b'Life with MSManaging MS Pain Managing MS Pain or chronic in naturePain can be acute, paroxysmal, By Cherie Binns There are three distinct types of pain seenantiepileptic and antidepressant medications in people with MS. They are acute, paroxysmal,work without the side-effect of rebound pain and chronic. Both acute and chronic pain canor dependence that opioids often produce. be either nerve or musculoskeletal in origin.Paroxysmal pain from nerve damage may Paroxysmal pain is generally related to nervenot need to be treated with medications, as injury that occurs as a result of damage to thethepainisepisodicandlastsforonlya myelin sheath.minute or two before calming. This, in some Musculoskeletal pain may be related topeople, may be an indicator that a nerve is gait disturbances that individuals may notinjuredordamagedandoncethatinjury even realize they have. A physical therapycalms or other nerve pathways have grown, evaluation may target these disturbances andthe pain goes away. even small changes to conscious movementFor many with pain, eating an anti-may improve this pain over time. Many peopleinammatorydietcanhelp.(Formoreon nd that a massage therapist, chiropractor, oranti-inammatory eating, see the MS Focus acupuncturist are benecial in helping thempublication Food to Fight MS.) Elimination of to get control of musculoskeletal pain.sugar that does not naturally occur in food Nerve pain can require medication to calmcan ramp down even very aggressive pain it. People describe nerve pain as stabbing,and make it more easily managed. People searing, tingling, vicelike, and electrical. Thealso report that with this sugar out of their primary meds used to treat nerve pain comesystems, other MS symptoms tend to be less from a class of drugs known as antiepileptics.severe as well. A regular exercise program In some cases, antidepressants may be usedthat both stretches and strengthens muscles to increase nerve-quieting chemicals in thegoes a long way in improving muscle tone central nervous system. Both of these classesand reducing pain. of medication have side-effects that includeNot all pain experienced by people with a sleepiness, dry mouth, and constipation butdiagnosisofMSisactuallycausedbythe these tend to disappear over time as the paincondition. If you do work that is repetitive and becomes better managed. have hand, wrist, arm, back, or neck pain, it Medications such as codeine or hydrocodonemay be related to your work or activity rather were once used for MS nerve pain. We nowthan the MS. Therefore, it is always important know they are less effective than medicationsto have pain evaluated to determine the cause in the above-mentioned categories, and theand develop a plan to manage it. msfocusmagazine.org 52'