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Multiple sclerosis (MS) is a condition that occurs when the immune system attacks the brain and nerves. MS can cause nerve damage that affects muscle movements, leading to a range of problems. Pain is a common symptom of MS, with up to two-thirds of people with the condition reporting it worldwide. This pain can manifest as muscle spasms, stiffness, and soreness, which can range from mild to severe. It is often described as musculoskeletal, paroxysmal, or chronic neurogenic. Musculoskeletal pain, which is caused by damage to muscles and the stresses and strains of living with MS, can result in muscle soreness and affect the hips, legs, and arms.
| Characteristics | Values |
|---|---|
| Prevalence of pain in people with MS | Up to two-thirds of people with MS report pain |
| Types of pain | Musculoskeletal, paroxysmal, chronic neurogenic |
| Musculoskeletal pain causes | Muscular weakness, spasticity, imbalance |
| Musculoskeletal pain location | Hips, legs, arms, back, neck |
| Muscle spasms | Affect 40-80% of people with MS |
| Muscle spasm causes | Nerve damage, increase in muscle tone, muscle stretching |
| Muscle spasm sensations | Twitching, jerking, clonus, uncontrollable movements |
| Muscle spasm triggers | Increase in body temperature, infections, tight clothing |
| Muscle stiffness | Common in MS |
| Muscle stiffness causes | Spasticity, nerve damage |
| Muscle stiffness sensations | Rigidity, slowness to relax |
| Muscle stiffness triggers | Increase in body temperature, infections |
| Muscle stiffness treatments | Aromatherapy, relaxation techniques, massage, ultrasound, chiropractic treatments, hydrotherapy, acupuncture, transcutaneous nerve stimulation (TENS), moist heat, ice, medication |
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What You'll Learn
MS can cause nerve damage, leading to muscle spasms and pain
Multiple sclerosis (MS) is a condition that occurs when the immune system attacks the brain and nerves. MS can cause nerve damage, which can lead to muscle spasms and pain. This nerve damage can cause a range of sensations, from mild irritation to intense, sharp, or burning pain.
Muscle spasms and stiffness are common symptoms of MS, affecting up to 80% of people with the condition at some point. These symptoms can range from minor annoyances to problems that make daily life uncomfortable and difficult. MS muscle spasms occur when a muscle suddenly and unexpectedly tightens or shortens, causing jerky movements in the affected body part, such as the arm or leg. The affected muscles may also twitch or jerk repeatedly, a condition known as clonus.
The pain associated with MS can be steady and achy or more intense and stabbing. It can be caused by muscles becoming fatigued and stretched as they compensate for other muscles weakened by MS. This can lead to musculoskeletal pain, which is often felt in the hips, legs, and arms, especially after remaining immobile for some time. Back pain may also occur due to improper seating or incorrect posture while walking.
Neuropathic pain, caused by nerve damage in the brain and spinal cord, can result in altered sensations such as pins and needles, numbness, crawling, or burning feelings. This type of pain can be acute or chronic and may include symptoms such as Lhermitte's sign, trigeminal neuralgia, or optic neuritis. The "MS hug" is another symptom, characterized by a tight feeling around the chest or stomach area, which can be frightening but is not dangerous.
Managing MS-related pain and muscle spasms can be challenging. While typical analgesics like aspirin may not provide relief, drugs that treat seizures or antidepressants can be effective. Relaxation techniques such as meditation and deep breathing, as well as physical therapy and stretching exercises, can also help manage chronic pain and reduce muscle spasms and soreness.
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MS hug: tightness around the chest or stomach
Multiple sclerosis (MS) is a condition that can cause nerve damage in the brain and spinal cord. This nerve damage can lead to abnormal physical sensations, known as dysesthesias, and spasticity, or abnormal muscle stiffness or tightness. Both dysesthesia and spasticity in the chest muscles can cause or trigger what is known as the "MS hug".
The MS hug is a common symptom of MS, characterised by feelings of tightness, squeezing, or pressure around the chest, torso, or abdomen. It is not a dangerous symptom, but it can be frightening, especially for those who are unfamiliar with it. The intensity and type of sensation vary widely, and while it is not always painful, some people do experience substantial pain. The pain can be dull, stabbing, or burning, and it may make it difficult to breathe. The MS hug can be one of the first symptoms of MS, or it may occur years after diagnosis, and it is not experienced by everyone with MS.
The MS hug is caused by spasms in the intercostal muscles, which are the small muscles between the ribs that help with breathing. It can be triggered by various factors, such as sudden temperature changes, tight-fitting clothing, illness, or stress. While there is no single solution to stop the MS hug, there are several ways to manage the symptom. These include avoiding triggers, stretching or moving the body, applying warm or cool compresses to the affected area, taking over-the-counter pain relievers, and trying relaxation techniques. Medications that ease muscle spasms and nerve pain may also be helpful in reducing the severity of the MS hug.
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Lhermitte's sign: pain or unusual sensations
Multiple sclerosis (MS) is a condition that can cause pain in the muscles. MS patients experience nerve pain and musculoskeletal pain. The former is caused by nerve damage in the brain and spinal cord, which can result in a range of sensations, from mild irritations to intense sharp or burning pains. The latter is caused by the stresses and strains MS places on the body, such as difficulties with balance, fatigue, or muscle weakness, which can lead to problems with posture and put a strain on joints, ligaments, or other muscles.
Lhermitte's sign, also known as Lhermitte's phenomenon, is a common symptom of MS. It is characterised by a sudden, painful, electrical shock-like sensation that travels from the neck down the spine and can radiate to the arms and legs. This sensation, which can be triggered by bending the neck forward or after coughing or sneezing, usually lasts only a few seconds.
Lhermitte's sign is caused by damage to the nerves in the spinal cord, specifically in the cervical spine region. This nerve damage is known as a lesion or "scar" and can be detected by imaging tests. The lesion occurs due to demyelination, which is the destruction of the myelin sheath that normally protects the nerves and helps transmit signals from the brain to other parts of the body. When this protective covering is damaged, certain neck movements can cause the affected nerve to overreact and send pain signals to the brain, resulting in the characteristic shock-like sensation of Lhermitte's sign.
While Lhermitte's sign can be startling and uncomfortable, it is not life-threatening and typically does not require medication. However, if the sensation becomes bothersome or interferes with daily activities, treatment options are available. Managing the underlying condition, such as MS, can also help reduce the frequency of Lhermitte's sign. Additionally, certain drugs used for seizures or depression, such as amitriptyline, duloxetine, gabapentin, or pregabalin, may be beneficial if the pain is frequent or impacts an individual's quality of life.
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Muscle stiffness and fatigue
Muscle stiffness and spasms are very common symptoms of MS, affecting between 40% and 80% of people with the condition at some point. MS causes nerve damage in the brain and spinal cord, which can lead to an increase in muscle tone or resistance, making muscles feel more rigid and slow to relax. This increased muscle tone can cause stiffness, making delicate movements with the hands and fingers difficult and affecting mobility.
MS can also cause muscle fatigue, as weakened muscles have to work harder to compensate for other muscles affected by the condition. This can lead to a feeling of tightness or pressure around the chest or stomach, known as the "MS hug". The MS hug can be frightening, especially if experienced for the first time, but it is not dangerous.
The pain and stiffness associated with MS can range from mild to severe and can be managed through various treatments. Drugs and therapies such as physiotherapy, occupational therapy, and muscle relaxants can help reduce muscle spasms and stiffness. Relaxation techniques such as meditation and deep breathing can also help manage chronic pain.
Additionally, exercises and physical therapy can reduce muscle soreness and spasticity. Regular stretching exercises and gentle movements can ease painful feelings and prevent further complications. Small changes to posture, such as using a rolled-up towel to support the spine, can also reduce back and neck pain. Applying heat or ice to the affected area can provide relief, and acupuncture and aromatherapy may also help reduce muscle stiffness.
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Treatment: medication, therapy, and relaxation techniques
While Multiple Sclerosis (MS) currently has no cure, treatments are constantly improving, and medication, therapy, and relaxation techniques can help patients manage the condition.
Medication
Doctors may prescribe pain relievers, such as acetaminophen, or skin gels with pain relievers, like lidocaine. They may also prescribe medications for seizures or depression, which can affect how the central nervous system reacts to pain. In the case of muscle spasms, doctors may prescribe muscle relaxers, such as baclofen, tizanidine, or diazepam, or spinal infusion pumps of muscle relaxers or pain medication. Botox shots can also help by temporarily paralysing a muscle or nerve.
Therapy
Physical therapy, including stretching exercises, can help with flexor spasms and reduce muscle soreness and spasticity. Massage and heat treatments, such as warm compresses, can also help.
Relaxation Techniques
Relaxation techniques such as progressive relaxation, meditation, and deep breathing can contribute to the management of chronic pain.
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Frequently asked questions
Yes, MS can cause sore muscles. This is due to nerve damage in the brain and spinal cord, which can cause a range of sensations, from mild discomfort to intense, sharp pains.
People with MS may experience steady and achy types of pain, or more sudden, stabbing pains. This is caused by muscles being fatigued and stretched as they compensate for muscles weakened by MS.
The MS hug is a feeling of tightness around the chest or stomach area. It is not dangerous but can be frightening. It is caused by the small muscles between the ribs, called intercostal muscles, going into spasm.
There are a variety of treatments for MS muscle pain, including drugs, physiotherapy, and occupational therapy. Relaxation techniques such as meditation and deep breathing can also help, as can massage, ultrasound, hydrotherapy, acupuncture, and transcutaneous nerve stimulation (TENS).
Muscle pain is a common symptom of MS, with up to two-thirds of people with MS reporting pain. Muscle spasms or stiffness affect between 40% and 80% of people with MS at some point.
