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Is pain a part of MS? |
| Pain is not an uncommon symptom in persons with MS. It may occur for a number of different reasons. Primary neuropathic pain is related to increased sensitivity in sensory fibers in the spinal cord or brain. This is usually quite intense and is treated with medicines that are also used to treat seizures because they suppress the discharges of the irritated nerve fibers. Low back pain is also common because changes in posture and walking due to weakness puts additional strain, often in an assymetrical way on the lower back as well as large joints such as hips and knees. Weakness may also limit activities which strengthen muscles in the back and abdomen used to maintain posture. The combination of these factors may predispose persons with MS to degenerative changes in the lower back and large joints of the lower extremities. Pain in muscles may result from strain due to variable degrees of weakness among muscles resulting in overexertion of the weaker muscles which fatigue faster. Treatment of musculoskeletal pain involves diagnostic studies to determine the cause, and combinations of medicines to relax muscles and suppress pain with physical therapy to strengthen muscles and improve posture. Sometimes an orthotic or external stabilizer is also necessary to compensate for assymetric weakness. Finally, it's important to remember that MS is not a guarantee against other illnesses and the possibility of another problem should always be considered in the case of an unusual or unresponsive pain syndrome |
- Dr. Bruce Cohen
Northwestern University
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