What's the best treatment for MS pain?

MS is a complex condition that can cause pain in a variety of ways. The 2 main types of pain caused by MS are nerve pain and musculoskeletal pain. Both types of pain may be either acute (short-term) or chronic (long-term). We will learn more about how each type of pain is caused and how this pain can be relieved.

Musculoskeletal pain is stiffness or pain in the muscles, bones, or joints. This type of pain may be caused by muscle spasms (uncontrollable muscle contractions – a symptom of MS), by prolonged sitting or lying due to mobility problems, or by changing the way you move or hold yourself to make up for weakness or coordination problems caused by MS.

Musculoskeletal pain can be treated with a combination of pain relievers (such as ibuprofen) and therapy to correct the source of the pain. When the pain is related to muscle spasms, medications such as baclofen and tizanidine are used to relieve the spasms and, as a result, to help with pain relief. Physiotherapy and stretching can be used to strengthen muscles, improve flexibility, and help prevent further injury and pain. Massages may also help by relieving muscle tightness and stiffness.

Nerve pain is caused by MS-related nerve damage. Healthy nerves conduct sensations of pain and touch. When the nerves become damaged, they can transmit abnormal messages, leading to unusual sensations and pain. Nerve pain can include prickling, burning, tingling, or aching sensations. Nerve damage can also turn normal sensations, such as the feeling of fabric touching the skin, into painful ones. There are many different types of nerve pain, including trigeminal neuralgia (sharp, severe pains in the face), Lhermitte's sign (stabbing pain down the neck and back that happens when you flex your neck), and dysesthesias (painful burning, aching or prickling sensations).

Nerve pain is often treated with anticonvulsants (such as gabapentin, carbamazepine, or phenytoin) or antidepressants (such as amitriptyline, imipramine, or desipramine). These medications are used because they work on the nerves to modify the pain sensations. Pressure stockings or gloves are sometimes used to treat nerve pain. They can help make the pain feel more like pressure.

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