Pain and MS: Neuropathic Pain

There is pain in MS.  It can be acute or chronic, generally categorized as neuropathic, musculoskeletal, or tertiary. Let's begin looking at details.

Sometimes the nervous system does not  function properly, and it actually becomes the cause of pain.  Neuropathic (nervous disease) pain is the most common kind in MS.  That makes sense because MS is a central nervous system disease.  Today I am going to talk about details and specific neuropathic pain.

Francois Bethoux, MD, director of rehabilitation services at the Mellen Center for Multiple Sclerosis Treatment and Research at The Cleveland Clinic talks about how MS pain differs from everyday headaches or muscle strains. "It's often more diffuse, affecting several areas of the body at a time. It often changes over time, getting worse or better for no apparent reason. It tends to fluctuate a lot," says Bethoux. "People often find it hard to describe: It's sometimes described as like a toothache, other times like a burning pain, and sometimes as a very intense sensation of pressure.”

This type of pain is not caused by an injury; rather, when nerves are damaged they become hypersensitive, and the nerves themselves generate the pain.  A second cause of neuropathic pain is damaged myelin that allows pain signals to be mistakenly communicated.

So what's causing this baffling, complex, often debilitating pain? Bethoux describes it as "an illusion created by the nervous system." Normally, he explains, the nervous system sends pain signals as a warning phenomenon when something harmful happens to the body. "But in MS, the nerves are too active and they send pain signals with no good reason -- they're firing a pain message when they shouldn't be."

So there are times when we feel intense pain for no reason other than a malfunctioning nervous system. It sounds suspiciously like the pain is all in our heads. However, this is not imagined pain, the pain is real and sometimes quite intense and debilitating. What kind of pain is this? 

Pains 

Neuropathic pain can be either acute or chronic, and it presents itself in many different specific ways.   Warning: Many of these pains are identified by medical terms that sound technical and are awkward to pronounce, but their descriptions are plain English and easy to the to understand. Here are some common neuropathic pains experienced by MSers -- 

Allodynia 

Allodynia is a particularly painful sensation as a response to a normally innocuous stimulus such as a light touch, bed sheets, or clothes.  It is usually short-lived,  and last only as long as the stimulus remains. 

Dysesthesias 

Dysesthesias is a burning, aching, itching, or girdling around the body.  It has also been described as feeling as if there is acid under the skin.  It may be triggered by a light touch or by nothing at all.  Some people say it is girdling, banding or squeezing, as if 'a tight band' or constricting pain is around the trunk of the body.  The “pins and needles” sensation often fits into this category.