Although a steamy soak may be tempting to help ease muscle stiffness or nerve pain, hot temperatures can actually worsen MS symptoms, even if temporarily.
There are several possible reasons. In many people with MS, getting hot slows down the messages passing along nerves which have already been damaged by MS and this gives rise to increased symptoms. In some cases, there is a lesion in a part of the brain that controls temperature regulation in the body.
Increased activity, hot weather, hot baths and showers, saunas, and hot tubs are all sources of heat that can cause issues for someone living with MS. These sources can trigger a phenomenon known as an MS pseudoexacerbation, which is the experience of having symptoms appear or worsen due to heat exposure.
Small increases – as little as ½ºF – in core body temperature can increase MS symptoms. Nerves that have lost their conductive coating (myelin sheath) become more sensitive to heat, and the nerve signal slows down or is blocked, resulting in an increase in symptoms.
Heat sensitivity or Uhthoff's phenomenon occurs in 60–80% of MS patients [1], where increases in core body temperature as little as ~ 0.5°C can trigger temporary symptoms worsening.
Possible triggers include infections and stress, but there may also be no noticeable trigger. Anyone who notices a worsening of symptoms or that new symptoms appear should contact a doctor in case they need additional treatment or monitoring.
Heat generally produces only temporary worsening of symptoms. It does not cause more disease activity (demyelination or damage to the nerves themselves). The symptoms improve after you cool down.
Hot water showers and baths are sources of heat that can result in elevations in core body temperature. In multiple sclerosis (MS) patients, this can further interfere with electrical signals from already damaged nerves and lead to a temporary exacerbation of symptoms or the appearance of new ones.
In the 19th and early 20th centuries, the effects of heat on people with MS were used in the diagnosis of the condition. The hot bath test involved lying in a bath of warm water. If this caused or worsened neurological symptoms, it was taken as evidence that the person had multiple sclerosis.
Some people with multiple sclerosis find that cold temperatures make their symptoms worse. It doesn't have to be extreme cold, it could be a light breeze or getting caught in the rain on a summer's day. The effect is temporary and, when you warm up, your symptoms should go back to their usual level.
For starters, the combination of specific breathing exercises and cold showers is known to strengthen the body's immune response, which has a positive effect on the reduction of inflammation associated with the development and progression of multiple sclerosis.
When MS is progressing, you might notice those muscles are not only getting weaker, but you're having more tightness and cramping in that area, too, Dr. Samdrawlar says. A general worsening can be true for whatever symptom you have, whether it's vision, numbness, or balance issues.
Many people with MS find that their symptoms get worse in the heat. This can be triggered by hot baths, the sun, or exercise.
Key Facts: Clemastine, an over-the-counter antihistamine, has been identified as a potential therapy for MS, with observed increases in myelin water fraction indicating myelin repair.
Install grab bars inside and outside the bathtub or shower. Use a bathtub transfer bench or a shower chair with back support. Put extended lever handles on faucets to make them easier to turn. Put a nonskid mat in the bathtub.
Exercising and Keeping Cool
It is recommended that the pool not be heated to more than about 85 degrees. In general, persons with Multiple Sclerosis should avoid hot tubs and saunas.
Abnormal sensations can be a common initial symptom of MS. This often takes the form of numbness or tingling in different parts of your body, such as the arms, legs or trunk, which typically spreads out over a few days.
A 2022 study found that 58 percent of people with MS reported heat sensitivity, 29 percent experienced both heat and cold sensitivity, and 13 percent reported sensitivity only to cold. In general, respondents reported that temperature extremes worsened their MS symptoms, with worse fatigue being the most common.
The exact mechanism that leads to a relapse is unknown, but it's thought to be related to an increased overall immune response. There's some evidence that systemic infection (viral or bacterial), postpartum period, stress, and assisted reproduction (infertility treatment) can be associated with a flare-up.
Current or previous smokers with the highest levels of EBV antibodies were 70 percent more likely to develop MS than those with neither risk factor. Study Provides Strongest Evidence Yet for the Role of Epstein-Barr Virus in Triggering Multiple Sclerosis. Ask an MS Expert: The Role of Epstein-Barr Virus in MS.
Tiredness is one of the most common symptoms of a flare. You may also experience weakness or malaise (a general overall feeling of sickness). During a flare, fatigue may be caused by cytokines — substances produced by the immune system.