Multiple sclerosis is an often painful, chronic neurologic condition. Pain with MS may be caused by nerve damage, muscle spasms, or changes in how you experience pain.
Multiple sclerosis (MS) is a neurologic condition that can lead to significant disability due to progressive neurological problems. MS can cause pain by activating nerves abnormally or damaging nerves.
The different causes of pain are treated differently, so if you have MS and pain, you should let your doctor or neurologist know. They can work with you to manage MS while also managing the pain you might feel.
MS is a demyelinating condition of the nervous system, meaning that the protective myelin around your nerves is worn away or damaged.
Without myelin, your nerves may become injured, which can cause problems throughout your body. This can include changes in vision, weakness, and abnormal sensations that can come and go over time and may affect any part of the body.
Pain is a very common symptom of MS. A 2015 study found that 63% of participants with MS experienced pain from the condition.
The pain usually becomes more intense as MS progresses in people who are over 65 years old, have more disability due to MS, and have depression or anxiety.
MS pain can be acute (lasting a brief period) or chronic (long lasting).
If you have MS, you may experience pain anywhere in your body that’s being affected. There are several common pain syndromes that are associated with MS:
- Migraine: This condition is characterized by long lasting, pounding headaches, with or without a visual aura.
- Trigeminal neuralgia: This describes the shocking sensation on one side of the face triggered by facial touching or cold temperatures.
- Lhermitte’s sign: This describes an electrical sensation in the neck or back that you may experience when bending your neck.
MS pay can be categorized into three types depending on the cause:
- Neuropathic pain: This type of MS pain occurs in areas of the body and is caused by injury to your nerves.
- Nociceptive pain: This type is due to the activation of pain receptors in the body from tissue injury, which most commonly is from muscle spasms in people with MS.
- Nociplastic pain (central pain): This type arises from a change in the way the brain functions and understands the pain. It’s usually caused by chronic disease and repeated episodes of pain which causes this change.
Because there are several different causes of pain in MS, the treatment plan to manage pain is usually unique and targets the cause of the pain.
- Pain relievers (analgesics): These medications include nonsteroidal anti-inflammatory drugs (NSAIDs) and opiates. They’re mostly used for nociceptive pain.
- Antiseizure medications: Antiseizure or anti-epileptic medications like carbamazepine and phenytoin can be used to treat neuropathic and nociplastic pain.
- Antidepressants: Antidepressant medications like duloxetine, venlafaxine, and amitriptyline can be used to treat neuropathic and nociplastic pain.
- Nerve agents: Nerve agents like gabapentin are chemicals that interfere with the nervous system. They’re most effective for neuropathic pain.
Some people with MS report that complementary treatments for pain, such as massage therapy, help improve their pain.
Another important component of pain management is the effective treatment of MS in general. Healthcare professionals may use steroids in the short term with long-term injectable or oral medications to help manage MS symptoms.
MS causes a wide variety of symptoms that may vary greatly from person to person. For this reason, treating MS may be difficult.
You may develop chronic pain that worsens and improves as MS flares occur and resolve. However, there are options for managing pain through medications for both chronic and acute pain and by managing the progression of the disease.
Working with your healthcare team, you may be able to minimize your pain and improve your quality of life.
Are there ways I can prevent pain in MS?
Where can I look for more information on MS?
A reliable place to find more information on MS is the Multiple Sclerosis Society.
Can MS pain affect mental health?
People who are depressed and anxious report more significant pain. If you’re concerned that you may be depressed, reach out to a doctor, therapist, or healthcare professional for help managing the symptoms of depression and pain.
Pain with multiple sclerosis is common. There are three major ways that MS can cause pain and lead to chronic pain.
While treatment can be difficult, there are many options for pain management. If you have MS, you should work closely with your doctors to develop a pain management plan.