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Finding the Right Multiple Sclerosis Treatment

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7 Ways to Manage Chronic Pain With Multiple Sclerosis

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Jennifer Larson on November 24, 2021
  • Young Caucasian woman holding hand on head with fever or headache
    Confronting the Complicated Challenge of Multiple Sclerosis Pain
    For many people with multiple sclerosis (MS), chronic pain is an ever-present companion that hampers their quality of life. Treating and managing chronic pain in people with MS is complicated, however. The pain they grapple with may be neuropathic pain, which is the direct result of damage to nerves in the central nervous system. Or it may be another kind of pain, like lower back pain or musculoskeletal pain that develops as a result of adjustments their bodies make to having MS. Many people with MS experience both kinds of pain. If you have MS, you may need to find a combination of various strategies to help you manage your pain—so you can regain more control over your life.

  • Woman complaining to doctor about pain
    1. Make sure your nerve pain is treated.
    Neuropathic pain is the pain that develops as the result of lesions or damage to axons, which are nerves that make up your brain and spinal cord. You can experience this kind of pain as acute pain, but it can linger and become chronic. It typically feels like a burning, stabbing, or squeezing sensation, and some people report that it’s worse at night. But you can’t pop an over-the-counter analgesic to knock out this type of pain. You will need a different type of medication, usually a tricyclic antidepressant like amitriptyline or imipramine, or an anti-epileptic (anti-seizure) medication like clonazepam, gabapentin, or carbamazepine. Let your doctor know if you experience this pain (and how severe it is) so you can get the right kind of prescription.

  • Close-up of woman's hands taking medication from pill bottle
    2. Consider analgesics for musculoskeletal pain.
    Musculoskeletal pain is also common among people with multiple sclerosis. For example, you might notice your lower back or your hip hurts, perhaps because you’ve had to alter your gait due to some nerve pain you’ve been experiencing. A nonsteroidal anti-inflammatory drug (NSAID) is appropriate for this type of pain. There are potential risks of relying on these NSAIDs too frequently, so you may want to talk to your doctor about how to take them safely.

  • Back of unseen African American woman getting acupuncture
    3. Give acupuncture a try.
    Needles might not be your first thought when it comes to sources of pain relief. But if you’re looking for a promising non-pharmacological approach to achieve some multiple sclerosis pain relief, consider acupuncture. Acupuncture is a complementary therapy in which very fine needles are inserted into specific locations of the body. Some research suggests acupuncture may help reduce your fatigue. Since fatigue can make pain feel worse, this modality could help you in that arena. It may also be effective in reducing some of the uncomfortable spasticity you might experience.

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  • unidentifiable woman indoors relaxing, meditating and doing breathing exercises
    4. Embrace mindfulness meditation.
    Mindfulness meditation has been shown to reduce feelings of anxiety, depression, and fatigue. It’s known for reducing stress, which often exacerbates MS pain. Incorporating mindfulness meditation, which involves focusing on the present moment, into your daily life may help you feel calmer and better able to cope with the challenges that chronic multiple sclerosis pain can pose. Look online for guided mindful meditations, find a therapist who can help guide your practice, or attend a meditation class in your area. You might also find it beneficial to blend it with other exercises or mind-body modalities, such as deep breathing exercises, massage, yoga, or Tai chi.

  • Young Caucasian woman talking to therapist or counselor in office
    5. Consider cognitive behavioral therapy.
    Cognitive behavioral therapy (CBT) is a type of therapy that focuses on identifying and shifting certain patterns of thinking or behavior. It may not completely relieve any debilitating pain you may have as a result of your MS, but it can change how you think about it, which can in turn change how you experience it. It’s been shown to be effective in helping people with many kinds of chronic pain, and research suggests it can be a useful adjunctive treatment for people with MS, too. That means you may find some additional success by adding it to your existing pain relief treatment. And that might also benefit your emotional well-being. If you’re already seeing a mental health professional, ask if they offer this type of service, but if they don’t, they may be able to refer you to someone who does.

  • smiling African American woman walking or jogging through forest trail
    6. Exercise.
    It may seem like healthcare experts recommend exercise as a potential treatment for almost everything, and yes, exercise is also recommended for people struggling with multiple sclerosis pain. Implementing a regular exercise routine and sticking with it, especially if you’re doing so in tandem with other pain-control measures, can help reduce the pain and fatigue you experience. Plus, regular exercise can also improve other aspects of your health, so it’s a win-win. You don’t have to engage in aggressive exercise–in fact, it’s probably better that you don’t because you might get injured. Moderate exercise, especially if you incorporate aerobic exercise, strength training and stretching, is the key. Talk to your doctor about starting an exercise routine so you can learn safe and effective strategies to get moving. You might also benefit from seeing a physical therapist who focuses on helping people with MS build strength and flexibility.

  • Woman taking cannabis drops
    7. Cannabinoids get mixed reviews.
    You’ve undoubtedly heard some people tout the pain-relieving qualities of medical marijuana or CBD. And some research suggests that cannabinoids do seem to reduce patient-reported spasticity and central pain, with the added advantage of being well-tolerated. But the research is still somewhat limited, and the topic does carry some controversy. As a result, many experts are calling for more research before embracing cannabinoids or cannabis products. For example, the Cleveland Clinic does not generally use cannabinoids for MS-related pain at the present. Talk to your doctor if you have any questions about the possible benefits of cannabinoids for multiple sclerosis pain.

Multiple Sclerosis Pain | MS Pain Relief

About The Author

Jennifer Larson has more than 15 years of professional writing experience with a specialization in healthcare. She has a master’s degree in journalism from the University of Maryland and memberships in the Association of Health Care Journalists, the Society of Professional Journalists, and the Education Writers Association.
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  3. Multiple Sclerosis and Exercise: Why MS Patients Should Stay Active. Penn Medicine.
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  5. Gromisch ES, et al. Cognitive Behavioral Therapy for the Management of Multiple Sclerosis-Related Pain: A Randomized Clinical Trial. International Journal of MS Care. 2020;22(1):8-14.
  6. Kratz AL, et al.Characterizing chronic pain phenotypes in multiple sclerosis: a nationwide survey study, PAIN: May 2021;162(5): 1426-1433.
  7. Marck CH, et al. Pain in people with multiple sclerosis: associations with modifiable lifestyle factors, fatigue, depression, anxiety, and mental health quality of life. Frontiers in Neurology. 2017;8:461.
  8. Murphy KL, et al. Neuropathic Pain in Multiple Sclerosis—Current Therapeutic Intervention and Future Treatment Perspectives.
  9. Pain. Multiple Sclerosis Association of America.
  10. Pain and itching. National Multiple Sclerosis Society.
  11. Pain in Multiple Sclerosis. Cleveland Clinic.
  12. Rice J, et al. Cannabinoids for Treatment of MS Symptoms: State of the Evidence. Current neurology and neuroscience reports. 2018 Jun 19;18(8):50.
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Last Review Date: 2021 Nov 10
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