Posted by: Thixia | March 14, 2008

MS Pain Management 3 of 7

Musculoskeletal

• Pain in the hips and base of the spine: this can be made worse by immobility.
• Pain in muscles, tendons and ligaments: this can be made worse by keeping limbs in fixed positions, which causes tension to build up.

Acute (short-term, but could be repetitive) Neuropathic

• Trigeminal neuralgia: an intense, sharp, stabbing facial pain. The pain is usually short-lived, but can leave behind a longer-lasting aching or burning. It is a relatively rare sensation in MS.
• L’Hermitte’s sign: a sudden, electric-shock-like sensation, that spreads into the arms or legs, often triggered when the neck is bent forward, or after a cough or sneeze.
• Optic neuritis: visual problems are sometimes, but not always, accompanied by pain when the eye is moved.
• Tonic spasms: this sort of painful spasm causes legs or arms to bend or shoot out unexpectedly. They usually last for seconds rather than minutes.

Musculoskeletal

• Muscle cramps or spasms (spasticity): this can be made worse by inactivity or postural problems. Very often, treating and managing your pain will require a combination of treatments. These will be tailored to your own needs and could include drug treatments, physiotherapy, looking at your posture, complementary therapies and relaxation techniques. Your doctor or MS nurse might refer you to other specialists to help find the best ways of managing your pain. Unfortunately, treating pain is sometimes a process of trial and error, particularly for long-lasting or repetitive pain. It is not always obvious which treatments will work for any individual. You may need to try a number of therapies and drugs to find an effective way to reduce your pain.

Investigate the causes and how it affects you

The first step in managing pain is to find the likely cause, or causes, so that the problem can be tackled appropriately. If pain can be traced to a bladder infection, for example, then treating the infection should clear the pain. Aching muscles, on the other hand, can sometimes be managed by adjusting posture, or physiotherapy. One way to asses the causes of pain is to complete a ‘pain questionnaire’. This will ask questions about where and when you feel the sensation, how long it lasts, and its impact on daily activities like dressing and washing. You might also be asked to rate your pain on a scale, perhaps from zero to 10, with zero being no pain, to 10 being severe pain. How pain affects you can vary, so it is important that assessments are not just a one-off, but are repeated over time. By comparing assessments before and after treatments, health care professionals can see whether treatments are having the desired effect, or whether useful changes can be made.

Your own coping strategies – fitting pain management into your life

Everyone’s circumstances and coping styles are different. If you experience pain, you may already have your own ways of trying to minimise it. Pe0rhaps you find relaxation techniques, like yoga or deep breathing, helpful. Some people find they avoid certain activities associated with pain, whilst others benefit from keeping as active as possible. It all depends on what is causing the pain and what works for you. Discussing these personal coping strategies with your doctor or MS nurse can help ensure any new treatments fit ‘he first step in managing pain is to find the likely cause, or causes.’ How can pain be treated and managed? into your life and are tailored to your circumstances. A treatment is more likely to bring benefits if it suits your needs. There may also be ways in which you have adapted to cope with pain that actually result in other difficulties.

For example, to compensate for pain in one leg, you might put an extra strain on the other, or on your back. For this reason, it is important to talk to experts, to ensure your coping strategies are appropriate in the long term. An occupational therapist or physiotherapist may suggest alternative ways to compensate for the pain that might avoid this strain or bad posture.

Compliments of:
UK Multiple Sclerosis Society

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