Factors such as age, length of time with MS and degree of disability play no part in patients who do or do not feel pain with MS. There are many different types and sources of pain in those with MS.
This is a type of chronic pain and can affect the muscles, ligaments, tendons and bones of a patient.
Musculoskeletal pain is also known as nociceptive pain. Nociceptors are free nerve endings that detect stimuli and interpret them as pain. Nociceptors, protected by myelin, are in all types of body tissue except the brain itself. Musculoskeletal pain is caused by actual tissue damage detected by the nociceptors.
Musculoskeletal pain is not caused by MS, but by MS symptoms. Therefore, musculoskeletal pains are defined as secondary pain. It is often made worse by our inactivity, immobility, spasticity, and posture problems. That is, simply having multiple sclerosis makes MS musculoskeletal pains worse.
Caused by spasticity and pressure on the body, caused by immobility.
1. Heat 2. Massage 3. Ultrasound 4. Physical Therapy
A multidisciplinary clinic may be able to treat chronic, disabling pain with medication in combination with alternative therapies (hypnosis, yoga, meditation, or acupuncture)
Generally speaking, chronic pain is characterized as a pain that is felt consistently for more than six months. Chronic pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating.
Different types of pain are managed in different ways, so a careful assessment of the factors that may be contributing to the symptom is necessary in order to find appropriate treatments.
MS related pain, whether acute or chronic, is caused by faulty nerve signals due to lesions as well as the side effects of other MS symptoms such as muscle fatigue.
**Pain varies from person to person in degree, type and frequency. Thus, chronic pain must be treated on an individual basis.**
This is a type of acute pain. It resembles a burning, aching or
These sensations can either be evoked or spontaneous and can resemble a variety of feelings including: burning, wetness, itching, electric shock and pins and needles. These feelings can happen in any bodily tissue, but most often occur in the mouth, scalp, skin or legs.
The pain or abnormal sensations in Dysesthesias is often described as painful feelings of tingling, burning, or numbness. Dysesthesias can simply be described as a burning pain that is worse where touch sensation is poorest.
Caused by lesions of the nervous system.
1. Neurontin (www.pfizer.com/products/rx/rx_product_neurontin.jsp) 2. Elavil 3. Wearing a pressure stocking or glove 4. Warm compresses 5. Tylenol (www.tylenol.com)
This is a type of acute pain. It resembles a brief, stabbing, electric-shock-like sensation that runs from the back of the head, down the spine into the limbs and is brought on by bending the neck forward.
Lhermitte’s sign is a sudden electric sensation that shoots down the spine and legs when the neck is bent forward, as in looking down. It is not usually treated because it is transitory, but there are ways of managing the pain when it occurs.
Lhermitte’s pain confirms that there is demyelination in the neck area of the spinal cord.
Suggests a lesion of the dorsal columns of the cervical cord or of the caudal medulla.
1. Medicinal therapy – anticonvulsants 2. Soft collar used to limit neck flexion
This is a type of chronic pain and includes muscle spasms or cramps that may occur in people with MS.
The imbalance of signals resulting in spasticity causes hyperactive muscle stretch reflexes, which result in involuntary contractions of the muscle and increased muscle tension.
To diagnose spasticity your doctor will first evaluate your medical history, including what medications you have taken and whether there is a history of neurological or muscular disorders in your family. To confirm the diagnosis of spasticity, several tests can be performed to evaluate arm and leg movements, muscular activity, passive and active range of motion, and ability to perform self-care activities.
Caused by an imbalance of signals from the central nervous system to a person’s muscles. Read more on spasticity (interlink to spasticity symptom page)
1. Lioresal 2. Zanaflex (www.acorda.com/products/zanaflex.aspx) 3. Ibuprofen (www.motrin.com) 4. Regular stretching exercises 5. Balancing water intake with adequate sodium and potassium
This is a type of acute pain and can occur as an initial symptom of MS. It resembles a stabbing pain in the face.
Trigeminal neuralgia is a nerve pain which causes shock-like or burning facial pain. The pain can last from a few seconds to a few minutes, depending on the episode. It is usually felt on one side of the cheek or jaw and rarely both sides at once.
Trigeminal neuralgia can occur in patients with or without MS. In those with MS, TN occurs at a much younger age than those without. A patient’s diagnosis of TN usually occurs much later than the MS diagnosis.
This is a type of neuropathic pain caused by damage to the trigeminal nerve.
1. Tegretol (www.pharma.us.novartis.com/products/tegretol.shtml) 2. Dilantin (www.dilantin.com)