Keep Cool: Multiple Sclerosis and Heat Tolerance
Jacqueline A. Hall, MS, OTR/L, MSCS
Often after someone develops multiple sclerosis (MS), it is not unusual to develop heat intolerance. Small increases – as little as ½ºF – in core body temperature can increase MS symptoms. The cause of this is that 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. Depending on the location of the nerve damage in the body, symptoms may include increased heart rate, sweating, dizziness, muscle weakness, slowed reaction times, reduced energy, and difficulties with attention and concentration.
Many things can cause body temperature to rise – some we usually think of, and some are a little harder to see. Obvious causes of increased body temperature are things such as being in a warm environment, increasing physical activity, or wearing too many clothes. All these can easily lead to increased body temperature and for some an increase in MS symptoms. A not so obvious cause of increased body heat is having a fever.
Warm environments may include things such as your kitchen during meal preparation, working hard around your home (whether cleaning the house or working outdoors), taking a hot shower, swimming in a warm pool, or being out in the sun. Your body temperature may also rise with increased physical activity, such as when walking, propelling your wheelchair, exercising or doing other leisure activities. Causes that are not too obvious would be things such as wearing clothing that keeps you too warm, or being in rooms that although they are comfortable for others are too warm for you. Medical illnesses such as bladder infections, colds, and/or the flu might cause you to experience a low to medium grade fever, which in turn increases your core body temperature.
If heat affects you, you need to take extra precautions and use strategies to keep cool. There are a number of ways you can help your body to stay cool and keep yourself healthy. These include:
Adjust the temperature in your environment
Use cooling equipment
Develop a personal cooling program
Research studies show that individuals who take a cool bath or shower (not cold), sit in an air conditioned room, or wear a cooling vest for 45 minutes a day have an overall decrease in their core body temperature. This results in an improvement in strength and less fatigue for up to 2 hours after cooling. Here are some tips:
The above strategies work well for most people, but this doesn’t mean that you will never have problems maintaining your body core temperature. When the “low-tech” methods (above) aren’t adequate, a cooling vest might meet your needs.
How does a cooling vest work? A cooling vest is designed to keep the body’s core temperature (around the heart and spinal cord) within safe levels to reduce symptoms of heat intolerance. The vest absorbs body heat, evaporates perspiration, and conducts cooler temperatures to the body through the skin. Cold packs for the neck, wrists and head conduct cold through to the arteries, cooling the blood circulating in the body.
When should I wear a cooling vest? The cooling vest should be worn in warm-to-hot conditions or when physical activity is planned. The vest can help keep you cool up to 3 hours when worn correctly, although this can depend on things such as environmental temperature, humidity, and your level of activity.
How do I use the cooling vest? It is beneficial to wear the cooling vest at least 30 minutes prior to physical activity. The cooling vest is more effective when worn over thin clothing and, when needed, when breathable fabrics are worn over the vest.
We have covered some of the important information on how to keep yourself healthy if you are someone who is affected by heat. You will need to discuss your heat tolerance problems with your healthcare provider to address the appropriate strategy for you. The VA generally covers adaptive devices like cooling vests to help people with MS manage their symptoms. If you experience heat intolerance contact your VA medical team which includes your primary care physician, neurologist, occupational therapist and others to find the best solution for your needs.
Links to Additional Information
Below are some Internet resources you may find helpful as you work on discovering what works best for you:
These websites are provided as a convenience to begin your Internet search about MS cooling strategies. The VA does not endorse any products that are advertised on these websites. We recommend that you review the information and products with your healthcare provider before deciding what will meet your medical needs.
Date posted: October 22, 2007