How to Manage Your Multiple Sclerosis Pain
Each person with multiple sclerosis has a different pain story. You might not have any at all. Or you could feel a tingle, stab, or spasm.
Why Does MS Hurt?
The pain can affect different places in your body. It depends on the cause:
Damage to the neurons in your brain and spine
Aches in your bones, joints, and muscles
Lots of things affect what you feel, including how long you’ve had MS, your age, and how active you are.
All-Over Pain
Your feet, legs, and arms might burn and ache. In the early stages of the disease, you might feel a tightness around your belly or chest that gets worse at night, after exercise, or with changes in temperature. It’s called the “MS hug.” It could make surprising things uncomfortable, such as the feel of your bedcovers or getting dressed.
Treatment: Your doctor will consider what kind of medicine you need. You might take a pain reliever like acetaminophen or use a skin gel with a pain reliever like lidocaine. Your doctor could prescribe medications for seizures or depression. They affect how your central nervous system reacts to pain. You can also try warm compresses or pressure gloves. They help change the pain to warmth.
On Your Face
It might feel like a terrible toothache. Or it could be a stabbing pain in your eye, cheek, or jaw. It can happen when your chew, talk, or brush your teeth. It may last from a few seconds to a few minutes. But it isn’t a problem with your teeth. Instead, it’s the result of nerve damage.
Treatment: Your doctor may prescribe anti-seizure drugs or may give you a nerve block injection. If your case is severe and medicine doesn’t help, you may need minor surgery to block those pain pathways.
In Your Neck
You may feel a brief shock when you nod your head forward. It can travel down your spine and into your arms and legs.
Treatment: The simplest, treatment is to wear a soft neck collar to hold your head steady. Your doctor may prescribe an anti-seizure drug such as gabapentin, pregabalin, or lamotrigine to reduce pain.
Causes of Chronic Pain in MS
Neuropathic pain, is caused by damage to the nerve fibers from the inflammatory process. And that may cause burning, tingling, and painful pins-and-needles sensations. Sometimes, people even perceive a light touch as painful in certain areas of the body “Some people describe a sunburned feeling. It can be different in different people,It can sometimes feel deep; it can sometimes feel on the surface.
Spasticity is a common type of stiffness in people with MS that’s caused by damage to motor nerve fibers., “It can cause muscle spasms, cramps, and an overall achiness and tightness in the body parts that are affected. And the spasms can be very painful and debilitating for people with MS.”
Finally, immobility and fatigue can cause people with MS to compensate by using other muscles in ways that cause pain. This process commonly causes back or joint pain, even if your underlying mobility issues mainly affect another area of the body.
Treatments for MS signs and symptoms
Physical therapy for multiple sclerosis
Physical therapy can build muscle strength and ease some of the symptoms of MS.
- Physical therapy. A physical or occupational therapist can teach you stretching and strengthening exercises and show you how to use devices to make it easier to perform daily tasks.
- Physical therapy along with the use of a mobility aid when necessary can also help manage leg weakness and other gait problems often associated with MS.
- Muscle relaxants. You may experience painful or uncontrollable muscle stiffness or spasms, particularly in your legs. Muscle relaxants such as baclofen (Lioresal, Gablofen), tizanidine (Zanaflex) and cyclobenzaprine may help. Onabotulinumtoxin A treatment is another option in those with spasticity.
- Medications to reduce fatigue. Amantadine (Gocovri, Osmolex), modafinil (Provigil) and methylphenidate (Ritalin) may be helpful in reducing MS-related fatigue. Some drugs used to treat depression, including selective serotonin reuptake inhibitors, may be recommended.
- Medication to increase walking speed. Dalfampridine (Ampyra) may help to slightly increase walking speed in some people. People with a history of seizures or kidney dysfunction should not take this medication.
- Other medications. Medications also may be prescribed for depression, pain, sexual dysfunction, insomnia, and bladder or bowel control problems that are associated with MS.
Managing pain in general
People with MS can manage their pain by doing light physical activities such as swimming, water aerobics, walking, and stretching.
Making some diet and lifestyle changes can also help reduce pain. Studies suggest that there may be an association between vitamin D deficiency and muscle pain. However, more studies are necessary to determine whether taking extra vitamin D can help with MS-related pain.
Vitamin D plays an important role in muscle function and maintenance. It also produces anti-inflammatory effects that can reduce muscle pain.
People can increase vitamin D and calcium consumption by increasing their daily intake of foods high in vitamin D and calcium.
Some of these foods include:
- milk
- eggs
- fish
- vegetables
Lifestyle plays a significant role in managing MS symptoms. Some natural pain remedies listed above focus on lowering stress, which can trigger MS symptoms.
Relaxing activities such as massage and yoga specifically focus on decreasing emotional stress by releasing physical tension within the body.
Other ways to lower stress include meditation, slow breathing exercises, and counseling.
Neurontin (gabapentin) for Pain Management in Multiple Sclerosis
Neurontin (gabapentin) is an anti-epileptic drug but it is also used to help multiple sclerosis patients control pain caused by MS lesions and spasticity. Gabapentin affects chemicals and nerves that cause seizures and some types of pain.
Neurontin is to be taken orally, usually three times a day, with or without food. It might help control the condition but will not cure it. Neurontin should not be stopped when symptoms are relieved or the patient may experience withdrawal symptoms such as anxiety, sleeping disorders, nausea, pain, and sweating.
Common neurontin side effects may include dizziness, drowsiness, or headache. A generic version of Neurontin has been approved by the FDA, but may not be available due to patent issues or exclusivity for uses.
Pain can have a significant negative impact on the quality of life of people with MS. A combination of medicine and positive lifestyle changes such as exercising and staying active, massages, chiropractic treatments, hydrotherapy, and acupuncture may improve the patient’s the quality of life.
Regular analgesics are typically not enough to ease pain from nerve damage in the central nervous system, so drugs that treat seizures (phenytoin, gabapentin, carbamazepine) and antidepressants (amitriptyline, nortriptyline) and some benzodiazepines (clonazepam) are commonly first choices for pain management in MS.