Life with MS

Keep Cool and Stay Fit

By Stephanie Butler, NP, MSCN
Many people with multiple sclerosis experience temperature sensitivity. A change in core body temperature can cause a temporary worsening of symptoms, such as blurry vision, numbness, or tingling. Heat is more commonly the culprit, but some people also experience similar effects in cool conditions too. It is important to keep this in mind, especially if you live somewhere that experiences extreme temperature changes, have a fever, or are exercising. Why do temperature changes affect people with MS, and what are methods for combating the effects of overheating?
MS and heat

MS attacks the myelin coating around nerves, causing demyelination. Much like a frayed wire, a damaged nerve may be able to conduct some electricity, but it is no longer in perfect working order. Demyelinated nerves cause symptoms such as vision changes, numbness, tingling, and pain. People with relapsing-remitting MS experience acute episodes of demyelination followed by periods of remission, during which their nervous system can find ways to compensate for some of the damage that has been done. This is what accounts for the waxing and waning of symptoms in people with RRMS. However, even though symptoms may improve or disappear altogether, the nerves are still damaged and have to work overtime to compensate. When your body gets too hot or too cold, electrical impulses are slowed even further, leading to what we call Uhthoff’s phenomenon or pseudo-exacerbations. These symptoms typically start when you get overheated and go away once your body temperature returns to normal.
Keeping Your Cool
Studies have shown that regular exercise can improve MS symptoms, but ironically, getting overheated can acutely worsen symptoms. But don’t give up; there are ways to beat the heat while staying in shape! Here are my personal tips for five easy things you can do:
  1. My personal favorite gym accessories are Mission Athlete Care’s Cooling Arm Sleeves (I’m not affiliated with them in any way; they just make a great product) and cooling towels. You add water to both items, ring them out, and they instantly become cold. I drape the towel around my neck, and it keeps me nice and chilled. These are popular products among athletes too, so they can usually be found at any sporting goods store. They work so well that I sent them to a good friend of mine while he was deployed with the military and having to endure 105+ degree heat, and he also found them to be extremely beneficial!
  2. The most efficient method of cooling is evaporation. With that in mind, I am always armed with one of those spray bottles that has a fan attached. A couple of sprays and some fanning can definitely help keep you cool.
  3. Drink ice cold water to keep yourself cool from the inside out. Many of my patients also freeze grapes and snack on them throughout their workouts.
  4. Choose activities such as yoga or swimming that are good for you but don’t leave you in a flop sweat.
  5. Whatever you do, make sure to stay properly hydrated!

Cold packing it in
If you are sick and have a fever, make sure to contact your doctor because it is important to keep your fever down. Over-the-counter medications can be used, and if you are feeling brave, cold showers and ice packs also help tremendously. In the hospital, we will place ice packs in areas with a lot of blood vessels, such as the armpits, groin, and the back of the neck, in order to get high fevers down. Just be sure to never place ice directly on the skin, and instead, wrap it in a towel or other insulator.
If you experience worsening symptoms in hot or cool conditions, make sure to listen to your body and try different strategies in order to find the one that works for you. Do you have any other tips and tricks for fighting temperature sensitivity?

Stephanie Butler is an ICU nurse who was diagnosed with multiple sclerosis at the age of 25. Six months after being diagnosed, she became a multiple sclerosis certified nurse and started working in the MS center where she was a patient. Her diagnosis was a defining moment in her life, but she feels that it has made her a better nurse and a better person. She is also attending graduate school to become a nurse practitioner, and she hopes to continue working with people who have MS for a very long time. She also writes for and serves on the Advocacy Committee at the New Jersey Metro Chapter of the MS Society. Her blog,, offers a unique perspective on multiple sclerosis from the point of view of both a healthcare provider and as a person living with the disease every day. Her mission is to bring compassion, humor, and a deeper understanding of MS to anyone who reads it.