Cold weather can exacerbate neurological symptoms. Here’s why, and what might help.

When temperatures drop, people with neurological symptoms of Long Covid or other conditions may notice an effect on their health. Here’s why this happens, plus tips for coping with the rest of the winter.

Neurological problems can stem from a variety of causes, including after a virus such as Covid-19. Symptom profiles can be wide-ranging and changeable, whilst flare-ups might be triggered by hotter or colder weather. This is common, and there are ways to help.

If you’ve observed that temperature affects your symptoms, you’re not alone if this brings you anxiety about what the rest of the winter may bring. This might be particularly so if you’re concerned about your energy bill, or already facing difficulties. Here are some tips for making sure you’re getting all the support you can, plus ideas for coping with the cold.

Which neurological problems can be affected by cold temperatures?

Neurological symptoms are often the result of peripheral neuropathy (PN): damage, or disease of, nerves in the body’s extremities (eg. hands, feet, arms). This usually involves numbness, tingling, or a pins and needles sensation in the areas affected, although symptoms can vary by the type of PN that you have. The condition can be the result of:

  • Injury (including carpal tunnel syndrome, and arthritis).

  • Conditions such as diabetes, or Reynaud’s syndrome.

  • Hormonal imbalances, such as thyroid problems.

  • Deficiencies caused by alcoholism, nutritional imbalances, toxin exposure, or some medication effects.

  • Autoimmune conditions such as lupus and rheumatoid arthritis.

  • Certain cancers (as well as cancer treatments like chemotherapy and radiotherapy).

  • Benign tumours.

  • Some kidney or liver disorders.

  • Some viruses (such as varicella-zoster — which causes chickenpox and shingles — HIV, herpes simplex, Covid-19, and Lyme’s disease).

  • Rarely, certain genetic conditions.

This factsheet explains more about how each of these can cause peripheral neuropathy. 

Other neurological problems that can be affected by the cold include MS (multiple sclerosis), epilepsy, Parkinson’s, and Functional Neurological Disorder. Due to Long Covid being a new condition, there haven’t yet been many cold seasons for individuals or researchers to observe how the weather affects it. 

Covid may, like other viruses, cause inflammation within the body that can aggravate a condition you already had (before having Covid). This may trigger flare-ups, or affect insulin resistance if you’re diabetic.  This can be very challenging, although having awareness of your usual symptoms and their triggers can be useful. For example, you could try keeping a diary to help you spot patterns, and to identify things that help.

Photo by Matthew Tkocz on Unsplash

How warmth helps

When pain is experienced from neuralgia (pain in a nerve pathway), it’s best to use something cold on the pain area for a couple of minutes if the pain feels sharp. When the sharpness subsides, you can apply warmth to help the tissue heal. 

With dull, tingling, or radiating pain, warmth can help. Warmth aids circulation, causing blood vessels to expand and increase, (or maintain), blood flow. This brings oxygen and nutrients to the area: essential for tissue health. It also helps your body to feel comfortable, as warmth relaxes muscles. (When cold, these can restrict and feel tight, painful, or they may spasm). 

The sensory sensation of warmth from having a bath may also help distract from pain and discomfort, whilst giving you the benefits described above. In some conditions, sudden changes in temperature trigger flare-ups. This can happen with Reynaud’s Syndrome, where temperature fluctuation, or sustained periods of being cold, can cause prickling pain and redness in the extremities. Keeping both ambient and local warmth as steady as possible can help to avoid this.

Ways to get help with keeping your home warm

Ambient warmth — having a warm temperature surrounding us — generally involves using a heat source for at least some of the day in winter. As energy prices have risen dramatically, this might be something that you are worried about affording. This page from Citizen’s Advice details support available for energy bills, whilst you can use this page and this one from the government to check that you are getting all the help that you can.

People living in Scotland can find help through Energy Action Scotland, who campaign to end fuel poverty and produce a Stay Warm, Stay Well leaflet. Meanwhile, the Welsh government’s Nest scheme offers “a range of free, impartial advice and, if you are eligible, a package of free home energy efficiency improvements”. The mayor of London recently announced an energy advice service specifically for those living in the capital. The Energy Saving Trust aims to tackle both the climate crisis and rising bills by supporting UK households and businesses to reduce energy use. They also have specific advice around help that people in Northern Ireland can access.

Macmillan’s website includes a section detailing help with the cost of living for those with cancer. The charity is facilitating specific energy help in collaboration with npower, as well as some support grants.

Energy suppliers differ in their exact support and payment options for those struggling to pay. However, if you’re experiencing hardship then it’s good to get in touch sooner rather than later with whoever your energy bill is with.

How massage and movement can help

When we move our bodies, or parts of it, our muscles require more blood to flow to them. As our blood is warm, this benefits the health of that area of our body for the reasons described above. 

Achieving this can feel hard if you are unable to go outdoors very often, have a risk of falling (particularly in icy conditions), or other mobility limitations. Alternatives include exercises advised by a physiotherapist, joining an online class, or trying chair yoga — type into YouTube or see this article. You don’t need marathon sessions for your body to benefit; maintaining circulation through brief but frequent stretches helps to keep your body active and warm.

Massage similarly increases blood flow to an area, as well as aiding relaxation and loosening stiff muscles (particularly when accompanied by stretches). This is something that you can do yourself, without specialist equipment, or long periods of time carved out. Hand massage may particularly benefit neurological conditions affected by the cold —you can follow these straight-forward steps to try for yourself. 

A few things to consider before massaging an area are:

  • Avoid massaging broken or irritated skin, or directly over bones.

  • Avoid massage when you have a fever, acute illness, or if you have taken medication in the past 1-2 hours, (or are under the effects of drugs or alcohol).

  • Speak to your GP or specialist practitioner if you have cancer or serious circulatory disorders, diabetes, varicose veins, or have had an injury or surgery in the past year.

  • If you use massage oil, check the ingredients if you have allergies or skin sensitivities.

  • Work with gentle pressure (at least at first), particularly if you experience numbness or hypo/hypersensitivity in that area.

Other tips for keeping warm

Many parts of the UK recently saw temperatures drop unusually low. If you faced challenges during this period, it’s understandable to feel worried whether similar cold snaps lie ahead. 

As weather is something that we cannot predict, (at least far ahead), or control, you might struggle with anxiety triggered by that uncertainty. As stress can impact upon flare-ups of neurological symptoms, it’s important to give this attention.

The Brain and Spine Foundation advise paying particular attention to wearing warm clothes over areas of the body that experience nerve pain. They suggest wrapping a scarf around your face, or wearing a balaclava, if you suffer from facial pain. Look out for fleecy blankets that have sleeves, as well as fleecy gloves. Other ideas include:

  • Layering clothes.

  • Drawing the curtains at dusk.

  • Consuming warm food and drinks.

  • Using hot water bottles and heat pads (although the MS Trust advises that some conditions, like MS, affect temperature sensation. They encourage people to take care when using these or electric blankets to avoid accidental burns).

  • Taking a warm drink in a flask when going out.

  • Using flannel sheets and socks in bed.

  • Eating well: those with anaemia, low body weight or low muscle mass may feel colder at night, making it harder to get to sleep.

  • It may be tempting to drink alcohol, or caffeine, for the short-term warmth they can give. However, these can exacerbate symptoms. Additionally, alcohol can deceive temperature sensation, along with bringing other risks.

It’s important to note that, if you start feeling cold suddenly in combination with chest pain, dizziness or fainting, getting medical advice is advised. Similarly, if you’ve recently started experiencing neurological symptoms, it’s good to talk to a GP sooner rather than later. This can sometimes avoid nerve damage, and they may be able to signpost you for other support. For example, oral or topical medication can be useful for some conditions, as can physical therapy. Stress-reduction techniques and CBT can also play a role in managing nerve pain.

The MS Trust acknowledges the impact that staying inside because of neurological symptoms can have on our mental health. This can be for social reasons and because we may consequently lack Vitamin D — particularly during these months of reduced sunlight. If this rings true for you, it’s essential to think about who you can reach out to if you feel low or isolated. Or plan activities that support your relaxation and elevate your mood.

Covid Aid’s online community offers support to anyone affected by Covid-19 and Long Covid. Other groups and forums across the web offer similar for various neurological conditions, too. Your GP may also know of local groups, where you can get through the winter together.

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