Posted by: Thixia | March 18, 2008

MS Pain Management 5 of 7

Cannabis-based drugs – Sativex     

Some people with MS say that they find cannabis relieves their pain. It is still an illegal drug in the UK. However, by isolating certain ingredients in cannabis – known as ‘cannabinoids’ – researchers have developed controlled ways of testing the possible benefits of cannabis. Sativex is a drug containing a cannabis extract that may help with spasticity and pain. It is taken by spraying it under the tongue or to the inside of the cheek.   

The dose of Sativex is controlled by varying the number of sprays taken. Side effects can include dizziness, sleepiness and feelings of intoxication, and the long-term safety of the drug is not known.  At the moment, Sativex is available in Canada, but does not have a UK licence.  GPs in the UK have occasionally prescribed Sativex on a ‘named patient’ basis for people with MS, but this is the exception rather than the norm. Access to this drug may change. Contact the MS Society information team for further details of the current prescription process.     

Transcutaneous Electical Nerve Stimulation (TENS) is a procedure in which electrodes are placed on the surface of the skin to stimulate nerves. The form and strength of the electrical signal can be altered to stimulate different nerves for different pains.  TENS is based on principles similar to those of acupuncture – that stimulation of these nerves can affect the way pain signals get through.  Some people find TENS helps both musculoskeletal and neuropathic pain, though the benefits of the treatment often wear off quickly after use. As with all treatments for pain, it does not suit everyone and some people have reported skin irritation and a burning sensation, rather than improvements.     

Some people feel they benefit from complementary therapies including acupuncture, chiropractic, osteopathy, massage, yoga, and t’ai chi. Some of these may be available through the NHS, though you may be asked to contribute towards costs for certain services. Others will need to be paid for privately.  Acupuncture, in particular, is available through many doctors’ surgeries. Although only small or preliminary studies of acupuncture in MS have been completed, it appears to alleviate pain in other conditions and is generally a well tolerated procedure.  Before beginning any complementary therapy, it is sensible to consult your doctor. Some therapies may interact with medications, or might even do more harm than good. If you do decide to use a complementary or alternative therapy, wherever possible, use practitioners who are registered with a nationally recognised body.      

Occasionally, surgery may help control pain. This is only used when other approaches have not proved effective, or drug side effects are intolerable. For example, trigeminal neuralgia may respond to techniques including ‘glycerol injection’, ‘gamma knife’ surgery or radiofrequency treatment. These procedures involve ‘numbing’ the nerve involved in trigeminal neuralgia. For some people, this provides relief for some time.       

TENS – Transcutaneous Electrical Nerve Stimulation Complementary therapies Surgical procedures     

 The gamma knife procedure is the least invasive of these. A beam of radiation is focused at the point where the nerve leaves the brain. It does not involve cutting the skin or injections, but has a possible side effect of complete numbness, or more occasionally painful tingling, on the side of the face that was treated.  Other techniques which may occasionally be used to control pain include ‘deep brain stimulation’ and ‘motor cortex stimulation’.    

Both procedures involve implanting a small programmable device, rather like a pacemaker, just below the collar bone. This sends electrical pulses, via tiny wires, to the brain. This electrical stimulation provides pain relief for some people, but is not successful for everyone and it is hard to predict which people it will benefit. Surgery of this kind would not be considered unless pain is long-lasting and does not respond to other therapies. For some people, treatments do not bring complete relief. The therapies mentioned above may still help reduce the pain, but other approaches might also be useful.         

Compliments of: UK Multiple Sclerosis Society 

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Responses

  1. an interesting post today here is a quick excerpt Cannabis-based drugs – Sativex      […]

  2. I like your writing style. Looking forward to reading more from you.

    – Sue.


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