Urinary Tract Infection
Bladder problems and incontinence, besides being a major inconvenience, may lead to repeated urinary tract infections, especially when a catheter is required. Most catheter-associated infections can be prevented with the right management techniques.

Osteoporosis
Immobility and inactivity, common in MS because of weakness,fatigue, and paralysis, lead to osteoporosis. Therefore, MSers, especially those of us in wheelchairs who do not have the option of weight-bearing exercise, have a greater risk of losing more bone density and experiencing fractures. I know all too well about how osteoporosis can become severe.

Pressure Sores
Pressure sores, pressure ulcers, or bedsores are caused by the immobility and inactivity brought on by paralysis. Continuous pressure due to sitting or laying cuts off circulation and the tissue dies creating a pressure sore. I, personally, have not experienced this one and hope I don't. Active movement and adjusting to correct an uncomfortable position may prevent or reduce developing pressure sores, but at the same time mayresult in increased back pain.

Posture Problems
Paralysis can result in poor trunk control and posture, including foot alignment. This is very awkward and painful, and ,once again, the struggle to adjust posture leads to increased back pain.

Paroxysmal Pain
This type of pain begins with a sudden, acute neuropathic pain onset that lasts a short time, then fades into a possibly chronic residual or lingering pain after the episode. Each of these is described in detail in the neuropathic pain article. They include:

Trigeminal Neuralgia (TN) or Tic Doloreux
After the sudden intense attack, there remains an ache or pain in the mouth or jaw.

L’Hermitte’s Sign
Following the initial electric-shock type sensation, breathing and comfort are often still affected.

Optic Neuritis
Although the intense pain may end before the vision problems correct themselves, discomfort may remain.

MS is a complex and confusing disease. Pains cause other pains, symptoms cause pain and make other symptoms worse resulting in even more pain -- a vicious circle in this cruel disease. Multiple sclerosis is not a painless disease. Our central nervous system generates pain and our musculoskeletal system is also hurting, but it does not end there.

Next time I’ll talk about tertiary and other assorted pains.  If you have some pains you would like to share, please do.  I would like to hear about them.



Notes and Links:
MedicineNet.com from WebMD
Explanation of nociception pain detection
Nociceptive and neuropathic pain
Webmd