Pain is one of the most common ways in which multiple sclerosis manifests itself. It can be acute or chronic, depending on the duration of the pain, and it’s often characterized aching or burning.
Acute vs chronic pain in multiple sclerosis
It’s important for MS patients to understand the differences between acute and chronic pain, in order to better determine which type of pain they are experiencing and consult their doctor about how to overcome it.
- Acute pain is generally short term pain that has a specific cause. In consequence, treating the injury or the problem that caused the pain can also lead to healing it.
- Chronic pain, on the other hand, manifests itself over a longer period of time, and it’s typically a result of an underlying condition (for example, arthritis).
Types of chronic pain in MS
Just like in the case of acute pain, chronic pain can take different forms:
- Musculoskeletal pain is caused by stress on ligaments, muscles, and joints. It’s generally caused by a weakening in the muscles and can typically be treated by taking painkillers. If the MS patient uses a wheelchair, they might experience lower back pain as a cause of inadequate posture.
- Chronic neurogenic pain (which is also referred to as “dysaesthesia”) is typically located in the extremities of the body, and will manifest itself through symptoms of prickling, aching, or burning. This type of pain is a result of the central nervous system being attacked by multiple sclerosis.
- Optic neuritis is what causes certain forms of vision-related problems. Patients with MS who experience optic neuritis will often have blurred vision as well as pain when the eyes are moved up-down or left-right. Other symptoms of optic neuritis include blind spots and reduced contrast sensitivity. All of these symptoms occur when the optic nerve is inflamed, but also as the nerve pathways are damaged. This, in turn, leads to difficulty in controlling the eye movements, as well as loss of visual sensitivity and coordination.
- Allodynia is a symptom characterized by a severe sensitivity to touch. When an MS patient experiences episodes of allodynia, they will start feeling pain after performing activities that aren’t painful for a person without this symptom. These activities can include anything from getting dressed (people can become sensitive to the clothes touching their skin), to the strokes required to brush one’s hair.
Physical therapy for chronic MS pain
With MS-related pain, physical therapy is one of the most common ways to alleviate the symptoms, as well as push patients towards being physically active. When an MS patient is experiencing musculoskeletal pain or spasticity, therapy can help. Stretching is a good way to improve spasticity, as long as it’s done on a daily basis. Muscles are often affected by cramps, so when those muscles are stretches, the pain goes away.
Performing exercises two hours per week can also help with chronic pain of musculoskeletal nature. These exercises can include something as basic as walking, as well more intense forms of exercise. Since stretching is good, MS patients can take yoga classes, which can improve a patient’s condition on both a mental and a physical level.
Common medication for chronic MS pain
Medications can sometimes be prescribed by doctors, once they have fully identified the type of pain and the cause that lies at its root. Some of the most common medications prescribed to treat different chronic pain symptoms are:
- Gabapentin is an anticonvulsant that’s normally used to reduce pain caused by spasticity and dysaesthesia. Fatigue is among the most common side effects.
- Naproxen, ibuprofen, and diclofenac are three of the most common ingredients used in medication that’s meant to treat inflammation. They are normally prescribed to alleviate musculoskeletal pain, but they are known to irritate the stomach. Without proper stomach protection, they can cause ulcers when taken for longer periods of time.
- Amitriptyline has long been used to treat pain caused by hypersensitivity to touch, also known as allodynia. However, it also can bring along side effects such as fatigue or dry mouth.
Alternative therapies for chronic MS pain
Experimenting with alternative therapies may be a solution for some MS patients who are experiencing chronic pain. However, none of these therapies should even be considered without first talking to your doctor about the potential risks (for example, despite exercising being good, it’s important to know when and how much to exercise, to avoid unnecessary episodes of fatigue). Some non-pharmacological pain relief methods include:
- TENS (short for “transcutaneous electrical nerve stimulation”) is a form of treatment that sends short electrical signals throughout the body to reduce chronic pain. TENS only works for some specific types of pain, such as tingling or burning, or for leg spasms or back pain. It’s typically a form of treatment that’s recommended when patients do not respond to medication.
- Acupuncture is a traditional form of Chinese medicine, recognized by the insertion of fine needles into the patient’s body. These needles are meant to stimulate nerve points in the patient’s muscles and skin, forcing the body to naturally release painkilling substances (like serotonin and endorphin).
- Massage may or may not render the best pain alleviation results, but it can help a patient relax mentally, making it easier to cope with pain.
The best way to deal with chronic pain in MS is to make sure that you keep a close track of how your pain progresses. A detailed diary may help you provide information that you can later communicate to your doctor or physical therapist, so they can understand more about the symptoms you’re experiencing.
This diary can include diversified information, such as what makes the pain better or worse, the time of day when it’s most intense, the location and severity of the pain experienced, how the pain feels, if there are any changes from day to day, what types of medication you’ve used n the past, and more.