Many people complain about winter, but it can be a particularly challenging time for those who live with chronic conditions.

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Chris Anderson is no stranger to bad winters. He lives in Minnesota — a state that gets, on average, between 35–70 inches of snow every year, depending on where you live.

In the winter, the average temperature can get as low as 18 to 8°F (-7 to -13°C).

And as someone living with multiple sclerosis (MS), this cold, frigid weather affects him more than most.

“The colder it gets, the shakier my legs get,” he says. “It makes it very difficult for me to move around in the colder months.”

After losing about 85 percent of his eyesight due to optic neuritis, inflammation of the optic nerve, Anderson was first diagnosed with MS in September 2004. At the time, he was working as a middle school social studies’ teacher.

While his eyesight did more or less recover, he soon developed other symptoms of MS including leg weakness, balance issues, and extreme fatigue.

The extreme winter weather in his state exacerbates many of these symptoms.

“Last winter was especially bad because of the ice,” Anderson says. “I normally use ice cleats on my shoes along with a walking stick with a metal tip on the end to help prevent falls, [but] last year, I slipped on the icy pavement and suffered a traumatic brain injury.”

Heat — whether from the weather, exercise, or a hot shower — has been linked to blurred vision and a temporary worsening of symptoms in people with MS.

While heat sensitivity is more commonly reported, around 20 percent of people with MS experience worsening symptoms due to cold temperatures.

A drop in temperature can cause temporary issues with cognition, mobility, vision, and balance and may lead to numb, burning, or tingling sensations and tremors in the body’s extremities.

It’s believed that this happens because the cold affects the speed of messages traveling along nerves that are already damaged by the disease. But it’s also been suggested that cold sensitivity in MS could occur due to an MS lesion in the part of the brain that affects body temperature.

If you have MS and are affected by the cold weather, it’s important to prepare.

Anderson recommends finding someone to help with snow removal and investing in a remote starter for your car (and making sure it’s working at the start of winter).

“Since the cold weather greatly affects my MS, I need to have a warm car to walk into to prevent the leg shakiness from flaring up,” he says.

Other folks with MS focus on ensuring they can wear layers of clothes to help them regulate their body temperature. Thermal socks and underwear are great for that, as are electric blankets.

Betsy Mahowald, who also lives in Minnesota, says that every winter she stocks up on winter clothes, like boots, hats, mittens, sweaters, and anything with a hood.

In case of bad weather, she makes sure her home is stocked so she can avoid going outside in the worst weather.

“I make sure I have a decent supply of food in the pantry and freezer, such as meats or frozen soups, Kleenex, toilet paper, and basic cold and flu medications,” she says.

It’s also important to move around — even if indoors — because staying active keeps your body warm and helps minimize muscle stiffness.

Keeping your home warm, as best as possible, can also be helpful. Just be sure not to make the temperature too hot because heat may also exacerbate MS symptoms.

Mahowald says she also tries to schedule her annual neurologist visit in the fall, before the bad weather starts. Just one less trip she has to make outside in the cold.

The best way to help a loved one with MS through the winter is simply by being there for them.

“There are a lot of things I need to do to prepare for winter,” says Anderson. “Admittedly, I cannot do all of them alone because of my MS.”

That’s why, he says, he’s grateful to the neighbors who help with snow removal or check in with him before or after a large storm.

Many people complain about winter, but it can be a particularly challenging time for those who live with chronic conditions or pain.

That’s why, if you can, simply offering to be a good ally or support system can go a long way in making things a little easier.

Simone M. Scully is a new mom and journalist who writes about health, science, and parenting. Find her on her website or on Facebook and Twitter.