Featuring Barry A. Hendin, MD
MSAA’s Chief Medical Officer
Question: What are the common types of pain in MS and are they treated differently?
Answer: Sensory symptoms are common in multiple sclerosis. Usually they are temporary, but sometimes they’re persistent. They may occur in the setting of a relapse or sometimes they evolve more subtly.
Sensory symptoms can be simplified as to those that create decreased sensation such as numbness or loss of feeling, versus those that are experienced as unwanted sensations, such as tingling, burning, itching, or pins and needles. Technically, diminished sensation can be referred to as hypoesthesia or anesthesia. The unpleasant excessive feelings (of tingling, burning, etc.) can be referred to as paresthesia, dysesthesia, or hyperpathia. Because all of these symptoms can occur independently of multiple sclerosis with peripheral neuropathy (a disorder with damage to the peripheral nerves versus those of the central nervous system [CNS]), it’s important to exclude other causes such as diabetes or the side effects from medications.
Numbness generally does not require medication, however, when it interferes with the function of the hands or feet, physical therapy or occupational therapy may be beneficial. The unwanted tingling, numbness, burning, or itching can be managed by the use of anti-seizure medications, such as gabapentin (Neurontin®), pregabalin (Lyrica®), or carbamazepine (Tegretol®), or by the use of low-dosage antidepressants such as amitriptyline (Elavil®). Fortunately, these symptoms tend to improve with or without interventions over time.
For more information, please visit MSAA’s website section focusing on numbness and sensory symptoms.
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Barry A. Hendin, MD, is a neurologist and Director of the Arizona Integrated Neurology MS Center. He is also Director of the Multiple Sclerosis Clinic at Banner University Medical Center and Clinical Professor of Neurology at the University of Arizona Medical School.
MSAA’s Ask the Expert series received a Merit Award from the 28th Annual Digital Health Awards!