Pain and MS: MS Plus

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If you have MS, pain may be a large part of it. What happens when someone has MS plus another disorder that may cause pain. Are you at risk for other pain-causing conditions? I know - you have MS, isn't the MS enough?

MS is enough, but life isn't fair, and contracting one condition does not reduce the chance of contracting another. Many blogs and stories I read include tales about a second and even third medical problem in addition to MS to add to the gamut of possible pains.

Multiple Sclerosis commonly couples with several other chronic conditions that add their own pain or symptoms. Let's look at some of those conditions.


I first talked about depression in the Tertiary Pain segment of this series. MS is a depressing condition, and depression with MS works against us.

The National MS Society says it is important to "keep moving" to delay disease progression, but depression works against that goal. A TV character on Boston Legal describes clinical depression: "You literally cannot get out of bed. There's a weight pressing down on you all the time. You don't care if you eat, if you stink -- it's all too much." The character continues saying she "was drowning."*

The description from this fictional program is true in real life, easy to understand, and easy to see how it adversely affects the MSer. Merely Me, well known to MSers on this MS site, is also an expert on the Depression) site.

Trigeminal Neuralgia (TN)

Seven types of TN are clearly defined and only one is named for and specifically refers to a disease. That disease is MS -- Multiple Sclerosis-related Trigeminal Neuralgia. The relationship between MS and TN is excruciatingly painful. TN is often active on both sides of the face as well as exhibiting other characteristics when coupled with MS. It is chronic, leads to depression, and "can eat into the fibre of your soul."* I can attest to that.

I first talked about TN in the Neuropathic Pain segment of this series. TN may begin as the result of frayed myelin around the trigeminal nerve. It is an unexpected searing lightning-like sensation triggered by such innocuous activities as a slight breeze on the face or even breathing.


This condition has symptoms ranging from "widespread pain to fatigue," in itself not unlike MS. Often a diagnosis of fibromyalgia is later amended to MS. Besides being confused with each other initially, these two similar conditions often co-exist. The widespread pain of MS is joined by the widespread pain of fibromyalgia, or perhaps the fibromyalgia pain is joined by MS pain. Either way, there is extra pain.

There is a large amount of anecdotal evidence concerning fibromyalgia adding to MS pain and complications. Here are some personal stories:

  • Kara Hash explores this relationship for her friend who experiences both.

  • Marciarita tells her story.

Rheumatoid Arthritis (RA)

RA attacks the joints, causing pain and deformities. Like MS, RA is also an individual disease and it is similar to other joint conditions. Just what an MSer needs -- another inflammatory disease that causes pain in the joints. There is an irony of having both MS and RA. With MS, joint pain is triggered by immobility. With RA, joint pain is triggered by walking. I first talked about joint pain in the Musculoskeletal Pain segment of this series.

Lisa Emrich is well known here on the MS sight, but she is also an expert on the RA site. She also recommends reading Lene Anderson to learn more about RA.


I have heard of Osteoporosis for years, but I never took it too seriously. Now I know better. Osteoporosis, low levels of calcium and other minerals, leaves weak, brittle bones, ready to fracture with the slightest misstep. There is a relationship between MS and Osteoporosis because an awkward gait or, in my case, transferring from a wheelchair to a car may fracture a bone with an audible pop. This is serious. It affects both women and men, and especially MSers.

MSers are particularly at risk because of inactivity, lack of weight-bearing exercise, and steroids prescribed for other symptoms. In addition, apparently doctors often do not test. Doctors Bowling and House wrote an article on Disaboom of hidden conditions such as osteoporosis when coupled with MS, emphasizing the role that health care professionals play by overlooking the possibility. Ask your doctor.


Each of the conditions in this list commonly co-exist with MS. What if a person has MS plus another, plus another, plus even another? Denise Coleman, right here on Health Central, tells of her plight with MS plus multiple disorders in her post One Step Forward, Two Steps Back. Denise tells us of her disorders and symptoms, then she describes the confusion of multiple diagnoses. She is not alone.

As we see with Denise's post, there are other conditions added to MS. One diagnosis does not exclude another. We must remain aware of our bodies and new symptoms that may indicate another invading condition -- any condition.

Whether we have more than one condition or we are simply trying to discover what is wrong, MS is confusing. Many of us know, after spending long periods of time in limbo, that identifying MS alone is complicated and time consuming; MS plus another condition adds confusion and time. Here is a landmark guideline for distinguishing MS from other conditions. It was developed by the National MS Society to increase diagnosis accuracy among MS and its look-alikes. It's about time.

"But pain" seems to me an insufficient reason not to embrace life. Being dead is quite painless. Pain, like time, is going to come on regardless. Question is, what glorious moments can you win from life in addition to the pain?"

~ Lois McMaster Bujold,

Next I will talk about treatment.