Chronic Pain in Multiple Sclerosis: An Overview

Abstract

The pathophysiology of pain in multiple sclerosis (MS) is poorly understood, but there are multiple schools of thought. Different mechanisms are associated with causation of this pain e.g. acute pain due to inflammation; chronic or intermittent neuropathic pain related to central nervous system (CNS) lesions; pain secondary to spasticity, spasms and muscle cramps from higher motor neuron lesions; and musculoskeletal pain from adopting maladaptive body positions and general physical deconditioning. Similarly evidence for treating pain in MS is limited. Treatment is often based on anecdotal reports and clinical experience as there is scarcity of randomized placebo-controlled trials for evidence of pharmacological treatment of pain in MS. The aim of this article is to provide a brief review of current concepts about the nature, causes and management of pain in MS.