Multiple Sclerosis (MS) is a chronic disease that affects the central nervous system. In a healthy individual, one’s nerves are covered with a protective coating called myelin. The myelin is destroyed in a person with MS, leaving the nerve fibers exposed. The unprotected nerve fibers don’t work as well as the protected nerves. Many areas of your body can be affected, including movement, vision, and cognitive function. Back pain is one of the many symptoms of MS.
People with MS may suffer from back pain for a number of reasons, including muscle stiffness (spasticity) and having trouble moving (immobility). Using mobility aids incorrectly can put pressure on your back, and lead to poor posture and pain. Your back may become sore if you struggle with your balance or walk in an unnatural pattern.
Sometimes your back hurts for reasons that are not related to MS, such as muscle strain or a herniated disk. The difference is that someone who has MS may not be able to compensate for otherwise typical back pain as well as an able-bodied person.
Your doctor will try to determine the root of your back pain before recommending specific medications. Pain from muscle strains may be treated with over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen. If you suffer from spasticity, your pain may respond well to stronger prescription drugs, including baclofen and tizanidine. Spasticity is an extreme tightness of the muscles that is common in MS.
Exercise may sound unappealing when you have MS-related back pain, but it’s often an effective treatment. Gentle stretching, such as range-of-motion exercises or the slow movements of yoga, reduces pain and lessens depression in many people. Exercising when you’re able may also help with the extreme fatigue that’s common in MS. Create a workout program with your doctor based on your abilities.
Physical therapy (PT) or occupational therapy (OT) is important for anyone with MS, not just those who have back pain. Rehabilitative therapies such as PT and OT help keep you as flexible and mobile as possible while teaching you how to conserve your energy and most efficiently move your body. Exercises may improve back pain by stretching tight muscles; gait training helps you learn how to walk more easily.
Occupational therapy teaches you how to adapt your home, work, and lifestyle to meet your changing needs. You'll learn how to use adaptive aids correctly, which may help prevent back pain that’s related to muscle strain or poor posture.
Your doctor may recommend water therapy to treat MS-related back pain. Sore muscles get a chance to relax in a heated pool. The warm buoyancy of the water supports joints that may be stiff and weak. Water aerobics can be the best of both worlds: a cocoon of warmth as well as a source of gentle exercise that lets you practice balance and coordination more easily than on land. Water exercises can even help fight the low energy levels that are common in MS. Check with your doctor first, before enrolling in a class.
If conventional treatments aren’t enough to keep your back pain under control, or if you prefer a more alternative approach, ask your doctor about complementary treatments such as acupuncture or massage therapy. Studies published in a 2013 issue of Clinical Journal of Pain suggest that acupuncture may be effective for treating lower back pain. Research from the International Journal of General Medicine shows that massage therapy may alleviate back pain too.
If you’ve got MS, pain is a symptom that you’ll likely deal with throughout your life. Lean on your medical team, friends, and family when your back pain is at its worst. Being active and keeping a positive attitude will help you through the challenges and limitations you encounter.