MS-related nerve damage often causes back pain. But people with MS are also at greater risk for other conditions that cause back pain. Depending on the cause, treatments include medication and physical therapy.

Multiple sclerosis (MS) is a chronic autoimmune disease that affects your central nervous system.

Your nerves are covered with a protective coating called myelin. MS destroys this myelin, leaving your nerve fibers exposed. The unprotected nerve fibers don’t work as well as protected nerves. This can affect many areas and functions of your body, including movement, vision, and cognitive function.

Back pain is one of many symptoms associated with MS. You may experience MS-related back pain for a number of reasons. Understanding the exact cause behind your MS-related back pain can help you treat it.

Neuropathic pain is one of the most common symptoms of MS that have a negative impact on quality of life. It occurs when MS-related nerve damage leads to a short-circuiting of the nerves as they carry signals from the brain to the body.

Neuropathic pain can be described as a type of pain that is:

  • burning
  • sharp
  • squeezing
  • stabbing
  • tingling

Certain factors can increase your risk of experiencing neuropathic pain, such as:

Taking steps to eliminate these types of triggers can help alleviate neuropathic pain.

Some people with MS experience a brief, electric shock-type sensation that goes from the back of the neck down the spine (and may continue to radiate to the ribs) when they bend their neck. This type of pain is known as Lhermitte’s sign.

Lhermitte’s sign is a specific type of neuropathic pain. It typically occurs when there’s MS damage in the nerves of the cervical spine. The pain typically only lasts for seconds at a time, but it can be very intense.

Triggers that may bring on Lhermitte’s sign include:

  • heat
  • fatigue
  • stress

Avoiding certain neck movements that trigger the sensation may help.

Spasticity is a type of extreme muscle stiffness and tightness that’s very common in people with MS. While it often affects the legs, spasticity can sometimes lead to pain or tightness in the lower back.

Spasticity can be brought on by certain factors, such as:

  • sudden movements
  • changes in position
  • humidity or extreme temperatures
  • infections
  • tight clothing

Spasticity can range from mild to severe. When it’s more severe, it can make day-to-day activities challenging.

Muscle weakness is another common MS symptom. It can affect any part of your body, including your back.

When MS damages the nerves in your spinal cord and brain that are responsible for stimulating your muscles, it can lead to muscle weakness. MS-related fatigue, imbalance, or mobility issues can also lead to a reduced level of activity and impact muscle strength.

Meanwhile, incorrectly using mobility aids can also put pressure on your back. This can lead to poor posture and pain.

Sometimes your back hurts for reasons that aren’t related to MS.

Though people living with MS are more prone to certain factors that can contribute to other types of back pain. That includes:

If you have MS, you won’t be able to compensate for this back pain as well as others might.

The exact treatment or combination of treatments can vary based on which type of MS-related back pain you’re experiencing. Your doctor may recommend one or more of the following options:

  • medications
  • exercise
  • physical therapy
  • occupational therapy
  • water therapy
  • complementary or alternative treatments


Your doctor will likely try to determine the root cause of your back pain before recommending specific medications. To treat pain from muscle strains, they may recommend over-the-counter (OTC) anti-inflammatory medications, such as ibuprofen or naproxen.

If you have spasticity (stiff muscles and spasms), they may prescribe drugs to relax the muscles, such as baclofen and tizanidine.

Neuropathic pain may be treated with antiseizure medications or certain types of antidepressants.


Exercise might sound unappealing when you’re experiencing back pain. However, it can be an effective treatment option and bring added benefits.

Gentle stretching can help reduce pain in many people. Exercising may also help alleviate depression, boost energy levels, and combat MS-related fatigue.

Work with your doctor or physical therapist to create a workout program that fits your needs and abilities.

Physical and occupational therapy

Rehabilitative therapies, such as physical therapy and occupational therapy, are important for anyone with MS — not just those who have back pain.

These therapies can help keep you as flexible, mobile, and active as possible. They can also teach you how to conserve your energy and move your body more efficiently.

A physical therapist can teach you exercises to help relieve some of your MS-related symptoms. They may teach you how to stretch tight muscles to alleviate your back pain. They may also recommend gait training to help you learn how to walk more easily.

An occupational therapist can teach you how to adapt your home, work, and lifestyle to meet your changing needs. They can show you how to integrate adaptive aids into your daily habits and environments, as well as how to use them correctly. This may prevent back pain that’s related to muscle strain or poor posture.

Water therapy

Your doctor may also recommend water therapy to help manage MS-related back pain.

Spending time in a heated pool gives sore muscles a chance to relax. The warmth and buoyancy of the water can soothe and support joints that are stiff and weak.

Water aerobics may also be a good choice as it offers the best of both worlds: a cocoon of warm water and a gentle form of exercise that can help promote balance and coordination. Water exercises may even help boost energy levels.

Check with your doctor or physical therapist before enrolling in a water aerobics class.

Complementary treatments

If conventional treatments aren’t enough to keep your back pain under control, or you prefer an alternative approach, ask your doctor about complementary therapies. These are meant to be used in addition to your prescribed treatment plan.

Options include:

Talk with your doctor before trying out a new complementary therapy. This helps ensure it won’t interact with any other part of your treatment plan.

If you have MS, pain is a symptom that you’ll likely deal with throughout your life. Work with your doctor to determine what’s causing your specific pain and brainstorm ways to find relief.