Multiple sclerosis treatment


Multiple sclerosis (MS) is one of the most common diseases of the central nervous system (brain and spinal cord). Today, 2.8 million people around the world have MS.

Multiple sclerosis (MS) is one of the most common diseases of the central nervous system (brain and spinal cord). Today, 2.8 million people around the world have MS.

MS is caused by damage to myelin – a fatty material that insulates nerves. In MS, the loss of myelin affects the way nerves conduct electrical impulses to and from the brain. Symptoms can include blurred vision, weak limbs, tingling sensations, unsteadiness, memory problems, and fatigue.

There is no drug that can cure MS, but treatments are available which can modify the course of the disease.

About pain in MS

Pain due to MS is complex. It can be mild or severe, chronic or acute, and every person will experience it differently.

What causes MS pain?

Pain may be caused directly, due to nerve damage, or indirectly, due to other MS symptoms. In other words:

Neuropathic pain is caused by MS nerve damage in the brain and spinal cord. Nerve damage might cause a range of sensations, from minor irritations to intense sharp or burning pains.

Musculoskeletal pain is the pain in muscles and joints that comes from living with the stresses and strains MS places on the body. For example, difficulties with balance, fatigue or muscle weakness could lead to problems with posture, putting a strain on joints, ligaments or other muscles.

The following offers a list of different types of MS-related pain beyond the above classification:

Optic neuritis

This is often one of the first symptoms of MS. It’s caused by inflammation of your optic nerve and usually only affects one eye. Problems with sight, like blurred or double vision, might come on with a sudden sharp pain behind your eye. The pain might be aggravated when you move your eye to look around.

Lhermitte’s sign

Lhermitte’s sign (pronounced "lair-meets") is a sudden brief pain or electrical buzzing sensation. It runs down your neck into your spine and might then spread into your arms or legs.

It can be triggered when you bend your neck forward, or after a cough or sneeze. Lhermitte’s sign is a sharp but short-lived pain (usually lasting a few seconds). You might hear it described as an acute or paroxysmal pain.

Trigeminal neuralgia

This is an uncommon symptom that affects only 2- % of people with MS at some time. It presents itself as a sudden severe pain in your face that comes and goes. It’s caused by damage to the Trigeminal nerve inside your head. This large nerve has three main branches so the place you feel pain depends on which branches of the nerve are damaged.

Squeezing or banding (sometimes called the MS hug)

This is caused by the small muscles between your ribs, called the intercostal muscles, going into spasm. It can feel like a tight band around the trunk of your body. It’s not dangerous but can be very scary. The MS hug can last for a short or long time, and it can come and go.

Treating pain in MS

Treatment varies from person to person and over time, but drug treatments and other therapies can help you cope. It can be a frustrating process, but it’s important to persevere as people do manage to control and live with pain every day.

Explaining your pain to others :

If you can describe pain well, both to health professionals and those around you, there is more chance it can be managed. When describing it, use whatever words seem best, even if they seem odd. Some words people use to describe pain:

  • squeezing or crushing
  • cold
  • hot or burning
  • sharp
  • dull
  • like ants under my skin or ‘creepy crawlies’
  • like a build-up of pressure
  • stabbing
  • creeping
  • like an electric shock
  • aching
  • pins and needles

When explaining what your pain is like, it’s useful to also mention any triggers that you may be aware of.

Drugs to treat MS pain:

Your doctor may prescribe medications like:

  • Anticonvulsants
  • Antidepressants
  • Steroids
  • Analgesic painkillers (these however are not usually effective for neuropathic pain).

Non-drug treatments for MS pain:

  • Physiotherapy
  • Transcutaneous Electrical Nerve Stimulation (TENS)
  • Complementary and alternative therapies such as yoga, meditation and relaxation
  • Surgery – usually only used when other approaches have not proved effective

Whatever the characteristics of your pain may be, it’s important to remember there are many options to treat it.

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