Sensory Symptoms and Pain - National Multiple Sclerosis Society

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Sensory Symptoms and Pain

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Symptom: Sensory symptoms (parasthesias)

Numbness, tingling, pins and needles

Treatment

No treatment required unless interfering with function; medication if necessary; referral to PT/OT if necessary

Symptom: Primary pain

Central neuropathic pain

Treatment

Medications:

  • carbamazepine, oxcarbamazepine, gabapentin

Surgery:

  • radiofrequency rhizotomy; radiofrequency electrocoagulation; glycerol rhizotomy

Trigeminal neuralgia 

Treatment

Medications:

  • carbamazepine, oxcarbamazepine, gabapentin

Surgery:

  • radiofrequency rhizotomy; radiofrequency electrocoagulation; glycerol rhizotomy

Dysesthesias

Treatment

Medications:

  • tricyclics, pregabalin, gabapentin; Lidoderm patch

Other:

  • topical application of capsaic acid cream; behavioral self-management (mindfulness, meditation)
  • hypnosis, cognitive behavior therapy

 

Retro-orbital pain

Treatment

Medications:

  • High-dose IV steroids

Psychosocial Implications for each pain symptom

  • Clumsiness, balance problems, and loss of dexterity from sensory loss
  • Discomfort that is sometimes excruciating
  • Increase in fatigue caused by medications and interrupted sleep

Note: People often told by doctors that MS does not cause pain. Yet Chronic pain is distracting, depressing, and debilitating

Symptom: Secondary pain (musculoskeletal)

Resulting from poor posture/balance in ambulatory individuals or improper use/fitting of wheelchair

Treatment

Interventions:

  • Referral to PT: gait and balance training; assessment of all seating (home, automobile, work, and wheelchair/scooter);

Medications:

  • analgesics

Resources for clinicians

Clinical Bulletin: Pain in Multiple Sclerosis (.pdf)

Resources for patients

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