Symptoms of MS
Pain
Although MS was thought to be a painless disease for many years, is now recognised that some patients with MS experience significant pain or discomfort during the course of the disease. Pain experienced generally falls into three categories:
Musculoskeletal pain
This is pain in the joints and muscles, tendons and ligaments associated with muscle weakness and spasm. It often occurs in the hips, legs and arms when they have remained immobile for a long time. Back pain is also common and is associated with sitting or walking with a poor posture.
Weakness and spasm can cause contractures (permanent shortening of muscles) that are painful. Cramps can also be painful and can occur in the legs at night. When musculoskeletal pain is being treated, the cause needs to be addressed before pain relief is offered.
Paroxysmal pain
Paroxysmal pain refers to sharp stabbing pains. Typically these occur in the face (trigeminal neuralgia) and as a stabbing, electric-shock-like pain running from the back of the head down the spine when head is bent forward. A soft neck collar can be used to prevent this pain.
Chronic neurogenic pain
This is the most common and distressing form of pain in MS. It is caused by faulty nerve signals being generated by MS lesions in the brain and spinal cord. Types of neurogenic pain include:
The paraesthesias; these include pins and needles, tingling, shivering, burning pain, feeling of pressure and a high sensitivity to touch. These pains are described as aching, throbbing, stabbing, shooting, gnawing, tingling, tightness and numbness.
The dysaesthesias; these include burning, aching or pressure around the body.
Controlling pain
Self-help can be an important part of controlling pain in MS because staying active and keeping a positive attitude can go a long way to reducing the impact of pain on the quality of life. The following may help:
- Exercise and physiotherapy can help with spasm and soreness of muscles
- Relaxation therapy included meditation and deep breathing
- Ultrasound
- Massage
- Hydrotherapy
- Moist heat and ice
- TENS (transcutaneous electrical nerve stimulation - mild electric currents through the skin)
- Acupuncture and chiropractic treatment
All these need to be administered by experienced therapists if damage is to be avoided.
Drug treatment
Drug treatment should be discussed in any case with your treating physician.
Reference texts
Barnes D. Multiple Sclerosis. Questions and Answers. Merit Publishing International 2000. Pp. 125
