Pain Management in Multiple Sclerosis
Summary
Pain affects a substantial proportion of people with multiple sclerosis (MS), arising from central nervous system lesions, musculoskeletal dysfunction and treatment side-effects. Neuropathic pain—often described as burning, stabbing or electric sensations—stems from demyelination and axonal injury in sensory pathways. Nociceptive pain, by contrast, arises from spasticity, postural abnormalities or secondary musculoskeletal strain. Both acute and chronic pain have profound effects on mobility, mental health, employment and overall quality of life. Management has evolved towards a mechanism-based approach, combining pharmacological agents (such as anticonvulsants, antidepressants, muscle relaxants and judicious use of opioids) with non-pharmacological strategies (including physiotherapy, cognitive-behavioural therapy and complementary therapies). Recent emphasis on personalised regimens and interdisciplinary care underlines the need to tailor interventions to individual pain phenotypes, lesion distribution and comorbidities. Advances in imaging, sensory testing and classification frameworks aim to refine diagnosis and direct targeted therapies, while lifestyle modifications and patient education are recognised as integral to long-term pain control and functional rehabilitation.
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Pain Management in Multiple Sclerosis publication trend
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Technical terms
Neuropathic pain: Pain arising from damage to or dysfunction of the central or peripheral nervous system, often described as burning or electric.
Deafferentation: Loss of sensory nerve input to the central nervous system, resulting in ongoing pain signals and sensory disturbances.
Spasticity: Velocity-dependent increase in muscle tone due to central motor pathway lesions, which can lead to musculoskeletal pain and functional impairment.
Trigeminal neuralgia: Paroxysmal, lancinating facial pain caused by lesions affecting the trigeminal nerve, often triggered by light touch or facial movements.
References
- Risk factors of neuropathic pain in multiple sclerosis: a retrospective case-cohort study. Frontiers in Immunology (2024).
- The Impact of Relapses on Pain and Quality of Life in Patients with Multiple Sclerosis Treated with Corticosteroids. Pharmaceuticals (2023).
- A mechanism-based classification of pain in multiple sclerosis. Journal of Neurology (2012).
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