What Dysesthesia in Multiple Sclerosis Feels Like

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"Dysesthesia" is a term that describes abnormal sensations—such as aching, itchy, burning, tingling, stabbing, or “pins and needles” sensations—commonly experienced by people with multiple sclerosis (MS). Dysesthesia can also be referred to as neuropathy, neuralgia, neurogenic pain, or neuropathic pain.

Dysesthesia is considered a paroxysmal symptom, meaning nerve-related symptoms that appear suddenly, last for only a few seconds or minutes, and then disappear. There are several types of dysesthesia associated with MS that are felt specifically around the torso (called an "MS hug") and feet (called the Lhermitte’s sign).

While dysesthesia can often be managed with lifestyle changes, severe cases may benefit from medications, physical therapy, or electrical stimulation therapy.

This article explains what dysesthesia feels like as well as the underlying cause of neuropathic pain in people with MS. It also looks at possible treatments, including home remedies and pharmaceutical drugs.

Dysesthesia in MS
Verywell / JR Bee 

What Does MS Neuropathy Feel Like?

Dysesthesia most often affects the feet, hands, legs, arms, and torso in people. The pain is often described as:

  • Burning
  • Jolting
  • Tightening
  • Shock-like
  • Itching
  • Aching
  • Tingling
  • Pins-and-needles
  • Stabbing
  • Wave-like

In some cases, dysesthesia manifests as allodynia. This is pain caused by something that shouldn't cause pain, such as a light touch.

There are several types of dysesthesia commonly experienced by people with MS:

  • "MS hug": Also known as banding or girdling, this is the sensation of tightness or squeezing around the chest or abdomen as if someone were giving you a hug. It is caused by spasms of the intercostal muscles which help expand and contract the chest during breathing.
  • Lhermitte’s sign: This is the sensation of an electrical shock that starts in the neck and radiates in waves down the spine to other parts of the body. Around 40% of people with MS experience the Lhermitte's sign at some point in their disease.
  • Erythromelalgia: Also known as "hot feet," this is the sensation of sudden tightness or swelling of the feet accompanied by intense burning. Erythromelgia can also affect the hands.
  • Pruritus: This is the medical term for itching. In people with MS, pruritus can affect any part of the body but is typically bilateral, meaning that it affects both sides of the body (such as both arms or legs). The itching is usually short-lived but can be chronic (persistent) in some people.
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3 Women Share Their Experiences Managing MS in the Cold

What Causes MS Neuropathy?

Multiple sclerosis is an autoimmune demyelinating disease. This is a disorder in which the immune system inappropriately targets and attacks a protein, called myelin, that covers nerves and acts as a form of insulation.

When myelin is stripped from nerves, the nerves can spontaneously "misfire," causing the abnormal transmission of nerve signals to the brain.

With MS, dysesthesia occurs when peripheral nerves are demyelinated. These are the nerves extending from the spinal cord that provide sensations to the rest of the body.

Dysesthesia with MS is distinct in that it causes spontaneous sensations in the absence of any stimuli.

How MS Neuropathy Is Diagnosed

Your healthcare provider will diagnose dysesthesia based on the symptoms you report. Because there are many other types of MS-related changes in sensation, the diagnosis will largely depend on ruling those out.

For example, dysesthesia should not be confused with anesthesia or hypoesthesia (which refers to a loss of sensation) or paresthesia (which refers to a distorted sensation, such as a limb "falling asleep").

How MS Neuropathy Is Treated

While there is no cure for dysesthesia, most people can learn to manage it. Here are some simple strategies that may ease your pain:

  • Compression: If pain or burning is located in the hands or legs, you may consider wearing compression gloves or stockings. These convert the sensation of pain to a less uncomfortable feeling of pressure.
  • Hot or cold therapy: Warm up too-cold feet by applying a warm compress to your skin; choose a cool compress if your feet are burning.
  • Capsaicin cream: This is an over-the-counter cream that contains a chemical called capsaicin that gives chili peppers their heat. When applied to the skin, this action can "mute" pain signals in some people.
  • Distraction: distraction can go a long way to take your mind off physical discomfort. Becoming engrossed in a book or movie, listening to music, or calling a friend can help you temporarily ignore your pain.

If these tactics don't provide enough relief, certain medications may help, especially if the pain is affecting your quality of life. Some medications that may be helpful include:

  • Medications typically prescribed to treat seizure disorders, such as Neurontin (gabapentin) and Lyrica (pregabalin)
  • Certain antidepressants such as the serotonin-norepinephrine reuptake inhibitor Cymbalta (duloxetine), or tricyclic antidepressants including Elavil (amitriptyline), Pamelor (nortriptyline), and Norpramin (desipramine)
  • Anti-anxiety medications like the benzodiazepine Klonopin (clonazepam)

Some healthcare providers will also recommend physical therapy or a non-invasive treatment known as transcutaneous electrical nerve stimulation (TENS). TENS involves the placement of electrodes on the skin to deliver mild electrical impulses that help modify pain signals. Some people achieve better results than others.

Engaging in certain mind-body therapies can also help alleviate your discomfort. Some that may be particularly useful for managing MS pain include:

Summary

Dysesthesia describes abnormal nerve sensations (including burning, itching, aching, or tingling) caused when MS destroys the protective coating of nerve cells, called myelin. Dysesthesia with MS tends to occur in short spells, lasting seconds or minutes, and mainly affects the feet, hands, torso, legs, and arms.

Lifestyle changes and mind-body therapies may help ease pain, while severe cases may benefit from medications, physical therapy, or a treatment known as transcutaneous electrical nerve stimulation (TENS).

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. National Multiple Sclerosis Society. Pain & Itching

  3. Murphy KL, Bethea JR, Fischer R. Neuropathic pain in multiple sclerosis—current therapeutic intervention and future treatment perspectives. In: Zagon IS, McLaughlin PJ. Multiple Sclerosis: perspectives in treatment and pathogenesis. Codon Publications. 2017;4:53-69. doi:10.15586/codon.multiplesclerosis.2017.ch4

  4. Multiple Sclerosis News Today. Dysesthesia

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Additional Reading

By Julie Stachowiak, PhD
Julie Stachowiak, PhD, is the author of the Multiple Sclerosis Manifesto, the winner of the 2009 ForeWord Book of the Year Award, Health Category.