Dr. Cross notes that these drugs include the anticonvulsants Neurontin (gabapentin), Tegretol (carbamazepine), and Dilantin (phenytoin), as well as the tricyclic antidepressant amitriptyline. For spasticity, the drugs baclofen and Zanaflex (tizanidine) can greatly reduce painful cramping and other symptoms.
Tricyclic antidepressants, such as amitriptyline (Elavil), doxepin (Sinequan), and nortriptyline (Pamelor). These drugs are prescribed for pain at doses lower than are effective for depression. Serotonin–norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta) and venlafaxine (Effexor).
With certain diseases and conditions involving severe pain that is not responsive to other drugs, opioids are a type of drug that is sometimes prescribed. With MS, opioids are not as effective, and they are typically avoided.
Routine use of opioids can have negative consequences, such as breathing difficulties, risk of overdose, and death, and they haven't been shown to be effective in treating MS-related pain.
Treatment of multiple sclerosis with Tramadol can considerably alleviate moderate to severe discomfort.
You might take a pain reliever like acetaminophen or use a skin gel with a pain reliever like lidocaine. Your doctor could prescribe medications for seizures or depression. They affect how your central nervous system reacts to pain. You can also try warm compresses or pressure gloves.
Medications such as codeine or hydrocodone were once used for MS nerve pain. We now know they are less effective than medications in the above-mentioned categories, and the antiepileptic and antidepressant medications work without the side-effect of rebound pain or dependence that opioids often produce.
MS can damage the nerves that affect your muscles. This can cause acute or paroxysmal pain in the form of spasms. Your arms and legs might shoot out uncontrollably and might have pain like cramping or pulling. Nerve pain can also be chronic in the form of painful or unusual sensations on your skin.
Multiple sclerosis (MS) triggers that worsen symptoms or cause a relapse can include stress, heart disease and smoking. While some are easier to avoid than others, maintaining a healthy lifestyle and overall health and wellness can have outsized benefits for MS patients.
Intrathecal phenol is a nerve blocker that has been used for more than 60 years to treat severe muscle stiffness. It is recommended for people with MS who have failed to respond to all oral medications and other treatments.
Pain that comes from weakness, stiffness or other mobility problems from MS is considered musculoskeletal pain. Both types of pain can be acute, having a rapid onset and short duration, or chronic, starting gradually and persisting daily or almost every day.
Dantrolene is a muscle relaxant for relief of cramping, spasms, and tightness of muscles (spasticity) caused by multiple sclerosis and other conditions. It acts directly on the muscles.
Adjuvant drugs such as the tricyclic antidepressants (TCAs), serotonin/norepinephrine reuptake inhibitors (SSRIs), and some anticonvulsants, for example, gabapentin or topical lidocaine are utilized as first-line drug therapy for alleviation of MS-associated neuropathic pain (34, 37, 46).
Duloxetine is recommended as a first-line drug for the treatment of chronic neuropathic pain.
Injections, such as peripheral nerve injections and epidurals may be recommended. We also offer spinal cord stimulation, an implanted device, which sends electrical pulses to the spinal cord to mask the pain. In some cases, surgery will be necessary.
In MS patients commonly have neuropathic pain. It often affects a limb or limbs, and sometimes involved the trunk. It is described in a various ways but often the following descriptions are used: “burning, tingling, jabbing, electrical, itching”.
Musculoskeletal pain may be helped by common pain relieving drugs such as paracetamol, ibuprofen or aspirin. If the pain is due to muscle stiffness (spasticity), then treatments for spasticity may be offered. A physiotherapist can identify any changes in your posture or walking that may be causing pain.
High-Dose Steroids
If you are having an acute exacerbation that needs treatment, you may be admitted to the hospital for an IV infusion of high-dose corticosteroids, such as methylprednisolone (Solu-Medrol). Corticosteroids are the most common treatment option for severe MS relapses.
Lesions in the brain may affect cognitive abilities. Some people with MS have trouble with memory, attention and concentration, multitasking and decision-making, says Dr. Scherz. The changes are usually mild at the beginning, but can be frustrating as time goes by.
What do MS attacks feel like? MS attack symptoms vary, including problems with balance and coordination, vision problems, trouble concentrating, fatigue, weakness, or numbness and tingling in your limbs.
Tizanidine (Zanaflex)
A muscle relaxant can reduce stiffness and spasms and may be particularly useful to treat painful night-time spasms. Because its effects last for only 3-6 hours, it can be best used around specific times when relief from symptoms is most important, for example at bedtime.
Corticosteroids are used to reduce inflammation and expedite recovery from acute relapses. The most commonly used corticosteroids in MS include methylprednisolone, dexamethasone and prednisone.