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J Clin Psychiatry. 2012 Jul;73(7):e23. doi: 10.4088/JCP.11093nr1c.

Identifying and treating pain caused by MS.

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From the Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee.


Multiple sclerosis (MS) is a chronic disease that causes disability due to inflammation and demyelination in the central nervous system. Pain is a common symptom in patients with MS but is often inadequately treated, leading to decreased functioning and a low quality of life. Pain associated with MS includes central neuropathic pain due to lesions of the somatosensory system, and nociceptive pain due to spasticity, muscle tightness or contracture, abnormal gait and postures caused by MS, or treatment-related pain. Patient education, physical therapy, and pharmacotherapy can all be helpful in treating the painful symptoms of MS. Tricyclic antidepressants, anticonvulsants, and opioids are first-line options for central neuropathic pain, and spasmolytics, muscle relaxants, benzodiazepines, and anticonvulsants are helpful for nociceptive pain. Pain should be regularly assessed and appropriately treated to improve functioning and quality of life for patients with MS.

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