Pain Treatment

How can MS pain be treated?

Pain in MS presents a challenge as it is often unresponsive to standard therapies. Management of the root cause is essential to control the resulting pain. Below are some medications used to treat MS-related pain.

Medications Used to Treat MS-related Pain (Brand Name (Generic) & Type of Pain)

Cymbalta® (duloxetine hydrochloride) Neurontin® (gabapentin) Lyrica® (pregabulin)

Pain directly caused by damage to the central nervous system Dilantin® (phenytoin)

Elavil® (amitriptyline) Pamelor®; Aventyl® (nortriptyline) Tofrani®l (imipramine)

Burning sensations, pins & needles, stabbing pains in the arms and legs Klonopin®; Rivotril (clonazepam) Tremor, pain, and spasticity Tegretol® (carbamazepine) Shock-like pain, such as trigeminal neuralgia (facial pain).

Over-the-counter medications and narcotics are generally not effective in relieving MS-related pain. Over the counter pain killers generally should not be used for more than 8 – 10 days per month as they may actually cause headaches if over used, it is best to see your doctor and obtain a safer pain medication. However, there are many people with advanced MS who are prescribed opioids.

If someone is taking opioids, constipation can be a difficult side effect to manage, so stool softeners/stimulants must be prescribed.

It is also important to know that, in advanced MS, opioids can further complicate respiration and swallowing, as well as cause sedation. The fentanyl patch might be the preferred choice of opioid due to fewer side effects and more sustained effect.