MS and cold weather
Cold weather can make some MS symptoms temporarily worse, most often muscle stiffness, spasms, fatigue and walking. Cold sensitivity is less common than heat sensitivity in MS, and the change usually fades once you warm up again. The practical goal is to stay steadily warm with layers and a warm home, while protecting skin that may not feel heat properly.
Does cold weather affect multiple sclerosis?
For some people, yes. The MS Trust describes cold sensitivity as a temporary worsening of MS symptoms when temperature drops, and notes it is much less common than heat sensitivity. It estimates that about 15 in 100 people with MS report cold sensitivity.
A 2022 survey of 757 people with MS who reported temperature sensitivity, published in Multiple Sclerosis and Related Disorders, found that 58% were heat sensitive only, 29% were sensitive to both heat and cold, and 13% were cold sensitive only. So even among people who react to temperature, heat is the more common problem, and many people who feel the cold also react to heat.
If heat is your bigger problem, our separate guide on cooling vests covers that side. This page is about the cold.
Which MS symptoms get worse in the cold?
The MS Society (UK) says people affected by cold may notice sensory symptoms or mobility getting worse until they warm up, or muscles that feel stiffer or more prone to spasms. The MS Trust singles out stiffness as especially likely to worsen in the cold.
In the 2022 survey, people in the cold-sensitive group most often reported fatigue (39%), muscle cramping (22.7%) and poor walking (22.7%) as the symptoms that worsened. Cold days and changes in the weather were the most commonly reported triggers.
| Symptom | What people commonly notice in the cold | Practical response |
|---|---|---|
| Stiffness and spasticity | Legs or arms feel tighter; spasms come more easily | Warm up indoors and stretch before going out; keep moving |
| Fatigue | More tired on cold days | Keep warm steadily so the body spends less energy fighting cold |
| Walking | Slower or less steady gait | Plan shorter trips; allow extra time on cold, icy days |
| Sensory symptoms | Tingling or numbness more noticeable | Cover hands and feet; check skin you cannot feel well |
Why does cold make MS symptoms worse?
Two things seem to be at work. The MS Society (UK) points out that muscles and joints work less well in the cold for everyone, with or without MS. It also notes that the nerves of the brain and spinal cord work best at a comfortable temperature, not too hot or too cold.
In MS, damaged myelin makes nerve signals less reliable, and the MS Trust notes that temperature changes as small as 0.5°C can affect how nerve impulses travel. Keeping warm also uses energy, which the MS Trust says can add to fatigue.
Is it a relapse or just the cold?
Cold-related worsening is usually temporary and eases once your temperature returns to normal. That pattern is what separates it from a relapse, where new or worsening symptoms persist.
If symptoms do not improve after you get warm, or if stiffness, spasms, numbness or tingling become significantly worse or persistent, the MS Trust advises contacting your doctor. Your MS team is the right place to decide what it means.
How can you stay warm with MS in winter?
The MS Trust suggests aiming to stay consistently warm rather than reacting once you already feel cold. In the 2022 survey, the most common cold strategies were staying in a heated environment (90.7%) and wearing layers of clothing (81.4%).
Heat the rooms you use most and close off drafts, so the home stays evenly warm.
Dress in several thin layers that are easy to add or remove, especially if heat and cold both affect you.
Cover hands, feet and head outdoors; keep a spare pair of dry socks and gloves.
Move regularly indoors; the MS Trust notes movement helps reduce stiffness and spasms.
Before exercising outside in the cold, stretch for a few minutes indoors to warm up your muscles.
If you are also heat sensitive, shed layers as soon as you come back indoors so you do not swing from chilled to overheated.
Are heating pads and hot water bottles safe with MS?
They can be used carefully, but MS can change how the skin senses heat. The MS Trust warns that with reduced sensation or numbness you could damage your skin without being aware of it, and advises avoiding direct skin contact. The MS Society (UK) cautions that a heat pad or hot water bottle left directly on the skin, or too hot, can cause blisters and burns.
Safer practice: never place a heat source directly on bare skin; wrap it or use it over clothing; use a timer and avoid sleeping on heating pads; check skin you cannot feel well for redness afterward; and favor keeping body heat in with layers, blankets and insulation over adding concentrated heat to one spot. Air-activated warmers and heated garments follow the same rules.
When to call a clinician or emergency services
Talk to your clinician or MS team about any change in your symptoms, especially if the pattern is new to you.
| Warning sign | What to do |
|---|---|
| Symptoms that do not improve after you warm up, last more than 24 hours, or come with a fever | Contact your MS team or clinician; this can signal an infection or a relapse |
| Stiffness, spasms, numbness or tingling that become significantly worse or persistent | Contact your MS team or clinician |
| Skin that stays red, blisters or breaks after using a heat source | Stop using it and get the skin checked |
| Shivering, confusion, fumbling hands, slurred speech or drowsiness in the cold (possible hypothermia) | Get medical attention; below 95°F body temperature is an emergency |
Key takeaways
Cold can temporarily worsen MS symptoms, most often stiffness, spasms, fatigue and walking.
Cold sensitivity is less common than heat sensitivity, and many people react to both.
Symptoms that ease once you warm up differ from a relapse; persistent changes need your MS team.
Stay steadily warm with a warm home and thin layers rather than chasing warmth after you are chilled.
Never put heat sources directly on skin that may not sense heat properly.
Frequently asked questions
Can cold weather cause an MS relapse?
Cold usually causes a temporary worsening of existing symptoms that fades once you warm up, not a true relapse. If symptoms stay after you are warm, or new symptoms appear, contact your MS team so they can assess what is happening.
Why do my legs get so stiff in the cold with MS?
Muscles and joints work less well in the cold for everyone, and MS nerves are sensitive to small temperature changes. The MS Trust notes stiffness is especially likely to worsen in cold weather. Warming up indoors, stretching and moving regularly can help.
Is it normal to feel cold all the time with MS?
Some people with MS do report feeling cold more easily, and MS can affect the brain areas and nerves involved in temperature control. Feeling cold all the time has many possible causes, though, so it is worth raising with your clinician.
Can you have both heat and cold sensitivity with MS?
Yes. In a 2022 survey of 757 people with MS who reported temperature sensitivity, 29% were sensitive to both heat and cold. Layers you can add or remove quickly are useful because they let you avoid both overheating and chilling.
Is a heated blanket safe if I have MS numbness?
It can be used with care. Use it to warm the bed before you get in rather than all night, never lie directly on a heat source, and check skin you cannot feel well for redness. If you are unsure, ask your MS nurse or occupational therapist.
Related reading
Sources
Temperature sensitivity and MS, MS Trust
Chilled out: cold sensitivity and MS, MS Trust
The effects of temperature on MS, MS Society (UK)
Heat and cold sensitivity in multiple sclerosis: A patient-centred perspective on triggers, symptoms, and thermal resilience practices (Christogianni et al., 2022), Multiple Sclerosis and Related Disorders
Preventing Hypothermia, Centers for Disease Control and Prevention
About HEATJAC. HEATJAC is a thermal architecture company founded by an anesthesiologist. We design patented garment systems that capture, conduct and broaden warmth across the body, and we publish this knowledge hub because the science of staying warm should be public. HEATJAC products are not medical devices and are not intended to diagnose, treat, cure or prevent any disease.