Considerations for Buying Cooling Garments for People with Multiple Sclerosis (MS)
Updated: Mar 29
Heat load intolerance is a common complicating factor in MS and is a key contributor to physical and psychological fatigue. This phenomenon, known as Uhthoff’s phenomenon, causes symptoms to worsen when the body temperature rises. Heat literally slows down the speed at which nerves in a person with MS send their signals. A person with MS might also get lesions in areas of the brain responsible for thermoregulation. This means a person with MS may not be able to sweat the same as a non-MS person, and therefore they can’t regulate their body temperature as well. Similarly, the ability of the blood vessels to vasodilate and constrict can be affected meaning blood can’t be moved about the body as easily and blood is a key heat transporter in the body. As a result, cooling garments can be an essential tool for managing MS symptoms during warmer weather or in environments that cause overheating.
It’s thought an estimated 60–80% of MS patients experience temporary worsening of clinical signs and neurological symptoms with heat exposure.
The current understanding of thermoregulatory dysfunction in MS has 5 main themes:
1) heat sensitivity;
2) central regulation of body temperature;
3) thermoregulatory effector responses;
4) heat-induced fatigue; and
5) countermeasures to improve or maintain function during thermal stress.
To read more about these 5 main themes head to this research article here https://doi.org/10.1152/japplphysiol.00460.2010
A recent systematic review and metanalysis supported the use of cooling garments in people with MS. Stevens CJ, Singh G, Peterson B, Vargas NT, Périard JD. The effect of cooling garments to improve physical function in people with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord. 2023 Oct;78:104912. doi: 10.1016/j.msard.2023.104912. Epub 2023 Jul 23. PMID: 37499339.
The study found “Cooling garments can improve physical function for people with MS. Since none of the cooling garments caused harm, and no particular cooling garment could be identified as being superior, people with MS should experiment with different cooling garments to determine their preference, and industry should focus on cooling garments that are effective, accessible and user-friendly.”
I recently wrote a letter of recommendation for an NDIS patient with MS who was struggling with heat load and fatigue, and while the National Multiple Sclerosis Society (America) has a 2-page document with the details of cooling equipment suppliers, I couldn’t find a list of Australian based products.
And so… The Cooling Equipment Information - National Australian Vendor List was born. If you think your product would benefit people diagnosed with MS and its not on the vendor list, please get in contact hello@youmovept.com.au
There are a whole range of equipment and garments to address the heat-related effects of MS such as cooling vests, wrist/ankle/neck wraps, hats/caps, and misters. This document outlines key considerations to help individuals with MS select the best cooling garments for their needs.
Hopefully this guide and The Cooling Equipment Information - National Australian Vendor List will help you mitigate heat-related flare-ups and improve overall comfort and your quality of life.
Key Considerations When Buying Cooling Garments
1. Type of Cooling Technology
Cooling garments typically use one of several cooling technologies. Understanding these options can help you choose the most effective product for your needs.
• Phase Change Materials (PCMs): PCMs are materials that absorb heat and change from solid to liquid to provide cooling. They are effective at maintaining a consistent temperature for a longer period of time.
• Evaporative Cooling: These garments use moisture to cool the body through evaporation. A garment is soaked in water, and as the water evaporates, it draws heat away from the body.
• Active Cooling Systems: Some garments use battery-powered systems that circulate cool air or liquid around the body. These provide continuous cooling but tend to be more expensive and bulkier.
Consider the level of cooling required and how long you need the garment to provide relief. PCMs tend to be great for prolonged, consistent cooling, while evaporative cooling works well in humid climates.
2. Fit and Comfort
The effectiveness of a cooling garment can be significantly influenced by its fit. A garment that’s too tight may restrict circulation, while one that’s too loose may not deliver cooling effectively. Key considerations for fit and comfort include:
• Size: Ensure the garment fits properly without being restrictive. Look for adjustable sizing or check manufacturer sizing charts to find the best fit.
• Breathability: Choose fabrics that are breathable and moisture-wicking to help with air circulation and prevent the buildup of sweat or moisture, which can cause discomfort.
• Material: Look for materials that are lightweight and flexible. Cotton, nylon, spandex, and polyester are commonly used in cooling garments because they offer stretch, comfort, and durability.
3. Level of Cooling Required
Different garments offer varying degrees of cooling. Consider how much cooling you need based on your lifestyle, climate, and how sensitive your body is to heat.
• Mild Cooling: If you're looking for light relief during everyday activities, a garment with basic evaporative cooling may be sufficient.
• Intensive Cooling: For individuals who experience severe heat intolerance or need extended cooling, garments with PCM or active cooling systems may be necessary.
4. Climate and Environment
Your local climate and the environments where you plan to wear cooling garments play a large role in the type of garment that will work best for you.
• Hot, Humid Environments: Evaporative cooling garments tend to work less effectively in humid conditions because evaporation is slower. In such climates, PCM-based garments or active cooling garments may be more suitable.
• Dry, Hot Environments: In dry conditions, evaporative cooling garments work well, as they can effectively utilize moisture for cooling. However, they may require regular re-soaking.
• Indoor vs. Outdoor Use: Consider whether you will be using the garment indoors (e.g., at home or in the office) or outdoors (e.g., while exercising or during outdoor work). Some garments are designed for extended outdoor use, while others are more suited for controlled indoor environments.
5. Ease of Maintenance
Cooling garments should be easy to care for and maintain. Consider the following:
• Washability: Check if the garment is machine washable or if it requires special care. Garments with PCM technology often require gentler care, while evaporative garments may be easier to wash.
• Durability: Look for garments made from durable fabrics that can withstand regular washing and use. Products that can maintain their cooling capabilities over time are a good investment.
• Reusability: Some cooling garments are designed to be used multiple times without needing constant recharging or re-soaking, while others may need to be reset periodically.
6. Activity Level and Mobility
Your level of physical activity and mobility should influence your choice of cooling garment.
• Active Lifestyle: If you plan to wear the garment during exercise or outdoor activities, opt for lightweight, breathable, and flexible cooling garments that allow for a full range of motion (e.g., cooling vests, bandanas, or hats).
• Sedentary or Office Work: For less active settings, a cooling garment such as a vest, necktie, or wristband may be sufficient, as you may not need the level of cooling required during physical activity.
• Extended Wear: If you need to wear a cooling garment for long periods, prioritize comfort, adjustability, and cooling duration.
7. Cost and Budget
Cooling garments vary widely in price depending on the technology used, material quality, and brand. While it is tempting to go for cheaper options, keep in mind the following:
• Budget Options: Basic evaporative cooling garments are usually more affordable and can provide short-term relief.
• Premium Options: Active cooling systems or PCM garments tend to be more expensive but offer longer-lasting and more effective cooling.
• Longevity: A higher-quality garment may be a better investment in the long run if it lasts longer and performs better. Compare the cost to the expected lifespan of the garment.
8. Ease of Use
The complexity of the garment can also affect its usability. Look for garments that are easy to put on, adjust, and remove.
• Adjustable Features: Many cooling garments come with adjustable straps, zippers, or Velcro, which help ensure a snug fit.
• Lightweight: Especially for people with limited mobility, a lightweight design that doesn’t add bulk can make a big difference in comfort.
9. Style and Appearance
While functionality is the priority, the style of the garment may also be important, especially for individuals who are concerned about appearance.
• Discreet Options: Many cooling garments are designed to be discreet, allowing you to wear them under your regular clothing without drawing attention.
• Variety of Styles: Cooling garments come in a range of styles, from vests and shirts to neck wraps and hats. Choose one that suits your personal preferences and the types of activities you will be doing.
10. Consulting Healthcare Providers
Before making a purchase, it’s always a good idea to consult with your GP, Physiotherapist, Occupational Therapist, or MS specialist. They can provide guidance based on your specific needs and symptoms, helping you choose the most appropriate cooling garment. Additionally, your doctor may recommend integrating cooling garments into your broader MS management strategy, especially if you have other temperature sensitivity concerns.
When selecting cooling garments for managing heat intolerance in MS, it’s important to consider the technology used, fit, cooling duration, and your activity level. Cooling garments can be an effective way to manage temperature-related symptoms, but finding the right product will depend on individual needs, preferences, and lifestyle. Careful consideration of these factors will help ensure that you stay comfortable and symptom-free during warm weather or situations that trigger heat sensitivity.
Will the NDIS cover the cost of cooling vests/equipment?
Yes, they should, as heat load intolerance is a common occurrence in people diagnosed with MS with the capacity to have a major negative impact on your quality of life. It is likely though you will need a letter of recommendation from suitably qualified clinician to support your purchase of low-cost assistive technology like cooling garments.
Australian Online Resources
American Online Resources
• Check out the ActiveMSers.org’s Cooling Gear Buying Guide.
Bianka Kent
Practice Owner | Physiotherapist
B. Ex Sci., M. Phty
m: 0410 586 259
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