Management of Pain in Neuromuscular Disorders

Abstract

Pain is a commonly recognized feature of many patients with neuromuscular disorders (NMDs). Although the rates, severity, and location of pain can vary across the many different types of neuromuscular disorders, at some point during their life-time all NMD patients experience some type of pain. This pain is often misunderstood by both patients and their healthcare providers because, for many the relationship between tissue damage and pain is often oversimplified. Failure to recognize the complexity of pain generation may result in a failure to capture the true implications of the pain experience these patients have contributing to the features of reduced physical functioning, poor social functioning, and reduced quality of life. Advances in research have expanded the options for pain management. Categories for pain medications are: (1) traditional analgesics including nonsteroidal anti-inflammatory drugs (NSAIDs), (2) antidepressants, (3) membrane-stabilizing agents and anticonvulsants, (4) topical medications, (5) opioids analgesics, and (6) spasticity-related pain medications. Selection of analgesics based upon the etiology of the neuromuscular disease has provided improved management of patients with NMDs. Combination of multiple categories of medications have produced enhanced analgesic effects in these patients.