You are here:

MS research update – How common is nerve pain in early MS? – 26 October 2015

Summary

This study examined how common nerve pain was in early MS, in 377 people with MS who attended a clinic in Germany.

Participants completed a PainDETECT questionnaire, which is a survey that was specifically developed to detect nerve pain. 4% of participants had scores on this questionnaire that indicated they were experiencing nerve pain. A further 9.5% had scores in a range where nerve pain is a possibility but cannot be confirmed as the type of pain.

Participants who were experiencing nerve pain, also had significantly higher levels of depression, fatigue and disability. The researchers suggest that treatment of the pain should take these other factors into account, to help improve overall wellbeing.

Background

Pain is a common symptom in MS and may have several causes. Some studies have suggested that up to 80% of people with MS may experience pain at some stage, but as pain is difficult to define, estimates vary as to how common it is. Nerve (neuropathic) pain is caused by damage to the nerves in the brain and spinal cord. Examples of nerve pain include trigeminal neuralgia, the MS hug, Lhermitte's sign and altered sensations such as pins and needles, numbness, crawling or burning feelings.

This study examined how common nerve pain was in early MS.

How this study was carried out

377 people with MS who attended a clinic in Germany took part in the study. Participants' average age was 36 years old, they had an average EDSS score of 1.6 and had lived with MS for an average of 4.2 years.

During their first visit to the clinic they completed a PainDETECT questionnaire. This is a survey that was specifically developed to detect nerve pain and has been used in the past for studies into pain in several health conditions including MS. The questionnaire contains questions about how severe the pain is, where it is, how it feels and if it is made worse by contact such as touching. Each question has an associated score and a total score of 19 of above (out of a total of 38) indicates nerve pain.

Participants also completed several other questionnaires that examined other MS symptoms and emotional aspects.

What was found

The study found that 4% of participants had scores (19 and above) that indicated they were experiencing nerve pain. A further 9.5% had scores between 13 and 18 where nerve pain could be a possibility but cannot be confirmed as the type of pain.

Participants who were experiencing nerve pain, also had significantly higher levels of depression, fatigue and disability.

What does it mean?

In this study nerve pain was not common in early MS. This is in contrast to previous studies that have found it to be much more common, affecting up to a third of people with MS. The researchers suggest that the difference in their results might be due to the characteristics of their participants which might be significantly different to the participants in other studies, so their results might not apply to the wider MS population. The study also only looked at one type of pain and assessed it using a questionnaire, if other methods were also used to assess pain they might find different results.

The researchers conclude that as the participants their study experiencing nerve pain also had higher levels of depression and fatigue, treatment of the pain should take these other factors into account. This should help improve overall wellbeing.

Heitmann H, Biberacher V, Tiemann L, et al.
Prevalence of neuropathic pain in early multiple sclerosis.
Mult Scler. 2015 Oct 19. pii: 1352458515613643. [Epub ahead of print]
abstract

More about nerve pain

Nerve pain (neuropathic pain) is the direct result of damage caused by MS to the covering of nerves in the brain and spinal cord. This damage interferes with the normal transmission of messages to the brain. The brain may interpret these disrupted messages as pain or as unusual feelings like numbness, pins and needles, crawling or burning. Other examples of nerve pain include trigeminal neuralgia, the MS hug and Lhermitte's sign. There are a range of options to manage pain including drug treatments or other therapies as well as lifestyle changes.

You can read more about pain and how to manage it in the A to Z of MS.

In the MS Trust newsletter Open Door, Dr Steve Allen, Consultant in Chronic Pain Management in Oxford talks about nerve pain in MS, its treatment and answer some common questions. Read his article here.

Assessment tools

Castelli L, Stocchi L, Patrignani M, et al.
We-Measure: toward a low-cost portable posturography for patients with multiple sclerosis using the commercial Wii balance board.
J Neurol Sci. 2015 Oct 14. [Epub ahead of print]
abstract

Co-existing conditions

Kyritsis AP, Boussios S, Pavlidis N.
Cancer specific risk in multiple sclerosis patients.
Crit Rev Oncol Hematol. 2015 Oct 9. [Epub ahead of print]
abstract
Read the full text of this paper

Disease modifying drugs

McGuigan C, Craner M, Guadagno J, et al.
Stratification and monitoring of natalizumab-associated progressive multifocal leukoencephalopathy risk: recommendations from an expert group.
J Neurol Neurosurg Psychiatry. 2015 Oct 22. [Epub ahead of print]
abstract

Pathophysiology

Jonkman LE, Rosenthal DM, Sormani MP, et al.
Gray matter correlates of cognitive performance differ between relapsing-remitting and primary-progressive multiple sclerosis.
PLoS One. 2015;10(10):e0129380.
abstract
Read the full text of this paper

Physical activity

Clarke R, Coote S.
Perceptions of participants in a group, community, exercise programme for people with multiple sclerosis.
Rehabil Res Pract. 2015;2015:123494.
abstract
Read the full text of this paper

Kalron A, Zeilig G.
Efficacy of exercise intervention programs on cognition in people suffering from multiple sclerosis, stroke and Parkinson's disease: A systematic review and meta-analysis of current evidence.
NeuroRehabilitation. 2015 Oct 15. [Epub ahead of print]
abstract

Review

Fawaz CN, Makki IS, Kazan JM, et al.
Neuroproteomics and microRNAs studies in multiple sclerosis: transforming research and clinical knowledge in biomarker research.
Expert Rev Proteomics. 2015 Oct 19:1-14. [Epub ahead of print]
abstract

Symptoms and symptom management

Scheepe JR, Alamyar M, Pastoor H, et al.
Female sexual dysfunction in multiple sclerosis: results of a survey among Dutch urologists and patients.
Neurourol Urodyn. 2015 Oct 23. [Epub ahead of print]
abstract

Thomas S, Kersten P, Thomas PW, et al.
Exploring strategies used following a group-based fatigue management programme for people with multiple sclerosis (FACETS) via the Fatigue Management Strategies Questionnaire (FMSQ).
BMJ Open. 2015 Oct 20;5(10):e008274.
abstract
Read the full text of this paper

Work

Leslie M, Kinyanjui B, Bishop M, et al.
Patterns in workplace accommodations for people with multiple sclerosis to overcome cognitive and other disease-related limitations.
NeuroRehabilitation. 2015 Oct 20. [Epub ahead of print]
abstract

Year: 2016

December 2016

November 2016

July 2016

May 2016

April 2016

March 2016

February 2016

January 2016

Year: 2015

December 2015

November 2015

October 2015

May 2015

April 2015

March 2015

February 2015

January 2015

Year: 2014

December 2014

November 2014

October 2014

September 2014

August 2014

July 2014

June 2014

May 2014

April 2014

March 2014

February 2014

January 2014

Year: 2013

December 2013

November 2013

October 2013

September 2013

August 2013

July 2013

June 2013

May 2013

April 2013

March 2013

February 2013

January 2013

Year: 2012

December 2012

November 2012

October 2012

September 2012

August 2012

July 2012

June 2012

May 2012

April 2012

March 2012

February 2012

January 2012

Print this page