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Multiple sclerosis (MS) is a progressive disease that can cause joint and muscle pain. While the experience of pain varies from person to person, it is a common symptom, with estimates suggesting that up to 80% of people with MS may experience pain at some point. This pain can be neuropathic, caused by nerve damage, or musculoskeletal, caused by the stresses and strains that living with MS places on the body. Treatments for MS can help manage joint and muscle pain, and drug treatments and other therapies are available to help patients cope.
| Characteristics | Values |
|---|---|
| Type of pain | Neuropathic pain, musculoskeletal pain |
| Cause | Nerve damage in the brain and spinal cord |
| Symptoms | Muscle weakness, stiffness, spasms, balance issues, fatigue, poor posture, joint pain, tightness in the chest ("MS hug"), Lhermitte's sign, trigeminal neuralgia, optic neuritis, numbness, pins and needles |
| Treatment | Physical therapy, medication, lifestyle changes, yoga, acupuncture, acupressure, guided imagery, biofeedback, tai chi, anti-seizure drugs, antidepressants, anti-pain medications |
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What You'll Learn
MS can cause muscle spasms, stiffness, and spasticity, leading to joint pain
Multiple sclerosis (MS) is a progressive disease that can cause joint and muscle pain. While the experience of pain varies from person to person, it is a common symptom, with some reports suggesting that up to 80% of people with MS experience pain at some point.
MS can cause muscle spasms, stiffness, and spasticity, which can lead to joint pain. Spasticity refers to an increase in muscle tone or tightness. The effects of MS can make these strengthened muscles less capable of relaxing, resulting in painful spasms. The severity of spasticity can vary, ranging from mildly annoying to debilitating. For example, some individuals with MS may have occasional trouble climbing stairs, while others may experience severe spasticity that affects their ability to walk.
Musculoskeletal pain is secondary pain that occurs due to muscle weakness, stiffness, or issues with coordination caused by interruptions in nerve signals. This type of pain is associated with living with a disability and its effects, such as the stresses and strains that MS places on the body. For instance, difficulties with balance, fatigue, or muscle weakness can lead to problems with posture, placing strain on joints, ligaments, and other muscles. Joint pain associated with MS is typically more severe around the hips, back, and legs.
To manage joint and muscle pain caused by MS, various treatments are available. Physical therapy, medication, and lifestyle changes can help individuals with MS lead a rich and enjoyable life. A physical therapist can identify problems with weak or tight muscles contributing to joint pain and teach stretching and strengthening exercises to improve joint pain and flexibility. They can also evaluate gait issues and recommend modifications to reduce joint pain and improve walking ability. Additionally, drug treatments, such as anti-seizure medications, anti-spasticity drugs, and anti-pain medications, can be used to manage pain associated with MS.
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MS hug: a tight band of pain around the torso
Multiple sclerosis (MS) is a progressive disease that can cause painful joints and muscles. MS is a disease of the central nervous system (CNS), which consists of the brain and spinal column. It stems from a problem with the immune system that causes it to attack healthy nerve fibres and myelin (the substance that coats them). When MS causes damage to the nervous system, a person may experience many different effects, one of which is the "MS hug".
The MS hug is a common symptom of MS that can be challenging to explain and may be mistaken for other conditions. It is characterised by a feeling of tightness or pressure around the torso, specifically the chest, ribs, or abdomen. This sensation can range from a mild discomfort to severe pain and may be described as pressure, an ache, a tickle, a burn, or a squeeze. It can be felt anywhere between the neck and the waist and may occur on only one side of the body.
The MS hug is caused by spasms in the intercostal muscles, which are the small muscles between the ribs that help with breathing. These spasms can be the result of nerve damage caused by MS, leading to blocked or disrupted nerve signal. While the MS hug often goes away without treatment, it can be very scary and uncomfortable, and in some cases, it may be persistent or extremely painful.
There are various treatments available to manage the MS hug. Medications such as muscle relaxants, antispastic drugs, antiseizure medications, and antidepressants may be prescribed for severe cases. Additionally, home therapies such as wearing tight clothing or applying heat or cold to the affected area may help trick the brain into accepting the feeling of tightness. Applying pressure with the flat of the hand, using topical analgesics, and practising deep breathing can also help minimise spasms and discomfort.
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MS nerve damage can cause neuropathic pain
Multiple sclerosis (MS) is a progressive disease that can cause joint and muscle pain. While everyone with MS experiences pain differently, some general remedies, therapies, and medications are available. Treatments for MS can help with joint pain.
Neuropathic pain can also be chronic, presenting as painful or unusual sensations on the skin. This is caused by a lesion or disease of the somatosensory nervous system. It is the most common form of chronic pain, affecting around 8% of the general population. In MS, chronic neuropathic pain is one of the most frequent symptoms, severely reducing the quality of life of patients.
There are several treatments for neuropathic pain. Analgesic painkillers like paracetamol, aspirin, ibuprofen, and codeine can help control non-neuropathic pain but are usually ineffective for neuropathic pain. Opioids such as tramadol are occasionally used for acute nerve pain. Capsaicin cream is an alternative for those who cannot or do not want to swallow medicines. Transcutaneous Electrical Nerve Stimulation (TENS) uses a small, battery-operated machine and sticky pads placed on the skin to stimulate nerves in the painful area.
Immunosuppressive therapies and glutamate receptors are also promising targets for MS neuropathic pain therapy. Fingolimod, an immune-suppressive drug, has been shown to promote pain alleviation in animals with peripheral nerve injury-mediated pain conditions. The N-methyl-D-Aspartate (NMDA) receptor has been proposed as a primary target for treating neuropathic pain, and clinical trials show beneficial effects of NMDA receptor antagonists on pain relief.
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MS can cause musculoskeletal pain, affecting muscles and joints
Multiple sclerosis (MS) can cause joint and muscle pain, which is known as musculoskeletal pain. This pain is caused by the stresses and strains that MS places on the body. For example, difficulties with balance, fatigue, or muscle weakness can lead to problems with posture, which can put a strain on joints, ligaments, and other muscles. This can result in painful pressure in the lower back.
The nerve and musculoskeletal symptoms that characterize MS can indirectly contribute to aching joints and body pains. For instance, numbness and tingling in the feet can cause a feeling of being off-balance or losing coordination (sensory ataxia). This can lead to compensatory joint stress and pain. MS can also cause muscle spasms, which can affect mobility and general flexibility, further supporting the joints.
In addition, MS can cause muscle stiffness (spasticity), which can result in painful spasms. The effects of spasticity in MS can vary from mildly annoying to debilitating. For example, some people with MS may have trouble climbing stairs, while others may experience severe spasticity that affects their ability to walk. Joint pain is also a common side effect of interferon-based disease-modifying therapies used to treat MS.
To manage MS-related joint and muscle pain, a combination of physical therapy, medication, and lifestyle changes may be recommended. Physical therapy can help identify problems with weak or tight muscles that can lead to joint pain and teach stretching and strengthening exercises to improve joint pain and mobility. Medications such as anti-seizure, anti-spasticity, anti-anxiety, antidepressant, and anti-pain drugs may also be prescribed. Lifestyle changes, such as losing excess weight, can also help reduce stress on the joints, particularly the hips and knees.
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MS can cause gait issues, leading to compensatory joint stress and pain
Multiple sclerosis (MS) is a progressive disease that can cause joint pain. This joint pain is often a result of nerve-related or muscle-related issues, rather than joint degeneration or inflammation. While the experience of pain varies from person to person, gait issues are common in MS and can lead to compensatory joint stress and pain.
Gait issues refer to difficulties with walking, which can arise from muscle stiffness, weakness, or problems with balance. These issues can cause alterations in how a person walks, leading to pain in the hips, back, and knees. For example, muscle weakness on one side of the body may cause a person to favour the other side, developing stiff joints and an unbalanced body. Similarly, relying on a cane or walker can affect a person's gait, causing painful joints.
The effects of MS can result in spasticity, or increased muscle tightness and tone. This can make it challenging for muscles to relax, leading to painful spasms. Spasticity can vary in severity, with some people experiencing mild annoyance and others facing significant mobility issues. Joint pain is a common side effect of interferon-based disease-modifying therapies used to treat MS.
To address gait issues and reduce joint pain, individuals with MS can benefit from working with a physical therapist. They can evaluate gait problems and recommend modifications to improve walking and reduce stress on the joints. This may include prescribing specific exercises to strengthen the appropriate muscle groups and improve balance and functional strength. Additionally, complementary therapies like yoga can be beneficial in improving balance and overall flexibility.
It is important to note that pain in MS can be challenging to define and varies from person to person. It can be an invisible symptom, affecting individuals physically and emotionally. Therefore, finding the right treatment for joint pain caused by gait issues may involve trying different therapies and medications to determine what works best for the individual.
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Frequently asked questions
Yes, multiple sclerosis (MS) can cause joint and muscle pain. This is usually due to nerve-related or muscle-related issues, rather than joint inflammation.
Joint and muscle pain in MS can be caused by nerve damage, muscle weakness, stiffness, or issues with coordination. It can also be caused by difficulties with balance, fatigue, or muscle weakness, which can lead to problems with posture and put a strain on joints, ligaments, and other muscles.
Joint and muscle pain caused by MS can be managed through physical therapy, medication, and lifestyle changes. A physical therapist can help identify problems with weak or tight muscles and recommend stretching and strengthening exercises. They can also evaluate gait problems and recommend modifications to reduce stress on joints. Pharmaceutical management can include anti-seizure, anti-spasticity, anti-anxiety, antidepressant, and anti-pain medications.
The two main types of pain in MS are nerve (neuropathic) pain and musculoskeletal (nociceptive) pain. Nerve pain is caused by MS nerve damage in the brain and spinal cord, which can cause a range of sensations from mild irritations to intense sharp or burning pains. Musculoskeletal pain refers to pain in the muscles and joints that comes from living with the stresses and strains that MS places on the body.
