Pain in Multiple Sclerosis: Prevalence and Characteristics of Various Pain Conditions

Introduction: Pain is a key symptom in patients with multiple sclerosis (MS), but the prevalence of pain in MS and its impact on quality of life of the patients is still underestimated. Objective: The aim of the study was to examine the occurrence of pain in MS patients, to identify the pain conditions and the relationship to important demographic variables (age, gender, type of MS) and to determine its impact on quality of life. Methods: Questionnaires on pain and health-related quality of life were sent to 307 patients with definitive MS diagnose. All patients with painful sensations were examined with aim to diagnose central and peripheral neuropathic and nociceptive pain. Results: Out of 220 responders 92% reported at least one type of pain or unpleasant pain sensation. Pain was more frequent in relapsing-remitting form of MS than in secondary progressive MS (p<0.0001) and less frequent in males than females (p=0,001). The ratio of different pain types was as follows: 51.38% headache, 57.94% neck or low back pain, 40.91% central neuropathic extremity and trunk pain, 5.91% trigeminal neuralgia, 34.26% Lhermitte‘s sign, 2.47% peripheral neuropathic pain. The commonest location of pain was lower extremities (84.09%) and the commonest pain quality was painful stiffness. Two and more concurrent pain locations were reported by 87.2% of patients and the total number of pain locations significantly increases with disease duration (p<0.0001). Pain limited the activities of daily living in 61.5% of patients. Conclusion: Our study confirmed the heterogenity of pain experienced in MS, the capacity to experience more than one type of pain simultaneously and inadequate pain treatment. Therefore pain is an important therapeutic target in MS.