Posted by: Thixia | August 19, 2008

MS: Controlling Pain 2 of 2

Taking control of your pain 


Everyone has a right to good pain control. Many people with MS live with pain that could be effectively relieved. Sometimes this is because their existing treatment is not working, because they or their health professionals are not aware of all treatment methods, or because they don’t know how to bring up the topic with their doctor. How can you make sure that you get effective pain relief?


Communication is key to successful pain control.


Pain is subjective – it can’t be measured with a blood test or a scan. Plus, the severity and types of pain vary widely between people with MS. This means that your own description of the pain will be a critical tool for the health professionals involved in your care. They will use your own evaluation of the pain to help choose and adjust treatment.


The “PQRST” is a popular way of measuring and describing pain:


  • P = Provoking and palliating factors: What makes the pain better (palliating) or worse (provoking)?
  • Q = Quality: What does the pain feel like? (e.g., burning, stinging, aching, pounding)
  • R = Radiation: Does the pain “move” to other areas of the body?
  • S = Severity: How bad is the pain? Usually you’ll be asked to rate the pain on a scale of zero to 10, with zero being “no pain” and 10 being “the worst pain you can imagine”.
  • T = Time: When did the pain start? Does it come and go? If so, how often to you have pain and how long does it last?

This method helps doctors understand what your pain is like. This will assist them in the next step of pain control, which is identifying the cause of the pain. This is important, since treatment options often depend on what is causing the pain. The doctor will also try to figure out whether the pain is being caused by MS, or by another medical condition (since people with MS can still get other conditions, such as arthritis). Using the PQRST will also help you track your pain over time to see how well treatments are working. Sometimes, it is not possible to completely relieve all pain, and it may be necessary to agree on an “acceptable” level of pain relief to try for.


Depending on the cause of your pain, you will probably need a combination of medication and non-medication treatment options to get effective pain relief. Medication options include:


  • painkillers taken by mouth, such as acetaminophen, ibuprofen, or codeine
  • painkillers given by injection, such as morphine
  • medications taken by mouth for nerve pain, such as amitriptyline and gabapentin
  • medications taken by mouth for spasticity, such as baclofen and tizanidine
  • medications that are applied to the skin, such as capsaicin

Non-medication options include hot or cold packs, physiotherapy, stretching, yoga, or acupuncture.



There is also a mental and emotional side to pain.


Many people also find that doing things they enjoy helps take their mind off of the pain. Meditation, humour, and relaxation techniques can also help with pain relief. It’s also important to have an emotional support network of friends, family, and other people with MS.


If you are not satisfied with your level of pain relief, or if you would like to try another pain control option, speak with your doctor, pharmacist, or nurse. Only you know how the pain feels, so only you can judge whether the pain relief plan is working.


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