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A to Z of MS Pain

More than half of all people with MS will experience pain at some stage.

There are two broadly recognised types of pain in MS:

Neuropathic pain

also known as nerve pain. It is thought that this arises as a direct result of the damaged to the covering of nerves interfering with the normal transmission of information to the brain. However, the origin of most nerve pain is not fully understood.

Musculoskeletal pain

also known as nociceptive pain. Nociceptors are pain receptors found throughout the body that respond to injury and inflammation. They send messages to the brain that are perceived as pain, usually in the joints or muscles. This type of pain is not directly related to MS, but may be exacerbated by it; for example, musculoskeletal pain can arise as the result of spasms or abnormal pressure on the muscles and joints due to changes in posture, typically in the back or hips.

Pain symptoms

A number of MS symptoms may be classed as pain, including:

  • numbness
  • feelings of constriction, tightness or being squeezed around the chest
  • tingling
  • pins and needles
  • burning sensations
  • sudden stabbing pains
  • chronic gnawing pains
  • changes in sensation, eg very sensitive patches of skin

No two people will experience pain in the same way; it is very subjective and is best described by the person experiencing it.

Management of pain

The management of pain in MS is not always easy and may not be successful. Some types of pain will never go away entirely. The body can adapt to tolerate a certain level of day-to-day pain and the person with MS may not recognise the pain as a symptom after a while. Treatment depends largely on the cause of the pain and so a proper assessment in necessary to determine whether the pain is nerve pain, muscle pain or might be due to causes other than MS.

The aim of treatment if the pain cannot be eradicated, is to manage the level of pain so that the individual can carry out normal day-to-day living; therefore it is important to be open to a range of possible treatment options, which may include drugs or non-drug treatments such as physiotherapy.

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