Brain & Nervous System Multiple Sclerosis Symptoms Cold Feet as a Symptom of Multiple Sclerosis By Colleen Doherty, MD Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. Learn about our editorial process Updated on March 11, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Nicholas R. Metrus, MD Medically reviewed by Nicholas R. Metrus, MD LinkedIn Nicholas R. Metrus, MD, is a board-certified neurologist and neuro-oncologist. He currently serves at the Glasser Brain Tumor Center in Summit, New Jersey. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Understanding Dysesthesia Other Reasons for Cold Feet Tips to Manage Your Cold Feet If you have multiple sclerosis (MS) and often feel like your feet are cold, even when they're warm to the touch, you're experiencing a symptom known as dysesthesia. Dysesthesia refers to abnormal sensations that are unpleasant, potentially painful, and occur anywhere on the body, although they're most commonly experienced in the legs and feet. Verywell / Cindy Chung Understanding Dysesthesia While MS used to be labeled a painless neurological disease, experts now know this is far from the truth. In fact, up to half of all people with MS experience pain at some point in their disease course, with many developing chronic pain. There are different types of pain a person with MS may experience, like the excruciating facial pain of trigeminal neuralgia or the eye pain of optic neuritis. When it comes to cold feet, MS experts call this pain a dysesthesia. Dysesthesias can occur on their own or may be triggered by something in the outside world, often by a change in the temperature or weather. They also tend to be worse at night and intensified with exercise. What Does MS Pain Feel Like? Sensitization of Your Nervous System You or someone else may notice that your feet are warm to the touch, despite the fact that they feel cold to you. This is because in MS, the myelin sheath—the protective coating around the nerve fibers in your brain and spinal cord (your central nervous system)—are damaged. This damage leads to faulty nerve communications that can cause erroneous pain messages to be sent to your brain. In other words, your feet are actually warm, but you think they're cold because your nervous system is telling you they are. With sensitization of the nervous system, two phenomena may develop: Allodynia means that a benign stimulus like a light touch or cool breeze triggers pain. Hyperalgesia refers to an increased sensitivity to pain. For instance, a pinprick on your foot, which is normally a little painful, may feel like a sharp knife. It's important to note that cold feet and other sensory symptoms are not necessarily signs that your MS is getting worse, especially if the symptoms come and go. If you experience cold feet for the first time, however, it's important to talk with your healthcare provider because it could be a sign of an MS relapse or another medical problem altogether. Other Reasons for Cold Feet Examples of other health conditions that may cause cold or painful feet include: An underactive thyroid (hypothyroidism) Blood vessel problems (for example, peripheral arterial disease) Diabetes (cold feet can result from both circulation and nerve problems) Raynaud's phenomenon While these can be the cause of cold feet, they can also compound cold feet that are due to other issues like MS. Hot Feet in Multiple Sclerosis Tips to Manage Your Cold Feet Besides the obvious, like warming your feet with blankets, there are other techniques—both medical and behavioral—that can help you manage your discomfort. 2:16 3 Women Share Their Experiences Managing MS in the Cold Distraction Distraction is a great psychological intervention for managing pain, as it forces your brain to shift focus from your pain onto the activity at hand, especially if that activity is cognitively demanding. If your feet are bothering you, consider trying one of these distraction techniques. Remember, though, depending on the intensity or nature of your discomfort, you may have to try a few different techniques before finding the one that works for you: Reading a book Calling a friend on the phone Playing a video game Listening to music or a podcast Coloring or painting Completing a puzzle Journaling Complementary Therapies Complementary therapies like hypnosis, cognitive-behavioral therapy, and mindfulness meditation can be especially useful in managing your pain, as well as other symptoms of your MS like fatigue or cognitive problems. Medications Of course, if your cold feet are significantly affecting your quality of life or impairing your functioning (for example, if you're falling or not going to work or seeing your friends and family), be sure to speak to your healthcare provider. The tricyclic antidepressant Elavil (amitriptyline) or a serotonin-norepinephrine reuptake inhibitor such as Cymbalta (duloxetine) may help; sometimes anti-seizure medications used to treat neuropathic pain like Neurontin (gabapentin) or Lyrica (pregabalin) can also be helpful. Some of these medications, though, do have side effects like sleepiness. Topical capsaicin cream is another potential option for your feet. 4:13 3 MS Patients Share Their Experiences Facing Mobility Challenges Other Therapies If your cold feet are impairing your walking and balance, you may need physical or occupational therapy. Regular visits to a podiatrist to ensure your feet appear healthy without ulcers, as well as special shoes called orthotics, may also be warranted. Seeing a therapist or psychiatrist may also be helpful as pain in multiple sclerosis can trigger or worsen depression or anxiety. Remember to discuss any medications or therapies with your healthcare provider first. A Word From Verywell Whatever form it takes, pain in MS can be debilitating, both physically and mentally. Seek guidance from your neurologist or a pain specialist can help you find effective strategies to feel better. Our Healthcare Provider Discussion Guide below can help you to start that conversation with a health professional. Multiple Sclerosis Healthcare Provider Discussion Guide Get our printable guide for your next healthcare provider's appointment to help you ask the right questions. Download PDF Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. 4 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Multiple Sclerosis Society. Pain: the basic facts. 2016. Bae KH, Go HY, Park KH, Ahn I, Yoon Y, Lee S. The association between cold hypersensitivity in the hands and feet and chronic disease: results of a multicentre study. BMC Complement Altern Med. 2018;18(1):40. doi:10.1186/s12906-018-2082-3 Jameson E, Trevena J, Swain N. Electronic gaming as pain distraction. Pain Res Manag. 2011 Jan-Feb;16(1):27-32. doi:10.1155/2011/856014 Azmi S, Elhadd KT, Nelson A, et al. Pregabalin in the management of painful diabetic neuropathy: a narrative review. Diabetes Ther. 2019;10(1):35-56. doi:10.1007/s13300-018-0550-x By Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit