Dealing with MS Pain: Causes, Treatment, and More

Medically Reviewed By Heidi Moawad, M.D.
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Multiple sclerosis (MS) can cause pain in different ways. Pain may occur due to the effects of MS on the nerves of the brain and spinal cord. MS pain can also be a result of weakness. This article explains different types of MS-related pain, including their causes and treatment. It also discusses when to contact your doctor and some frequently asked questions about MS pain.

Why is MS painful?

An older adult smiles and holds a walking cane in front of them.
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MS is a chronic autoimmune condition. In MR, your immune system mistakenly targets your nervous system and causes demyelination.

Demyelination is when the protective coating of the nerves becomes damaged and can no longer completely protect the nerves. This causes inflammation of the optic nerves and the nerves of the spinal cord and brain, which can lead to the symptoms of MS, including pain.

However, people may experience pain with MS in different ways and for different reasons, such as:

  • Neuropathic pain: This refers to pain, itching, and unusual sensations that result from the demyelination of the sensory nerves.
  • Musculoskeletal pain: Musculoskeletal pain affects the muscles and bones. It can occur as a result of stress or strain on your body.
  • Complication-related pain: You may experience additional pain if you develop a complication of MS, such as an infection.

MS pain may also be:

  • Acute: This refers to pain that can be severe, sudden, and relatively brief.
  • Paroxysmal: Paroxysmal pain occurs in abrupt episodes.
  • Chronic: This is pain that is long lasting or recurrent.

Below are some more examples of MS pain and how to treat it.

Optic neuritis

Optic neuritis affects the optic nerve, which helps the eye and brain process visual input. It causes inflammation which can lead to pain during eye movement.

In severe cases, optic neuritis may lead to vision impairment or loss.


Pain and vision may improve without treatment once inflammation naturally starts to resolve.

However, treatment can also help symptoms to improve more quickly.

Your doctor can work with you to find the best treatment approach for your condition.

Lhermitte’s sign

Lhermitte’s sign is a brief pain or odd sensation that may feel like it is moving down the body. This pain may not be severe. Pain from Lhermitte’s sign can occur when a person is having an MS flare, or when they are in a period of remission.

Lhermitte’s sign occurs when the nerves of the spinal cord lose their protective coating, which can happen due to MS.


Lhermitte’s sign usually improves on its own and does not cause further complications.

However, treatment of the underlying MS can benefit symptoms. Other treatments to improve neuropathic pain can include:

  • anti-inflammatory medications
  • antiseizure or anticonvulsant medications
  • oral corticosteroids
  • transcutaneous nerve stimulation

Learn more about Lhermitte’s sign, including its symptoms and management.


Dyskinesia refers to sudden, uncontrolled movements due to painful muscle spasms. These spasms can occur due to demyelination of the nerves.

Paroxysmal dyskinesia is a type of dyskinesia that often worsens with periods of stress or sudden movements.


There is no cure for dyskinesia. However, the following treatments may help relax the muscles and reduce spasms and spasticity:

  • muscle relaxants
  • antiseizure or anticonvulsant medications
  • anti-inflammatory medications, such as methylprednisolone
  • botulinum toxin (Botox) infections
  • deep brain stimulation

Trigeminal neuralgia

Trigeminal neuralgia occurs due to damage or demyelination of the trigeminal nerve, which runs from the brain to the face. It can cause sharp, shooting pain in the face and nearby areas, such as the jaw or gums.


Your doctor may prescribe you medications for trigeminal neuralgia, such as:

  • pain relief medication
  • antidepressants
  • anticonvulsants

If medications are not effective, doctors may recommend surgical procedures. Surgery can restructure the blood vessels and nerves to reduce pain. However, as with any surgery, there may be risks and side effects, such as functional impairments or death.

Read more about treatments for different symptoms of MS.


Dysesthesias refer to unusual sensations. Examples can include paraesthesia or “pins and needles,” and the MS hug, which causes tightness or spasming around your ribs and chest.

These unusual sensations can include feelings of:

  • burning
  • prickling
  • tingling
  • numbness
  • aching
  • stabbing

While some dysesthesias can be temporary and usual from time to time, they can also be chronic due to nerve damage or demyelination.


Treatments for dysesthesia can depend on the cause. General treatment approaches include:

  • rest
  • lifestyle changes, such as avoiding stress and temperature extremes
  • splints and braces
  • anti-inflammatory medications
  • injections of pain relief medication
  • physiotherapy

Musculoskeletal pain

Musculoskeletal pain can feel like a sharp, burning, or aching pain. It may occur alongside symptoms such as:

  • weakness
  • fatigue
  • spasticity, or muscle tightness
  • functional impairments, such as difficulty walking due to spasticity

Examples include joint pain and some types of headaches.


The treatment for musculoskeletal pain can depend on the cause, symptoms, and location of your pain.

General approaches may include:

  • muscle relaxant medication
  • pain relief medication
  • physiotherapy
  • occupational therapy
  • mobility aids
  • lifestyle changes, such as managing stress

Pain as an early symptom of MS

Pain may be your first symptom of MS. The following conditions that can cause pain can sometimes occur as early signs of MS:

Some people experience clinically isolated syndrome (CIS). This is an episode of neurological symptoms that lasts 24 hours or more. It can occur due to the same demyelination process that causes MS. Due to CIS, some people may experience episodes of pain.

However, not everyone who experiences an isolated CIS episode or other kinds of neuropathic pain goes on to develop MS.

Read more about the early symptoms of multiple sclerosis.

When to contact your doctor

Contact your doctor in any of the following circumstances:

  • You have new, changing, or persistent symptoms of pain.
  • You experience pain or other symptoms after starting a new treatment.
  • Your symptoms are affecting your quality of life.
  • You feel that your current treatment is not effective enough.
  • You have questions or concerns about your condition or treatment.

Your doctor can then help optimize the effectiveness of your treatment plan.

Frequently asked questions

The following are some frequently asked questions about MS pain.

Where does MS pain usually start?

MS pain can start anywhere, and symptoms may be different for each person.

What does the beginning of MS feel like?

Early symptoms of MS can include:

  • fatigue
  • pain, numbness, or tingling
  • weakness on one side of the body
  • stiffness or spasms
  • loss of balance
  • bladder or bowel problems
  • vision problems
  • difficulty with memory or thinking


MS pain is different for everybody with the condition and can occur due to different reasons. For example, MS pain can occur due to nerve damage and demyelination, muscle conditions, and complications of MS.

Treatment for MS pain can depend on its underlying cause. It generally includes medication and lifestyle changes.

Contact your doctor if you are experiencing new, changing, or unmanageable pain symptoms.

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Medical Reviewer: Heidi Moawad, M.D.
Last Review Date: 2022 Dec 23
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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