Multiple sclerosis (MS) is a chronic condition that affects the central nervous system. Specifically, MS causes damage to a substance called myelin, which insulates the nerves and helps them transmit signals. Myelin damage can result in a range of symptoms, including joint pain.
According to the Multiple Sclerosis Association of America, more than 50% of people living with MS identify pain as a significant symptom of the disease.
Two types of pain are associated with MS: nerve pain and musculoskeletal pain. The latter refers to pain in the muscles and joints.
In this article, we describe how MS can cause joint pain. We also outline the symptoms of MS joint pain and the treatment options available.
Multiple sclerosis does not directly affect the joints. However, it does cause issues that can lead to joint pain. Examples of such issues include:
- weakened muscles
- poor posture
- abnormal gait
- loss of balance
- loss of muscle coordination, called ataxia
- muscle spasms
- stiffness in the arms and legs, particularly after long periods of rest
In some cases, a person may experience joint pain and stiffness as a result of the body compensating for one or more of the above issues.
MS joint pain commonly affects the following areas of the body:
- lower back
The symptoms of MS will differ from person to person. Other factors that may vary are the severity of a person’s symptoms and the speed with which they develop.
The symptoms of MS joint pain may develop slowly over time. Other signs and symptoms that may occur alongside the pain include:
- balance issues
- changes in posture
- stiff muscles
- a feeling of numbness, tingling, or tightness in the muscles
- noticeable fatigue
A doctor will typically begin the diagnostic process for MS by asking about a person’s symptoms and medical history. The doctor will then conduct a physical examination, which may include an assessment of the following neurological functions:
- language ability
- sensory perception
- eye movements
To assist the diagnosis, a doctor may order one or more of the following tests:
- blood tests to rule out other conditions
- cerebrospinal fluid analysis, which checks the spinal fluid for abnormalities associated with MS
- evoked potential test, which assesses how quickly the brain responds to sensory stimuli
- ocular coherence tomography, which takes a picture of the eye and allows a doctor to evaluate the optic nerve directly
- MRI scan to help identify damage to the brain and spinal cord
- eye examination to help identify eye conditions resulting from MS
There is currently no cure for MS. Instead, treatments aim to:
- slow the progression of the disease
- reduce the frequency and severity of relapses
- manage symptoms
- improve mobility
- prolong independence
A person’s treatment plan may include one or more of the following:
- disease-modifying therapies (DMTs) to slow the progression of disability, as well as reducing the frequency of relapses and the number of brain and spine lesions
- medications to treat muscle stiffness and spasms, such as:
- medications to reduce fatigue, such as amantadine, modafinil, and armodafinil
- physical therapy to maintain or improve mobility and independence
- use of medical equipment, such as braces, walkers, or canes, to assist mobility
- acupuncture to help relieve pain
- transcutaneous electrical nerve stimulation (TENS) to help alleviate nerve pain and loosen stiff muscles
The following home remedies may also be effective in alleviating MS joint pain:
- regular massages
- light-to-moderate exercise
- application of heat or ice to painful joints
- regular stretching
A person should see a doctor if they have MS, and they experience new or worsening symptoms.
A person should also see a doctor if they develop joint pain that prevents them from carrying out their usual daily activities.
A doctor can suggest medical treatments and lifestyle changes to help manage the pain and maintain joint function and mobility. They can also refer the person to a physiatrist. These healthcare professionals specialize in physical medicine and rehabilitation, including the interactions between muscles and joints.
At least half of those living with multiple sclerosis experience MS-related joint pain. Joint pain is associated with other symptoms of MS, including muscle weakness, balance and coordination issues, and muscle spasms.
A person should see their doctor if they are experiencing new or worsening symptoms of MS.
Although there is no cure for MS, treatments can help alleviate the symptoms and slow the progression of the disease. The treatment plan for MS joint pain may involve a combination of medications, physical therapy, and light-to-moderate exercise.