Does MS Cause Joint Pain?

Multiple Sclerosis (MS) can cause a whole host of symptoms, including muscle weakness, physical fatigue, and numbness in your arms and legs. So, if you’re living with MS and you’re experiencing joint pain, you’re probably wondering if MS is the culprit.

The answer is a little complicated. While MS isn’t directly to blame for your joint pain, it could be contributing to symptoms that lead to joint pain.

“Multiple sclerosis does not directly affect joints or cause joint pain,” says Vincent Truong, M.D., a neurologist and the medical director of the MS program and the Comprehensive Stroke Center at Loma Linda University Health in Loma Linda, CA. “However, MS causes nerve damage, resulting in neuropathic pain that patients can experience as burning, stabbing, or squeezing pain or sensations in their joints.”

Multiple sclerosis can also cause musculoskeletal complications including muscle weakness, stiffness, spasm, contraction, and immobility, which can put abnormal pressure and pulling on joints, causing significant joint pain.

Let’s take a closer look.

MS is an inflammatory autoimmune disease, which mistakenly attacks myelin, a fatty tissue that protects the nerve cells in your central nervous system. When this damage occurs, it affects how the central nervous system sends signals to the rest of your body and that can trigger both neuropathic and musculoskeletal pain and many of the symptoms associated with MS.

“While neither of these types of pain are the result of problems with the joints, the way that each person experiences these types of pain can vary quite a bit, and certainly can be perceived as joint pain,” says Michael Z. Moore, M.D., a neurologist and assistant professor with the Maxine Mesinger Multiple Sclerosis Clinic at the Baylor College of Medicine in Houston, TX.

Like, if the muscles in your upper back are weak, it may put added pressure on your lower back and result in pain. Or, if you experience frequent muscle spasms, they may hinder the mobility and flexibility that supports healthy and happy joints. And if muscle weakness forces you to be more sedentary, it might result in stiff and uncomfortable joints.

“MS can also adversely affect the gait, causing someone to walk in a manner for which their body is not best suited,” says Dr. Moore. “This can increase the stress on load bearing joints like hips and knees, which can indirectly lead to joint pain.”

The joints that are most commonly affected by MS symptoms include the ankles, knees, hips, and lower back, adds Dr. Truong.

“There are no specific tests or blood work to diagnose joint pain due to MS,” says Dr. Truong. Instead, your doctor will consider a detailed description and history of the type of pain you’re experiencing in order to categorize it and select the most appropriate treatment strategy, adds Dr. Moore.

MS itself is generally diagnosed through a thorough medical history review, physical examination, and neurological examination, Dr. Truong explains. Your doctor will analyze the symptoms you’re experiencing alongside your complete medical history.

Your doctor may also consult MRIs of the brain and spinal cord, spinal tap analysis, or electrodes to gauge the responsiveness of your nervous system, according to the National Institutes of Health.

“As with many types of pain, there are multiple approaches that can be helpful in management,” says Dr. Moore. “Each situation is unique, and the best approach depends largely upon the primary cause of the pain.”

You’ll probably want to consider multiple strategies for pain relief, including both pharmacologic and non-pharmacologic options, as layering different pain management approaches may be more effective than any single strategy by itself, says Moore.

Medications for Pain Relief

“The treatment for MS-related joint pain focuses on symptomatic relief,” says Truong. When it comes to the joint pain associated with MS symptoms, your doctor will look for options that can help ease your pain and reduce any symptoms you’re experiencing.

• Joint pain caused by neuropathic pain: Truong says Gabapentin, Pregabalin, and Duloxetine are some of the most frequently prescribed medications to relieve the burning, stabbing, or squeezing pain near or around your joints.

• Joint pain caused by musculoskeletal issues: Muscle relaxants, such as Baclofen and Cyclobenzaprine, are used to alleviate the muscle stiffness, spasms, and contractions and they can help reduce the joint pain associated with these symptoms. Botox injections are also sometimes used to alleviate stiffness that may be contributing to joint pain, says Dr. Truong.

Exercise and Yoga for Reducing Pain

Pain management strategies beyond medications are also an important and effective way to relieve joint pain and discomfort, says Dr. Truong. Movement is some of the best medicine for joint pain—and moving as much as you can tolerate can help ease discomfort.

Truong recommends trying things like daily range of motion exercises, yoga, light stretches, and mobility exercises to help reduce joint pain.

Weight Management

It’s not uncommon to gain weight while living with MS, thanks to things like fatigue, depression, and certain medications. And since a little extra weight can put extra pressue on your joints, it can also increase your pain and discomfort.

Managing your weight can help alleviate some of this joint pain. The CDC recommends eating healthy (aim for colorful plates of fruits, vegetables, whole grains, and lean proteins), getting sufficient sleep (at least seven hours a night), increasing physical activity (go for 150 minutes of moderate aerobic exercise per week), and reducing stress.

Physical Therapy

Physical therapy is an effective way to treat joint pain caused by many different conditions, including osteoarthritis, and multiple sclerosis is no exception.

A physical therapist can help you target weak, tight muscles that might be causing your joint pain – by giving you stretching and strengthening exercises that can loosen up your joints, relieve unwanted pressure, and provide better support for your joints. And they can also help you improve your gait or address imbalances that could be contributing to your symptoms.

While MS itself doesn’t cause joint pain, MS symptoms can affect your joints. If you experience joint discomfort while living with MS, ask your doctor about the best options to help you manage your pain.

But keep in mind that many other health conditions, like rheumatoid arthritis and gout, can also cause joint pain and it’s important to keep those things in mind if any joint issues do pop up. Dr. Moore says he sees a number of patients who think MS is to blame for their joint pain, when it’s actually a separate health issue, which could require its own diagnosis and treatment strategy.

“While MS is an uncommon condition, joint pain is incredibly common and the majority of people who are experiencing joint pain have another more common cause, such as osteoarthritis or overuse injuries,” he says. “People with a confirmed diagnosis of multiple sclerosis can also suffer from more common causes of joint pain.”