Multiple sclerosis and back pain

Author: Adam Rowden

MedicalNewsToday

Multiple sclerosis (MS) is a condition that affects the central nervous system. It disrupts the flow of information between the brain and the rest of the body. In mild cases of MS, people can experience blurred vision, as well as numbness and tingling in the limbs. More severe cases can cause paralysis, vision loss, and mobility problems.

Back pain is another common symptom Trusted Source of MS. There are a number of reasons people with MS may have back pain.

For example, they may experience pain due to damaged nerves. Medical professionals refer to this as neuropathic pain.

An individual may also feel pain as a result of changes in the body due to MS. For instance, MS may cause weakness in a person’s legs, which can affect the way they walk. This in turn may result in back and hip pain.

Other people with MS may have back pain that is not related to MS but to another health problem, such as muscle strains or a herniated disc. People with MS may be less able to compensate for this pain than people without MS, which can worsen the pain over time.

This article will explain the possible causes of and treatment options for back pain in people with MS.

Spasticity and muscle tightness

Spasticity is a common symptom of MS. It is the tightness or stiffness of the muscles that also includes a wide range of muscle spasms. It typically occurs in the legs, groin, and buttocks, but it may affect the lower back as well.

There are two main types of spasticity: in flexor spasticity and in extensor spasticity.

In flexor spasticity occurs when the muscles are so tight that they bend the limbs and make it difficult to straighten them.

By contrast, in extensor spasticity develops when the muscles are so tight that the limbs remain straight and become difficult to bend.

A number of factors may aggravate spasticity, including:

sudden movements
position changes
extreme hot and cold temperatures
tight clothing
infections
humidity

Mild spasticity is not painful. However, more severe spasticity can become very painful and make carrying out daily tasks more challenging.

Spasticity can also cause muscle spasms or cramps, which can be severe and cause more discomfort.

Treating and managing spasticity

Spasticity varies from person to person. This means that treatment also tends to differ.

Medical professionals often use the following methods to treat spasticity in people with MS:

medications
physical therapy
occupational therapy

Without treatment, spasticity can become more serious and lead to complications, including contractures, which is the name for frozen or immobilized joints, and pressure sores.

If a person has MS and experiences spasticity, they should contact a healthcare professional to discuss treatment options.

Nerve damage: Neuropathic pain

MS damages the nerves. This can cause people with MS to feel pain due to a “short-circuiting” of these nerves as they carry signals from the brain to the body.

Medical professionals refer to this pain as neuropathic pain. It is one of the most common symptomsTrusted Source of MS that can dramatically reduce a person’s quality of life.

This type of pain can occur all over the body. If a person has neuropathic pain in their back, it can manifest as a sharp, stabbing, or shooting sensation. A person may also experience a burning sensation in the lower back. This pain can feel as if it moves from the lower back into the leg.

A number of factors may increase a person’s likelihood of experiencing neuropathic pain, including:

stress
fatigue
illness
being overheated

Treating neuropathic pain

Anti-seizure medications and certain antidepressants are common Trusted Source treatments for neuropathic pain. Medical professionals use these medications to calm overactive nerves, which can reduce pain.

However, according to the National Multiple Sclerosis Society,the Food and Drug Administration (FDA) has not approved these drugs for use to treat pain that MS causes.

Other methods for treating neuropathic pain include:

acupuncture
mindfulness and meditation
cognitive behavioral therapy (CBT)

Lhermitte’s sign is another common symptom Trusted Source of MS. It is a short, intense pain that runs from the back of the head down the spine and sometimes into the arms or legs. The pain tends to occur when a person bends their neck forward.

A 2015 study Trusted Source notes that around 1 in 3 people with MS experience Lhermitte’s sign.

Typically, Lhermitte’s sign means that MS has caused damage to the nerves in the neck. Hyperexcitability, which is an increased firing of nerve fibers in the brain, is another possible cause.

There are some other factors that can increase a person’s risk of experiencing the pain. They include Trusted Source:

fatigue
stress
extreme heat

Treating Lhermitte’s sign

Lhermitte’s sign pain is sharp, resembling an electric shock, and does not last long. Usually, the pain resolves on its own over time. That is why healthcare professionals often do not treat the pain itself.

Some evidence Trusted Source suggests that drugs such as carbamazepine, oxcarbazepine, and gabapentin may be useful for some people.

However, for many individuals, education about the triggers of Lhermitte’s sign can help them manage the discomfort.

A medical professional may wish to manage the causes of stress to lower a person’s likelihood of experiencing Lhermitte’s sign.

In some instances, a person may wish Trusted Source to wear a soft neck brace to avoid the neck movements that may trigger the condition.

A person may also wish to wear an electrical stimulating device. These can use a mild electric current to reduce pain signals and relax the neck muscles.

Muscles and mobility issues

Many people with MS may have muscle and mobility problems that can affect a person’s gait and posture.

Poor posture can cause Trusted Source back pain to develop over time.

MS can also cause pain or a numbing sensation in the legs or feet. A person with MS may then adjust the way they walk, distributing their weight unevenly, in order to compensate for this. By walking in this manner, they may put their back under additional strain, which can cause back pain to develop.

If a person with MS has mobility problems, they can use a cane or other assistive device to walk. However, if they use them incorrectly, this can also put additional strain on the back, potentially causing back pain.

Treating muscle and mobility issues

A person may undergo a variety of treatments to address muscle and mobility problems. Common treatment options include Trusted Source:

physical therapy
massage
heat therapy
training on how to use a specific assistive device

Other causes of back pain

People with MS may have back pain that is unrelated to their MS. However, some causes are more prevalent in people with the condition.

Causes that may particularly affect people with MS

The following possible causes of back pain may affect people with MS.

A herniated disk

Disks in the spine cushion the vertebrae. If a disk ruptures or tears, which medical professionals refer to as a herniated disk, then a person may experience back pain. This is because the nucleus inside the disk pushes outward and can put pressure on nearby nerves.

Healthcare professionals sometimes call herniated disks slipped or ruptured disks. A herniated disk can also cause numbness or weakness in the limbs.

Sciatica

If a person’s sciatic nerve becomes irritated, it may cause pain. Medical professionals call this condition sciatica.

If a person has sciatica, they may experience shooting pain in the lower back and buttocks. They may also experience numbness in the legs and a tingling sensation in their feet and toes.

Arthritis

Arthritis is the general term for joint inflammation. It can affect a person’s joints, the tissues that surround them, and other connective tissue, potentially causing back pain.

A 2016 study Trusted Source reports that people with MS have an increased risk of developing arthritis.

Osteoporosis

Osteoporosis causes a person’s bones to become weaker and break more easily. This can affect the bones in a person’s spine, which can lead to back pain.

Authors of a 2014 study Trusted Source state there is mounting evidence that people with MS are at a higher risk of developing osteoporosis.

Other causes of back pain

Other causes of back pain include:

muscle strains
poor posture
muscle tension
muscle spasms
muscle injury
kidney problems

Below are a number of ways a medical professional may use to treat back pain in people with MS:

over-the-counter anti-inflammatory medications, such as ibuprofen and naproxen
physical therapy
occupational therapy
heat therapy
acupuncture
CBT
massage

A person may also wish to try certain methods themselves in order to prevent or treat back pain. These include:

getting regular exercise
practicing mindfulness and meditation
avoiding triggers
improving posture
correctly using canes or other assistive devices

Summary

MS is a condition that disrupts the flow of information between the brain and the rest of the body. This can cause a number of symptoms, including back pain.

There are many possible causes of back pain in people with MS, such as spasticity, muscle tightness, nerve damage, Lhermitte’s sign, muscle issues, and mobility problems.

There are numerous ways a person can treat their back pain, including pain medication, physical therapy, CBT, occupational therapy, and massage.

With the right treatment, a person can manage back pain effectively. A person with MS should discuss back pain and possible treatment options with a doctor.