When you have multiple sclerosis (MS), your local weather report may predict not only tomorrow’s forecast but also how well you're going to feel.
Many people who have MS experience a temporary exacerbation of their symptoms when the weather is very hot or humid, notes the National Multiple Sclerosis Society (NMSS).
This is a feature of Uhthoff’s phenomenon, a temporary worsening of symptoms that can occur in people with MS due to an increase in core body temperature. Uhthoff’s phenomenon can be triggered by exposure to hot weather, among other factors.
Meanwhile, some people who have MS notice that certain symptoms, spasticity in particular, get worse when the weather is cold, per the NMSS.
People with MS who are sensitive to temperature are typically advised to avoid extreme temperatures, both hot and cold, the NMSS says. (It’s important to note that symptoms brought on by fluctuations in temperature only worsen temporarily — this is not a true MS flare.)
Could changing where you live affect how well you feel? If you are considering a move for this reason, you may want to test it out to see if the new climate improves your symptoms before you relocate.
Here are a few other factors that people who have MS should consider before making a move.
Look Up the Average Monthly Temperatures
Before you move, especially if you’re considering the southern United States, search for the average monthly temperatures for the areas that interest you.
Between 60 and 80 percent of people with MS experience Uhthoff’s phenomenon with exposure to heat. Other factors, in addition to the temperature outdoors, can increase core body temperature, such as saunas, hot tubs, hot showers, and exercise during midday, when the weather is hotter.
While heat and humidity can temporarily worsen MS symptoms, they do not cause more actual nerve damage, notes Barbara Giesser, MD, a multiple sclerosis specialist with Pacific Neuroscience Institute and professor emeritus of clinical neurology at the David Geffen UCLA School of Medicine in Los Angeles.
Research the Average Annual Snowfall
Not only can colder temps worsen symptoms for some people who have MS, snow and ice on the sidewalks and streets can make getting around difficult or even impossible, especially if you have trouble walking or use a wheelchair.
“Ice and snow can make for potential hazards for persons who already have impaired mobility,” says Dr. Giesser, who notes that some people with MS may have worse symptoms with cold or cold and wet weather.
Before making a permanent move, look up the average annual snowfall for the places that interest you.
If you happen to like cold weather, you can make walking in slippery conditions a bit safer by putting removable traction devices on your winter boots and an ice tip attachment on your cane. Trekking poles may be another option. If you have a manual wheelchair, consider swapping your tires for wider tires with knobby treads and softer rubber, or pneumatic tires, notes University of Utah Health.
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Consider How Much Vitamin D You Will Get
Research suggests that vitamin D may play a role in lowering the risk of relapse and may decrease new scarring in the nervous system, notes Mayo Clinic. And since the skin uses ultraviolet B from the sun to make vitamin D, living in a sunnier climate may make a difference. The skin makes little if any vitamin D during the fall, winter, and spring months at latitudes above 37 degrees north of the equator, and people who live in these areas have a relatively greater risk of vitamin D deficiency, according to Harvard Health.
“Vitamin D appears to be involved in the risk of developing MS, and there are some data that suggest that higher vitamin D levels may protect somewhat against relapses,” says Giesser.
The benefits of sun exposure must be balanced against the risks of overheating, as well as the deleterious effects of the sun, such as skin cancer, she warns.
“Vitamin D supplementation can also be accomplished with vitamin D–containing foods or vitamin supplementation. It’s important to remember that too much vitamin D can be toxic, so levels should be monitored,” says Giesser. A review of research notes that there are risks and benefits to vitamin D supplementation in MS, specifically at higher doses, and the research is still inconclusive, so it’s best to talk to your neurologist before taking supplements.
Make Sure You Have Access to Medical Care
Your healthcare team may go beyond your neurologist to include a physical therapist, occupational therapist, speech-language pathologist, psychologist, social worker, and other specialists.
To find a city where you'll have access to all these healthcare providers, go to the NMSS’s Find Doctors and Resources page. Enter the ZIP code of your desired location to search for doctors, specialists, and other resources within 5 to 250 miles.
But if you do move and want to continue to see a certain doctor or healthcare provider, the recently expanded availability of telemedicine may give you more options.
Get to Know Your Transportation Options
If you use a wheelchair or scooter to get around, be sure to consider your transportation options. Some cities may have public transportation that’s accessible for those with disabilities, while other areas may offer paratransit, where you call in advance to reserve a ride in a van or minibus. Ride-hailing apps may offer another transportation option in some areas.
How do you find out what’s available in a given location? Try searching online for city or county transportation information, which should list public transit options and indicate whether they are wheelchair accessible. You might also search for a municipality’s office (or agency) on aging and disabilities for information on additional transportation services for people who cannot use public buses, subways, or trains.
Keep Your Personal Preferences in Mind
The best place to live — with or without multiple sclerosis — depends in part on your lifestyle. Would you prefer to be in a city? Suburb? Rural community? Do you need to be in a certain area for your work? And, of course, you have to consider your budget and what you can or cannot afford.
In addition, consider your answers to questions such as: How close are you to activities that are important to you? How easy is it to access them? What’s your proximity to family and friends? If you have to rely on them to get places, where they live can affect where you live.
Take Care Not to Increase Stress Levels
Stress can make symptoms of MS seem worse, notes the Multiple Sclerosis Trust. While it all depends on how you handle it, potential sources of stress related to where you live include:
A long daily commute
Lack of community services
No strong social connections to people in your area
Excess noise in your living environment
High level of air pollution (from living near a busy road, for example)
Any of these can be an argument for changing your location or for staying put, if a move would introduce new sources of stress into your life.
The Takeaway
When you have MS, it matters where you live. Climate can affect your symptoms; access to medical care and transportation are important factors; and the stress of living in certain environments can affect how you feel. If you’re considering relocating, the best places are those that meet your specific needs, so be sure to identify what your requirements and preferences are before you make a move.
Jason Chua, MD, PhD, is an assistant professor in the Department of Neurology and Division of Movement Disorders at Johns Hopkins School of Medicine. He received his training at the University of Michigan, where he obtained medical and graduate degrees, then completed a residency in neurology and a combined clinical/research fellowship in movement disorders and neurodegeneration.
Dr. Chua’s primary research interests are in neurodegenerative disease, with a special focus on the cellular housekeeping pathway of autophagy and its impact on disease development in diseases such as Parkinson disease. His work has been supported by multiple research training and career development grants from the National Institute of Neurological Disorders and Stroke and the American Academy of Neurology. He is the primary or coauthor of 14 peer-reviewed scientific publications and two peer-reviewed online learning modules from the American Academy of Neurology. He is also a contributing author to The Little Black Book of Neurology by Osama Zaldat, MD and Alan Lerner, MD, and has peer reviewed for the scientific journals Autophagy, eLife, and Neurobiology of Disease.
Beth W. Orenstein is a freelance writer for HealthDay, Radiology Today, the Living Well section of TheAmerican Legion Magazine, St. Luke’s University Health Network, and others. She is a magna cum laude graduate of Tufts University (1978), where she majored in English and was editor of the student newspaper for three years.
No matter the weather around her eastern Pennsylvania home, Orenstein either bikes 25 to 30 miles or walks at least 6 miles every day. Her one indulgence is blueberry pancakes — but only after biking a long distance.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Christogianni A et al. Temperature Sensitivity in Multiple Sclerosis: An Overview of Its Impact on Sensory and Cognitive Symptoms. Temperature. September 5, 2018.
