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Everyone has experienced pain at some point in their life. Upon reading this, I’d be willing to bet most of you are dealing with some form of pain right now. I know I am! 

Most often, pain is a short-term event that does not cause any permanent damage or setback. Sometimes, pain is more intense, even severe when it is caused by a particular event, accident, surgery, or injury. This kind of pain can cause a lot of discomfort and can last for some time, but in many cases, this is a temporary situation, and the pain typically subsides or will halt completely once healed. 

Chronic pain is a different story altogether. Chronic pain might persist for three months, six months, or indefinitely. This is the kind of pain that kidnaps your body and can also affect your psyche. If ignored, chronic pain can spiral out of control causing additional problems such as depression, anxiety, sleep deprivation, isolation, and even financial stress. 

Chronic pain

Chronic pain symptoms vary, and they can come on without warning and will often rear their ugly heads every day and night. This kind of pain is quite common for many people with MS and it can take on many forms symptomatically (i.e., spasticity, trigeminal neuralgia, neuropathic pain in different areas, headaches, and eyes). The pain is real – sometimes it feels like a white hot burning pain and it’s miserable. I continue to be amazed whenever I hear people talk about how their doctors insist that there’s no such thing as having pain with MS. I find this to be frustrating and infuriating on so many levels.

There are many different forms of chronic pain – musculoskeletal, inflammatory, neuropathic, and even pain related to psychological issues. All of these can apply to a person living with MS. Some people have pain symptoms that are somewhat mild while others will find themselves dealing with a variety of symptoms that can cause an unbearable amount of pain – an ongoing pain that can become overwhelming and all consuming. 

For those of us who have other health conditions in addition to MS, the pain situation can be multifaceted and more challenging to deal with. Sometimes it can be difficult to pinpoint what is causing the pain. Is it MS or is it something else? Aging also plays a factor. As we age, our pain can worsen, our activities may become more limited, and thus, our overall quality of life becomes less than wonderful. So, what can we do to better understand chronic pain and how can we best treat and manage it? ’Tis the question indeed.

Treating pain

There is no single cure or remedy for treating pain. Just like MS, everyone is different, and we should be treated as individuals, not as the symptom or disease. I’m sure most everyone has been asked to rate their pain level using the pain scale, right? It’s where you rate your pain from 0 (no pain) to 10 (worst possible pain). Personally, I’m not a fan of this “diagnostic” measure because everyone is different. Pain is subjective and personal. Tolerance levels, stress, age, psychological issues, and other factors may also come into play, so it’s important to get a grasp of the big picture with each patient before grabbing the prescription pad. 

Treating acute pain is very different from treating chronic pain. Doctors used to prescribe hard-core medications (opiates) to patients who presented themselves with pain – any kind of pain. People gobbled these up like candy only to become addicted or worse. The thing is, those kinds of medications don’t treat the problem effectively, nor do they address the pain appropriately; therefore, there’s no benefit and the patient pays the price. I can attest to this. After having major neck surgery in 2008, I found myself getting dangerously close to falling into a bad place with pain medications. All I can say is how grateful I am to the doctor who took notice of this and brought it to my attention. He didn’t scold or judge, he just cared enough to help me find a different path to take without narcotics.

Here's a sample list of some of the different therapies, treatments, and medications for those living with MS and chronic pain. A lot of these are common OTC medications, yet that doesn’t mean they’re a good fit for anybody and everybody. Always keep in mind the risks of possible side effects, drug interactions, and the like. Bottom line, explore in depth with your doctors:

• Acetaminophen (Tylenol)
• NSAIDS (Advil, Ibuprofen, Aspirin)
• Oral steroids (Prednisone and others)
• Anticonvulsants (Gabapentin, Pregabalin, Lyrica)
• Depressants (Benzodiazepines – Xanax, Valium, Ativan)
• Antidepressants (Tricyclics and SNRI’s)
• Botox injections
• Muscle relaxers (Baclofen, Zanaflex, Flexeril, etc.)
• Sleep aids (Trazadone, Melatonin, Hypnotics, etc.)
• Topicals (Lidocaine patches, creams, gels, Biofreeze (menthol, etc.)
• Ice, heat, compression socks, magnesium (Theraworx foam, etc.)
• Mattress and pillows (Important)
• Accupuncture (Medicare now covers a portion of this)
• Massage (learn some self-massage techniques or professional/PT)
• Water therapy (swimming pool, cool or warm jacuzzi – no hot water) 
• Cognitive behavioral therapy
• Other treatments are on the horizon for treating peripheral neuropathy and other forms of chronic pain. Stay tuned for more information about this.

Pain is real, but it’s much more complex than having an “ouch.” As doctors continue to research, learn, and understand this complexity, the better they will be able to treat their patients more safely, successfully, and for the long term. We, as patients also need to research, learn, and try to understand this complexity and hopefully, we’ll be able to find a better way to manage chronic pain, and take back our life.