) or Lyrica (pregabalin).

Some of these medications, though, do have side effects like sleepiness, which is something you and your doctor will have to work through.

Topical capsaicin cream is another potential option for your feet, although be sure to discuss it first with your doctor before applying.

4. Other therapies. In addition, you may need physical therapy or occupational therapy if your cold feet are impairing your walking and balance. Regular visits to a podiatrist (a foot doctor) to ensure your feet appear healthy without ulcers, as well as special shoes called orthotics may also be warranted. Seeing a therapist or psychiatrist may also be helpful as pain in multiple sclerosis can trigger or worsen depression or anxiety.

A Word From Verywell

Cold feet is simply one example of pain experienced in MS. There are many other types of pain, some neurological in origin, like MS spasticity, and others that stem not necessarily from nerve problems, but from having MS (for example, back pain from an unsteady gait or immobility related to your MS).

Whatever it is, pain in MS can be debilitating, both physically and mentally. Please seek guidance from your neurologist or a pain specialist—you can find strategies to feel better.

Sources:

Drulovic J, Basic-Kes V, Grgic S, et al. The prevalence of pain in adults with multiple sclerosis: A multicenter cross-sectional survey. Pain Medicine. 2015 Aug;16(8):1597-602.

Iannitti T, Kerr BJ, Taylor BK. Mechanisms and pharmacology of neuropathic pain in multiple sclerosis. Current Topics in Behavioural Neurosciences. 2014;20:75-97.

Jameson E, Trevena J, Swain N. Electronic gaming as pain distraction. Pain Res Manag. 2011 Jan-Feb;16(1):27-32.

National Multiple Sclerosis Society. Sensory Symptoms and Pain.

Olek MJ, Narayan RN, Frohman EM, Frohman TC. (2017). Clinical features of multiple sclerosis in adults. Gonzálex-Scarano F, ed. UpToDate. Waltham, MA: UpToDate Inc.

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