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MS research update - Chronic pain in MS - a seven year study - 01 May 2013

Summary

This study in Australia followed 74 people with MS. It found that, after seven years, 14% more of them experienced pain. However, there was no change in the average intensity of the pain when scores were compared between the start of the study and seven years later. Participants reported greater disability and that pain limited their daily activities more than previously so they were more dependent on others.

Background

Pain is very common in MS with more than half experiencing it at some time. Altered sensations, such as numbness, tingling, feelings of tightness or very sensitive patches of skin, all count as pain.

How this study was carried out

This research followed up 74 people with MS in Australia after seven years to see how many experienced pain, how intense it was, what impact it had on their lives and what treatments they used.

The participants had an average age of 57 and almost three quarters (72%) were women. They had been diagnosed with MS, on average, for 17 years.

They completed two questionnaires about their pain (the Visual Analogue Scale -VAS and the Chronic Pain Grade -CPG) and another about their quality of life (Assessment of Quality Of Life -AQoL).

What was found

After seven years, 14% more participants reported chronic pain. However, there was no change in the average intensity of the pain when scores were compared between the start of the study and seven years later. Participants reported greater disability and that pain limited their daily activities more than previously so they were more dependent on others.

After seven years, participants were using fewer drugs to control their chronic pain and had adopted other therapies.

What does it mean?

This study shows how common pain is for people with MS and how it has an increasing impact on daily life. The authors suggest that it is important for health professionals to recognise this, to treat pain early and encourage self management by the person with MS. This should help decrease pain-related disability and improve overall well being.

Khan F, Amatya B, Kesselring J.
Longitudinal 7-year follow-up of chronic pain in persons with multiple sclerosis in the community..
J Neurol. 2013 Apr 25. [Epub ahead of print]
abstract

More about pain

There are two types of pain in MS:

  • Neuropathic pain, also known as nerve pain, which is thought to arises as a direct result of the damage to the covering of nerves by MS
  • Musculoskeletal pain, also known as nociceptive pain, which is usually experienced in the joints or muscles and arises from spasms or changes in posture.

You can read more about pain 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 types of pain in MS, their treatment and answer some common questions. Read his article here.

Symptoms and symptom management

Ghajarzadeh M, Jalilian R, Eskandari G, et al.
Fatigue in multiple sclerosis: relationship with disease duration, physical disability, disease pattern, age and sex.
Acta Neurol Belg. 2013 Apr 25. [Epub ahead of print]
abstract

Disease modifying treatments

Hanson KA, Agashivala N, Stringer SM, et al.
A cross-sectional survey of patient satisfaction and subjective experiences of treatment with fingolimod.
Patient Prefer Adherence. 2013 Apr 16;7:309-18.
abstract

Ali R, Nicholas RS, Muraro PA.
Drugs in development for relapsing multiple sclerosis.
Drugs. 2013 Apr 23. [Epub ahead of print]
abstract

Other treatments

Tanasescu R, Constantinescu CS.
Pharmacokinetic evaluation of nabiximols for the treatment of multiple sclerosis pain.
Expert Opin Drug Metab Toxicol. 2013 Apr 27. [Epub ahead of print]
abstract

Horton L, Conger A, Conger D, et al.
Effect of 4-aminopyridine on vision in multiple sclerosis patients with optic neuropathy.
Neurology. 2013 Apr 24. [Epub ahead of print]
abstract

Rommer PS, Stüve O.
Management of secondary progressive multiple sclerosis: prophylactic treatment-past, present, and future aspects.
Curr Treat Options Neurol. 2013 Apr 23. [Epub ahead of print]
abstract

Preiningerova JL, Baumhackl U, Csepany T, et al.
Recommendations for the use of prolonged-release fampridine in patients with multiple sclerosis (MS).
CNS Neurosci Ther. 2013 May;19(5):302-6.
abstract

Assessment tools

Lamers I, Timmermans AA, Kerkhofs L, et al.
Self-reported use of the upper limbs related to clinical tests in persons with multiple sclerosis.
Disabil Rehabil. 2013 Apr 29. [Epub ahead of print]
abstract

Baumstarck K, Boucekine M, Klemina I, et al.
What is the relevance of quality of life assessment for patients with attention impairment?
Health Qual Life Outcomes. 2013 Apr 25;11(1):70. [Epub ahead of print]
abstract

Learmonth YC, Motl RW, Sandroff BM, et al.
Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis.
BMC Neurol. 2013 Apr 25;13(1):37. [Epub ahead of print]
abstract

Causes of MS

Chitnis T.
Role of puberty in multiple sclerosis risk and course.
Clin Immunol. 2013 Apr 2. doi:pii: S1521-6616(13)00087-9. 10.1016/j.clim.2013.03.014. [Epub ahead of print]
abstract

Bove R, Chitnis T.
Sexual disparities in the incidence and course of MS.
Clin Immunol. 2013 Mar 22. doi:pii: S1521-6616(13)00067-3. 10.1016/j.clim.2013.03.005. [Epub ahead of print]
abstract

Dobson R, Giovannoni G, Ramagopalan S.
The month of birth effect in multiple sclerosis: systematic review, meta-analysis and effect of latitude.
J Neurol Neurosurg Psychiatry. 2013 Apr;84(4):427-32.
abstract

Paediatric MS

Banwell BL.
Pediatric multiple sclerosis.
Handb Clin Neurol. 2013;112:1263-74.
abstract

Bigi S, Marrie RA, Verhey L, et al.
2010 McDonald criteria in a pediatric cohort: is positivity at onset associated with a more aggressive multiple sclerosis course?
Mult Scler. 2013 Apr 25. [Epub ahead of print]
abstract

Physical activity

Plow M, Finlayson M.
A qualitative study exploring the usability of Nintendo Wii Fit among persons with multiple sclerosis.
Occup Ther Int. 2013 Apr 24. doi: 10.1002/oti.1345. [Epub ahead of print]
abstract

Carter AM, Daley AJ, Kesterton SW, et al.
Pragmatic exercise intervention in people with mild to moderate multiple sclerosis: A randomised controlled feasibility study.
Contemp Clin Trials. 2013 Apr 21. doi:pii: S1551-7144(13)00049-9. 10.1016/j.cct.2013.04.003. [Epub ahead of print]
abstract

Prognosis

Viterbo RG, Iaffaldano P, Trojano M.
Verbal fluency deficits in clinically isolated syndrome suggestive of multiple sclerosis.
J Neurol Sci. 2013 Apr 27.doi:pii: S0022-510X(13)00166-4. 10.1016/j.jns.2013.04.004. [Epub ahead of print]
abstract

Roudbari SA, Ansar MM, Yousefzad A.
Smoking as a risk factor for development of secondary progressive multiple sclerosis: A study in IRAN, Guilan.
J Neurol Sci. 2013 Apr 26. doi:pii: S0022-510X(13)00165-2. 10.1016/j.jns.2013.04.003.[Epub ahead of print]
abstract

Pregnancy and childbirth

Jalkanen A, Saraste M, Gfeller A, et al.
Increased thyroid autoimmunity among women with multiple sclerosis in the postpartum setting.
Mult Scler. 2013 Apr 29. [Epub ahead of print]
abstract

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