Sensitivity to Heat or Cold
Sensitivity to heat or cold is a common and unique aspect of multiple sclerosis (MS), affecting a large proportion of people with the condition. Temperature changes—whether due to weather, exercise, or daily activities—can temporarily worsen existing MS symptoms, impacting mobility, energy, and overall quality of life.
What Is Sensitivity to Heat or Cold?
Heat sensitivity (often called Uhthoff’s phenomenon) occurs when even a small increase in body temperature—such as from hot weather, hot baths, or physical activity—triggers a temporary worsening of MS symptoms. Cold sensitivity happens when exposure to cold temperatures or cold environments causes similar symptom flare-ups.
Both heat and cold sensitivity can lead to what are known as pseudo-exacerbations—temporary increases in symptoms that do not indicate new disease activity. These symptoms usually improve once body temperature returns to normal.
What Causes Sensitivity to Heat or Cold?
- Nerve conduction issues: In MS, damage to the myelin sheath around nerve fibres disrupts normal nerve signal transmission. Small changes in body temperature can slow or block nerve signals in these damaged areas, leading to symptom flares.
- Thermoregulatory dysfunction: MS can affect the body’s ability to regulate temperature, making it harder to respond to heat or cold.
- Environmental and lifestyle factors: Hot or cold weather, hot baths, exercise, fever, stress, and even air conditioning can trigger temperature sensitivity.
What Should I Do If I Experience Sensitivity to Heat or Cold?
- Recognise triggers: Pay attention to what situations or activities cause your symptoms to worsen.
- Monitor symptoms: Keep a diary to track when and how temperature changes affect you.
- Seek advice: Talk to your neurologist, MS nurse, or GP if temperature sensitivity is affecting your daily life or if you have concerns about managing symptoms.
Self-Management Strategies
Cooling techniques:
- Wear cooling vests, neck wraps, or bandanas.
- Apply cool packs to wrists, neck, or forehead.
- Take cool showers or baths (avoid extremely cold water).
- Drink chilled beverages.
Warming strategies:
- Layer clothing and wear gloves, scarves, or insulated footwear in cold environments.
- Use blankets or heating pads (with caution to avoid overheating).
Environmental adjustments:
- Maintain a comfortable indoor temperature using air conditioning, fans, or heating.
- Use humidifiers in cold, dry weather to prevent chills.
Activity planning:
- Schedule outdoor activities or exercise during cooler or warmer parts of the day, as appropriate.
- Take breaks and find a cooler or warmer place if you start to feel uncomfortable.
Hydration and diet:
- Drink plenty of fluids to stay hydrated.
- Choose cooling foods (fruits, vegetables) in hot weather and warm meals in cold weather.
Communication:
- Explain your temperature sensitivity to family, friends, and colleagues so they understand your needs.
How is it treated?
- Behavioural interventions: Focus on cooling or warming strategies tailored to your individual sensitivity patterns.
- Physical aids: Use assistive devices such as fans, cooling garments, or thermal wraps to maintain stable body temperature.
- Multidisciplinary support: Involve occupational therapists for home modifications, physiotherapists for guided exercise, and dietitians for hydration and nutrition advice.
- Medication review: Adjust MS medications or symptomatic treatments in consultation with your healthcare provider if needed.
General Information
Living with temperature sensitivity in MS can be challenging, but support is available:
- Healthline – 0800 611 116 – Free health advice from trained registered nurses, available 24/7.
- Disability Connect – 09 636 0351 – Information, advice, and support for families of people with disabilities.
- Work and Income New Zealand – 0800 559 009 – Information about financial assistance that may be available to you.
Always consult your healthcare team before making changes to your treatment or self-management plan to ensure it fits your individual needs.