Pain and Multiple Sclerosis
The National Multiple Sclerosis Society reports that nearly half of those people afflicted with multiple sclerosis (MS) have chronic pain. The pain in MS is described as being diffuse, affecting several areas of the body at once, changing over time, and getting worse or better for no apparent reason. There are many common pain types experienced by patients with MS. One of these is sudden onset pain that is often intense and brief, and is described as burning, tingling, shooting, or stabbing. Another type is trigeminal neuralgia, with stabbing facial pain brought on by facial movement (eg, chewing, yawning, sneezing, washing the face, brushing the teeth), which is seen in 5% to 10% of people with MS. Pain may also manifest as brief, stabbing, electric-shocklike sensation running from the back of the head down the spine, and is brought on by bending the neck forward (Lhermitte sign). Yet another type of MS pain is burning, aching, or “girdling” around the body (dysesthesia), a sensation called “MS hug.” The most common type of MS pain is spasticity with muscle cramps, tight and aching joints, and back or musculoskeletal pain.
Acute MS pain is not effectively treated with acetaminophen, aspirin, NSAIDs, or over-the-counter (OTC) pain relievers. Instead, off-label anticonvulsants and antidepressants are used. Exercise and physical therapy help decrease spasticity and soreness of muscles, and regular stretching helps flexor spasms. Nonpharmacologic options include: relaxation techniques, meditation, and deep breathing. Massage, ultrasound, chiropractic treatments, hydrotherapy, acupuncture, transcutaneous nerve stimulation (TENS), moist heat/ice, and Botox have also been used.
Pain is a covert symptom of MS, but one that causes much distress, which severely impacts quality of life. Maintaining a sense of control through activity and a positive attitude reduces the impact of pain on quality of life in patients who suffer from MS.