Up to two-thirds of people with multiple sclerosis (MS) worldwide experience a wide range of pain-related symptoms from headache to back pain, painful tonic spasms (cramping and pulling pain), and continual burning pain in the extremities.
Pain caused by MS can be musculoskeletal, paroxysmal, or chronically neurogenic in nature.
Musculoskeletal pain due to muscular weakness, spasticity, and general imbalance is caused by the progression of the disease. It occurs most when muscles, tendons, and ligaments are immobile for some time. Contractures (shortening and hardening of muscles, tendons, or other tissue) associated with weakness and spasticity are also quite painful. Muscular spasms or cramps can be severe.
Paroxysmal (sudden) pain is less common, but is most frequency experienced by MS patients in facial pain caused by trigeminal neuralgia.
Neurogenic pain (caused by issues with the nervous system) is the most common and distressing of all pain experienced by people with MS. It typically occurs in the legs as a persistent and burning pain.
Pain can have a major negative impact on the quality of life of people with MS. Combining a positive attitude with exercising, staying active socially, body massages, chiropractic treatments, hydrotherapy, acupucture, and medicines can improve the MS patient’s quality of life.
Most common analgesics are usually not enough to ease pain caused by nerve damage in the central nervous system, so drugs that treat seizures (phenytoin, gabapentin, carbamazepine), antidepressants (amitriptyline, nortriptyline), and some benzodiazepines (clonazepam) are among the common first choices for pain management.
Some of the more common drugs prescribed for pain in multiple sclerosis include:
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