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Overview of Pain as a Symptom of Multiple Sclerosis (continued)

Descriptions of musculoskeletal pain and paroxysmal pain


Updated June 30, 2014

Musculoskeletal or Secondary Pain

Also called nociceptive pain, this is usually a result of the symptoms of MS, such as spasticity, weakness, immobility or problems walking, and not the disease process itself. Some examples of this are:

Joint Pain: Many people with MS feel pain in the joints of the hips and knees due to imbalance and change in gait.

Stiffness: A person with MS may experience stiffness in the legs, arms and hips due to immobility.

Back Pain: Back pain can be the result of an unsteady gait, immobility, trying to adapt to the annoying feeling of the MS hug, sitting for extended periods in wheelchairs or any constant adjustment in movement or position as a result of MS symptoms.

Pain from Spasms: Flexor spasms cause a limb to contract, or bend, towards the body. This can make the limb feel like it has a constant cramp or dull ache.

Paroxysmal Pain

This refers to pain that has an acute (or sudden) onset, stays for just a couple of minutes, then fades rapidly or disappears completely. (Read the full article: Paroxysmal Symptoms of Multiple Sclerosis.) However, there may be residual or lingering pain after the episode. Painful paroxysmal symptoms include:

Tic Doloreux: See above.

Extensor Spasms: Extensor spasms are when a limb, usually a leg, stiffens and the person is unable to bend the joint. These cause the limb to jerk away from the body. Extensor spasms are usually not very painful, but can be forceful enough to make people fall out of their wheelchairs or beds.

L’Hermitte’s Sign: This is an electric-shock type of sensation that runs down the spine when the head is bent forward.

My Experience

We all have our good days and our bad ones. For me, the good days are the ones where I don’t have a symptom that was bad enough to be memorable a week later (as opposed to just those kind of yucky ones that we have learned to live with). I can say that some of my pain symptoms have seared themselves into my memory so well that I can remember them years later, including the specific circumstances of where I was and what was going on when I felt that degree of pain.

Since my MS diagnosis, I have experienced:

  • Excruciating “hard-to-catch-my-breath” pain from the MS hug
  • Dull, achy pains in my legs from trying to adjust my gait to sensory ataxia
  • Pretty severe dysthesia, as well as allodynia, including episodes where my clothes touching my legs felt like stinging insects
  • “Screaming-out-loud” (literally) pain when moving my eyes during a bout of optic neuritis

This list does not include what I guess could be called “tertiary” MS pain - because of MS, I have fallen, run into doors and bumped my hips on tables. I have cut myself badly and spilled hot coffee on myself when my hands were shaking. I suppose it would be a stretch to include the pain from injections and infusions, confinement in MRI tubes, or side effects from Solu-Medrol in this list, but all of these things hurt, and I’m sure many of you could add to this list.


Alex D Rae-Grant, Nancy J Eckert, Sharon Bartz, and James F Reed. Sensory symptoms of multiple sclerosis: a hidden reservoir of morbidity. Multiple Sclerosis. Jun 1999; vol. 5: pp. 179-183.

Michael J Olek. Epidemiology, risk factors, and clinical features of multiple sclerosis in adults. UpToDate. Accessed: January 2009.

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