Acute Pain
Trigeminal neuralgia is a stabbing pain in the face. It can usually be treated successfully with medications such as carbamazepine (Lioresal® or Tegretol®) or diphenylhydantoin (Dilantin®).
Lhermitte’s sign is a stabbing, electric-shock-like sensation running from the back of the head down the spine, brought on by bowing the head or flexing the neck.
Burning, Aching, or “Girdling” around the Body are all neurological in origin. The technical name for them is dysesthesias. These pains are sometimes treated with antidepressants such as amitriptyline (Elavil®) because such agents modify how the central nervous system reacts to pain.
Chronic Pain
Burning, Aching, Prickling, or “Pins and Needles” (Parasthesias) may be chronic rather than acute. The treatments are the same as for the acute dysesthesias described above.
Pain of Spasticity has its own subcategories. Muscle Spasms or Cramps, called flexor spasms, may occur. Treatments include medication with Baclofen (Lioresal®) or Tizanidine (Zanaflex®), ibuprofen, or other prescription strength anti-inflammatory agents. Treatment also includes regular stretching exercises and balancing water intake with adequate sodium and potassium, as shortages in either of these can cause muscle cramps. Tightness and Aching in Joints is another manifestation of spasticity, and generally responds well to the treatment described above.
Back and Other Musculoskeletal Pain in MS can have many causes, including spasticity. Pressure on the body caused by immobility, or incorrect use of mobility aids, or the struggle to compensate for gait and balance problems may all contribute. An evaluation to pinpoint the source of the pain is essential. Treatments may include heat, massage, ultrasound, physical therapy, and treatment for spasticity.
Pain and the Emotions
Most pain in MS can be treated. But not all pain a person with MS has is due to MS. Whatever the source, pain is a complex problem that should not be ignored. Many factors may contribute, including fear and worry. A multidisciplinary pain clinic may be indicated for chronic disabling pain, where medication in combination with alternative therapies, such as biofeedback, hypnosis, yoga, meditation, or acupuncture may be used. Self-help may play an important role in pain control, for people who stay active and maintain positive attitudes are often able to reduce the impact of pain on their quality of life.
SOURCE: NMSS Information Resource Center and Library. Compendium of Multiple Sclerosis Information (CMSI). copyright 1997, National Multiple Sclerosis Society. Rev. 10/97