Coping with Cold Weather When You Have Multiple Sclerosis

When it comes to extreme weather, both heat and cold can affect your MS

Woman pampering the service dog of her friend with multiple sclerosis. Credit: Huntstock / Getty Images

Cold weather and multiple sclerosis (MS) would seem to go well together. For those who suffer from MS-related heat intolerance, cold weather can be a refreshing change. But for many living with MS, MS-related symptoms can actually worsen as the temperature drops.

How Temperature Extremes Affect People with MS

Many with multiple sclerosis (MS) are heat intolerant to the point of being unable to function outside at peak summer temperatures.

For many, temperatures of 80 degrees or higher are almost unbearable. 

However, what is even more interesting about temperature tolerance among people with multiple sclerosis is that many say that while hot temperatures are not comfortable, cold weather and MS don’t go very well together for them, either. Here are some of the comments I received when I asked readers about their comfort level in hot and cold temperatures:

  • “I don’t like either extreme, but I choose heat over cold. I can get fatigued with heat, but cold cramps up my muscles. A few times I have even dealt with aphasia. I was trying to ‘pull it off’ in my head, but I knew that I was mumbling and no one could understand me.”
  • “From my first symptoms 6 years ago, cold has been my arch-nemesis. Living in Canada, it is something I face most of the year. For me cold means PAIN -- instant and overwhelming pain. My legs spasm, and I often have difficulty walking as a result. I also get an increase in banding sensation around my chest that can be very uncomfortable. My hands freeze up and are useless. On the flip side, heat can feel wonderful. It often eases the spasms and therefore the pain, but it really just numbs things – I’ll take it! Numb is better than pain! In the summer I spend most of my late afternoons inside because it gets too warm and I become weak and tired. So I guess I am one of the “rare” cases of people that are more affected by the cold than the heat. Although I can’t do much of anything in either extreme, cold is by far more difficult for me to handle.”
  • “I thought I was the only one who was ‘opposite’! I live in Colorado and cold is WAY worse than heat for me. Heat seems to actually help me, even if I get a little more tired than normal if I get too hot. Cold makes all my muscles seize up. I can barely make my legs move and I lose the ability to control my arms. I hate winter!”

    How Cold Weather May Affect People With MS

    Cold and Spasticity. Many people wrote in to complain of increased spasticity (muscle stiffness and tightness) in the cold weather. People mentioned that their limbs "felt like wood" or that their joints ached in the lower temperatures. A couple of people also mentioned that the MS hug became intolerable in the cold. (The MS hug is the gripping feeling around the torso that is caused by spasticity of the tiny muscles between the ribs.)

    Cold and Fatigue. I also learned that some people living with MS tend to feel more fatigued in winter months. This could be an indirect result of coping with some of the symptoms mentioned above. It could also be that the shorter days and limited sunlight are making depression worse; as you may know, depression can be a symptom of MS.

    Vitamin D and Cold Weather. New data are emerging all the time on the role of vitamin D in MS. Experts are fairly confident that low vitamin D has a role in developing MS, but now it’s looking like vitamin D levels have an impact on relapses and the way we experience symptoms.

    It’s been well established that vitamin D levels in people are lower in winter months due to less exposure to sunlight (which is necessary for the body to produce vitamin D). Perhaps we feel our MS symptoms more acutely when our vitamin D reserves are at their winter lows.

    Cold Climate vs. Warm Climate. The effects of cold on MS symptoms have not been studied extensively. However, I was able to find a study that compared people with MS who were randomized to a 4-week inpatient physical therapy program in Spain (warm) and Norway (cold).

    It turns out that Spain was a better place for this therapy. After therapy, the average walking distance had increased more in Spain: 70 meters (230 feet), as opposed to 49 meters (161 feet) in Norway. People also reported less exertion after walking in Spain than they did in Norway. (Note: The people in this study were not heat intolerant.)

    Tips for Coping With Cold Weather and MS

    Keep your hands and feet warm. Many people with MS also have a condition called Raynaud's syndrome, in which the capillaries in the fingers and toes overreact in the cold. As a result, the area under the fingernails and toenails turns blue and can be very painful.

    Soak up the sunshine. Go outside during the warmest part of a sunny winter day and remain there as long as you can stand it. Even better, get a little exercise outside while you’re at it. And remember, sunlight helps your body produce vitamin D.

    Don't overdo the heat inside. I tend to get a little dramatic when I get too cold and, as a result, I run really hot baths or showers. Recently, I got dangerously dizzy in a hot shower. Remember, extreme heat is not our friend, either.

    Warm yourself from the inside. Try drinking hot beverages to take the chill off and warm your body’s core faster.

    Don’t Let the Cold Freeze You Out of Things You Enjoy

    Cold weather and MS may not go together as we might like, but we can learn to tolerate the combination better. Like many other MS-related situations that we must get through, a little strategic planning about winter activities can help you have at least a little control over symptoms. Put some thought into what you enjoy doing in the winter, take proper precautions, and get the most out of the cold months.


    “Heat and temperature sensitivity.” National Multiple Sclerosis Society (2016).

    Stachowiak J. “MS symptoms and winter weather.” National Multiple Sclerosis Society: MS Connection, Winter 2013.

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