Chronic and Neuropathic Pain in MS Patients Should Be Routinely Evaluated, Study Says

Multiple sclerosis (MS) patients should be routinely assessed for chronic and, especially, neuropathic pain in order to properly diagnose and treat this condition, which appears to directly affect the degree of a patient’s disability, a new study reports.

The study, “Systematic assessment and characterization of chronic pain in multiple sclerosis patients,” was published in the journal Neurological Sciences.

Pain is one of the most disabling clinical symptoms of MS, associated with suffering, distress, and lower quality of life. Many studies have investigated the prevalence of chronic pain in MS patients but with highly varying results: estimates range from 29 percent up to 92 percent.

This disparity is likely due to methodological differences between the studies, as well as differences in the studied population. The result is the prevalence of pain in MS is still unclear, and underdiagnoses of pain in this patient population likely.

Researchers in Italy conducted a single-center study to determine the prevalence and characteristics of chronic pain, defined as constant pain for more than three months, in a population of MS patients.

Pain was evaluated using validated tools, and the results were analyzed in relation to clinical features such as disease duration and disability.

In total, 374 MS patients with different disease severities were assessed for pain.

Results found an overall prevalence of chronic pain of 52.1, most frequently affecting the lower limbs. Neuropathic pain, which refers to pain resulting from a lesion or disease impacting the sensory nervous system, was the most frequent type of chronic pain, affecting 23.7 percent of the patients analyzed (89  people).

Pain intensity was also found to be significantly higher in patients with neuropathic pain compared to those with non-neuropathic pain.

Researchers measured patients’ disability using the Expanded Disability Status Scale (EDSS). They determined that patients with chronic pain, and especially those with chronic neuropathic pain, had significantly higher EDSS scores (meaning greater disability) than those without such pain.

Both these patient groups were also more likely to be on long-term pain medications: 33 percent of MS patients with neuropathic pain, and 24 percent of those with chronic pain.

These results indicate that pain is underdiagnosed and undertreated in MS patients, and a factor that may contribute to increased disability.

“Our results suggest that clinical disability is higher in MS patients with chronic pain and, in particular, in those with neuropathic pain,” the researchers concluded. “The present study supports the routine assessment of neuropathic pain in MS patients.”