Pain in Multiple Sclerosis: An Overview

 Dealing with pain on an everyday basis can be hard, particularly when that pain inhibits daily function. For patients with Multiple Sclerosis, pain in some form is a regular occurrence, whether in a specific body part or as a result of general weakness. While many physicians did not recognize pain as an official symptom earlier, multiple studies have documented the impact it has on functionality, and the frequency with which it occurs. Here, we take a closer look at the different kinds of pain someone with Multiple Sclerosis might experience.

Understanding Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic inflammatory condition of the central nervous system. It is an autoimmune demyelinating disease, which means the immune system mistakenly attacks normal tissues — in this case, the myelin or protective covering around nerve fibers. This leaves scarred tissues or lesions in multiple areas, disrupting electrical impulses throughout the body. When the myelin sheath is damaged, nerve impulses slow or even stop, causing neurological problems.

Types of pain in Multiple Sclerosis

Pain is one of the most common symptoms of Multiple Sclerosis. Pain can arise from mobility issues related to the disease or directly as an outcome of the damage to the central nervous system. The pain associated with Multiple Sclerosis can be classified based on origin, as follows:

• Neuropathic pain: This occurs due to a ‘short-circuiting’ of the nerves carrying signals from the brain to the rest of the body. Pain of this type can take a stabbing, squeezing, or burning form. There are two subtypes of neuropathic pain

• Acute neuropathic pain: This type of pain has a short duration and comes on rapidly. It can be an initial symptom of Multiple Sclerosis or occur as part of a relapse. Acute neuropathic pain can take the following forms.

• Lhermitte’s sign: This is one of the classic initial Multiple Sclerosis symptoms and occurs due to nerve damage in the cervical spine. It manifests as a brief sensation, like an electric shock when the patient brings their neck forward, and runs from the back of the head down to the arms or even the legs.

• Paroxysmal spasms: These involve painful tightening of muscles in the limbs, and may occur intermittently throughout the day.

• MS hug: This occurs due to damage to the spine, and appears as a squeezing sensation around the torso like the tightening of a strait-jacket or a blood pressure cuff.

• Trigeminal neuralgia: This occurs due to damage to the trigeminal nerve and is unpredictable in terms of when it comes on and how long it lasts. It manifests as a stabbing sensation in the face or jaw, which is why it is often confused with dental pain.

• Chronic neuropathic pain: This also occurs due to nerve damage, but appears on a consistent basis rather than at intervals. Acute neuropathic pain can often transition into chronic pain affecting the same body parts. Chronic pain can also take the form of Dysesthesias, which is a burning, stabbing or prickling sensation that affects the limbs and frequently interferes with daily activities. Patients experiencing higher levels of stress and fatigue are more likely to experience chronic neuropathic pain. 

• Musculoskeletal pain: This type of Multiple Sclerosis pain occurs due to physical weakness, stiffness, or other mobility problems that affect coordination and movement. Many patients experience spasticity, or a tightening of the muscles, that causes pain in the back and the joints. In addition, owing to muscle weakness, other muscles may end up compensating during the course of daily movements, which can lead to fatigue and further pain in turn.

Treating Multiple Sclerosis pain

Your physician can help with the best avenue for appropriate treatment to manage your Multiple Sclerosis pain. For the best course of treatment however, you will need to describe accurately and in detail what the pain feels like. Some points that your physician may want to know, include:

• Which parts of the body you feel pain in

• Whether the pain appears in short bursts or is persistent

• Whether the pain feels sharp, dull, throbbing, burning, aching, tingling, squeezing, or otherwise

• Whether the pain has increased over time 

• Whether the pain intensifies as a result of any certain conditions

• Whether mild painkillers relieve the pain

• Whether the pain appeared at the same time as other Multiple Sclerosis symptoms

• Whether the pain affects your daily activities, such as sleeping, standing, walking, or writing

Treatment will typically take the form of Physiotherapy and Occupational Therapy in addition to medication. Based on the degree of the pain and the extent of its impact on daily activities, your therapist may recommend specific exercises to reduce muscle spasticity, and improve overall gait and strength. You may also wish to consider alternative therapies such as Meditation, Hypnosis, Mindfulness, Yoga, Aqua Therapy, Massage Therapy, Cognitive Behavioral Therapy, or Acupuncture. Always consult your doctor before embarking on any new course of treatment, and make sure you follow a regular sleep schedule to combat the pain better.

FAQs

• Are people with MS more sensitive to pain?

As a consequence of the nerve damage in Multiple Sclerosis, patients may experience increased sensitivity to pain, as well as abnormal sensations like burning, tingling, or stabbing. Patients experiencing chronic neuropathic pain are also likelier to be more sensitive to pain in general.

• Does the pain come and go with MS?

Particularly with acute neuropathic pain, the pain associated with Multiple Sclerosis may come and go without apparent cause. The pain may last for days, weeks, or even months before reducing. 

• How do you manage the pain of Multiple Sclerosis?

Your doctor can prescribe appropriate pain relievers to help you manage the pain associated with Multiple Sclerosis. You can also try some light exercises like aerobics, walking, or stretching to ease muscle pain.

• When should you suspect Multiple Sclerosis?

Some of the classic early symptoms of Multiple Sclerosis include numbness and/or tingling in one or more limbs, vision loss in one or both eyes, muscle spasms, or paralysis in one limb or one side of the body. If you have one or more of these symptoms, consult a doctor immediately.

• What does MS feel like in the beginning?

Quite often, the early stages of Multiple Sclerosis may involve symptoms like fatigue or tingling feet, which could be attributed to other conditions as well. You may feel numbness or tingling in the face or one side of the body, dizziness, sudden weakness, or blurry vision.

• What does MS feel like in the legs?

Multiple Sclerosis causes muscle weakness, which can make it harder to walk around. Many also experience painful muscle spasms in the legs owing to nerve damage. Patients may also feel numbness or tingling, or experience intense fatigue that can feel like heavy weights attached to the legs.

• What does MS neck pain feel like?

Patients with Multiple Sclerosis often experience pain in the neck and back owing to mobility issues. Multiple Sclerosis back pain or neck pain feels like a moderate to severe aching sensation. There is also Lhermitte’s sign, which is a painful sensation like an electric shock that occurs when the patient moves their neck forward.

• Why does MS cause neck pain?

Many patients with Multiple Sclerosis experience an electric-shock-like sensation when the neck is craned forward. This occurs due to damage to the myelin sheath covering the nerves in the cervical spine.

• Can MS feel like a pinched nerve?

Neuropathic Multiple Sclerosis pain can feel like a burning, stabbing, pinching, or squeezing sensation that is sharp and acutely painful.

• Does MS cause sharp pains in the head?

The damage to the nerves caused by Multiple Sclerosis can lead to both sharp and throbbing headaches. They can be acute and last a shorter time, or be duller and last for up to several hours. These headaches may be accompanied by nausea and sensitivity to light and sound.

Final word

In short, living with Multiple Sclerosis pain can undoubtedly be hard, but there are several ways to ease the pain and even eliminate it altogether. Consider joining an emotional support group for people living with Multiple Sclerosis, or ensure that you have a close network of family and friends around you. Continuing to do things you love, while taking the right treatment, can help overcome the pain associated with Multiple Sclerosis and consequently enable a life on your own terms.