Hip and Knee Pain in Multiple Sclerosis

Joint pain, specifically in the knees and hips, is very common in people with multiple sclerosis (MS). It is usually due to a nerve-related or muscle-related manifestation of MS rather than degeneration of cartilage or inflammation of the joints, as seen in rheumatoid arthritis, osteoarthritis, or lupus.

Causes

The nerve and musculoskeletal symptoms that characterize MS can indirectly contribute to aching joints and body pains. Causes include:

• Spasticity of the leg muscles
• Lack of coordination
• Balance problems (caused by a disturbance in proprioception)
• Numbness and tingling in the feet, which cause you to be off-balance or lose coordination (sensory ataxia)
• Fatigue
• Muscle weakness
• Foot drop
• Muscle spasms

In addition, if you rely on a cane or walker, this can throw off your gait, which can cause the joints to be sore. For example, when experiencing what's known as the MS hug, you may clutch your side with one hand; after a full day of walking around like this, your knee and hip on one side might be a little sore.

Joint pain is also a common side effect of interferon-based disease-modifying therapies, such as Avonex, Rebif (interferon beta-1a), and Betaseron (interferon beta-1b).

Pay special attention to whether or not your joint pain is worse in the 24 to 48 hours following your injections and if it is more concentrated in the knees or hips, as opposed to more generalized.

Diagnosis

In order for your healthcare provider to conclude that your joint pain is due to MS, they will rule out any other potential causes, such as osteoarthritis, rheumatoid arthritis, or an injury. Diagnostic tests may include X-rays and blood tests, as well as a physical exam.

Your healthcare provider may also evaluate your gait and balance, or the degree of spasticity and muscle weakness to see how that may be affecting your joints.

Treatment

Addressing the underlying causes of your joint pain—such as spasticity and muscle weakness—can improve your gait, and, consequently, reduce joint pain.

Another way to improve your gait and reduce associated joint pain is to embark on an exercise program that includes aerobic, resistance, and balance exercises. You may also want to consider taking up yoga. There is some evidence that yoga can improve balance and functional strength, as well as fatigue and possibly muscle spasticity.

Analgesics, such as acetaminophen, or a non-steroidal anti-inflammatory drug like ibuprofen can relieve pain temporarily. Finally, if you are overweight, losing excess weight may put less stress on your hips and knees.

A Word From Verywell

Joint pain can interfere in leading an active life. Fortunately, once your healthcare provider identifies the reasons for your pain, you can work together on a plan to combat it successfully.