What Does MS Pain Feel Like?

Multiple sclerosis (MS) can be very painful. Pain can be acute, meaning it generally happens quickly and doesn't last long. Pain can also be chronic, meaning it is consistent every day or nearly every day. As many as 50%–75% of MS patients have chronic pain at some point.

Pain in MS is complicated. Basically, it can be divided into the following three categories:

  • Neuropathic pain
  • Musculoskeletal or secondary pain
  • Paroxysmal pain

This article explains these three different types of MS pain using several examples. It also covers different types of treatment for MS pain, including medication, alternative treatments, and lifestyle changes.

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Neuropathic Pain

Neuropathic pain is the most common kind of pain in MS. It is caused by demyelination, which is the loss of the protective sheath that covers nerve fibers.

The human body has nerve endings called nociceptors that specifically detect painful stimuli. When demyelination occurs, nerve signals traveling along nerve cells may get misdirected to nearby nociceptors, which mistakenly communicate pain signals to the brain.

Types of neuropathic pain in MS can vary:

  • Allodynia: Allodynia occurs when a person feels pain in response to a stimulus that is normally not painful, such as a person’s touch or even clothing or bed linens touching skin. It is stimulus-dependent, so it only lasts as long as the stimulus is present (when the clothes are removed, the painful sensation goes away). The good news for people with MS is that allodynia is usually a short-term problem.
  • Tic douloureux: Trigeminal neuralgia, often called tic douloureux (French for “painful twitch”), is perhaps the most severely painful MS-related symptom. Tic douloureux may also occur on its own, not just in people with MS. It is most commonly described as an intense, sharp pain occurring in the lower part of the face (often triggered by chewing, drinking or brushing one’s teeth).
  • MS hug: The MS hug is a type of pain characteristic to MS that can be felt anywhere on the torso, from the waist to the shoulders. It may be localized (in one small area) or encircle the whole body. Some people describe the MS hug as a sharp pain, whereas others describe it as dull or more neuropathic in quality, like burning, tickling, or tingling. Still, others may note a crushing or constricting sensation.
    Like many MS symptoms, the MS hug feels different for different people. It may also feel different in the same person on different days or at different times of day. The pain may come and go or it may be constant and debilitating.
  • Paresthesia: This feels like numbness, pins and needles, burning, severe itchiness, tingling, buzzing or vibrating sensations. Although often paresthesia is described as extremely annoying and unpleasant, occasionally the sensation can be so intense, as to be painful.
  • Headaches: People with multiple sclerosis commonly experience headaches and migraines.
  • Optic neuritis: Most people with optic neuritis experience pain when moving their eyes. This pain usually subsides after a couple of days, even if vision is still affected. This vision problem can be an early symptom of MS in females, especially young females. Males are less likely to have optic neuritis. Instead, they are more often affected by motor problems.

The MS hug, numbness or tingling, vision problems, and hearing loss are among the early symptoms of MS for many people.

Man having pain on his side
Jan-Otto/iStockphoto

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. This pain takes on different forms:

  • Joint pain: Many people with MS feel pain in the hip and knee joints due to imbalance and a 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. Spasticity can cause leg pain, including ankle, knee, and hip pain, as well as the back pain.
  • Weakness: MS musculoskeletal pain can also come from weakness. If you have leg weakness, you may not walk the same as you did before, which can create other problems like back and hip pain.

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. However, there may be residual or lingering pain after the episode. Painful paroxysmal symptoms include:

  • Tic douloureux: Also associated with neuropathic pain, this condition can come on suddenly and produce intense symptoms. The most intense pain is short-lived (lasting usually a few seconds), but it can come back multiple times within a short period of time, making it seem like one long attack.
  • 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. Spasms can occur in your arm or leg multiple times a day or night.
  • L’Hermitte’s sign: This is an electric-shock type of sensation that runs down the spine when the head is bent forward. The sensation can travel from the back of the head down the spine and into the arms or legs. If it happens for the first time, it could be a relapse or first sign of MS.
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How Is MS Pain Treated?

MS pain can be treated. Both medications and non-medication treatments can help alleviate pain and address other problems that can be causing pain.

Medication

Various medications are used to address different types of MS pain.

Neuropathic pain medications include antiseizure drugs or certain antidepressants. For musculoskeletal pain, your healthcare provider may have you try pain medication or nonsteroidal anti-inflammatory drugs (NSAIDs). Muscle relaxant medications can be prescribed for spasticity.

Healthcare providers may prescribe these specific medications for MS pain:

  • Cymbalta (duloxetine)
  • Effexor (venlafaxine)
  • Elavil (amitriptyline)
  • Lamictal (lamotrigine)
  • Lyrica (pregabalin)
  • Neurontin (gabapentin)
  • Pamelor, Aventyl (nortriptyline)
  • Tegetrol (carbamazepine)
  • Trileptal (oxcarbazepine)

Other Treatments

Non-drug treatments are also effective in treating MS pain.

Treatments for neuropathic pain include acupuncture, mindfulness and medication, and cognitive behavioral therapy. Physical therapy, massage, and the application of cold or heat can help with musculoskeletal pain. Stretching exercises and aqua therapy in a non-heated pool can reduce spasticity.

As a practice that unites the body, mind, and spirit, yoga can be extremely effective in helping you manage MS pain and other related challenges. Yoga poses can be modified to fit your needs according to your body's ability. Yoga can not only improve your balance and strengthen your core and other muscles, but also provide the relaxing benefits of meditation.

While exercise is beneficial on the whole, a word of caution is advised. Exercise can increase your body temperature, which may cause a temporary flare-up of symptoms.

Diet and Nutrition

What you eat can have an impact on your MS symptoms. While there is no "best diet" for people with MS, these healthy-eating tips promote good health:

  • Prepare meals at home whenever possible. This gives you full control of the ingredients in your food.
  • Incorporate colorful fresh fruits and vegetables into your diet every day.
  • Go for whole grains over refried grains, or try skipping grains completely.
  • Avoid/limit processed foods and added sugars.

Maintaining a healthy body weight is important if you have MS. It is associated with better outcomes for people with MS and can improve cardiovascular risk factors, which are linked with higher levels of MS-related disability and disease activity as well as other health conditions like heart disease and stroke. A healthy diet is also beneficial to the immune system and brain.

Summary

You are not alone if you have MS-related pain. MS-related neuropathic, musculoskeletal, and paroxysmal pain can cause discomfort and weird sensations throughout the body, including face, arm, torso, and leg pain.

The good news is that there are ways to treat MS pain, usually through a combination of medication, lifestyle changes, and alternative therapies like yoga and meditation. Talk to your healthcare provider about the best approaches to managing your specific pain.

12 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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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.