Pain and Spasticity in Multiple Sclerosis: A Short Treatment Guide

Objective: Multiple Sclerosis (MS) causes many disabling symptoms that can lead to physical and psychological burden for patients. Pain and spasticity are common MS symptoms that affect patient’s quality of life. Effective management of MS symptoms reduces their impact on daily activities and helps patients to continue in employment. The aim of the study is to provide a short treatment guide for pain and spasticity in patients with MS, in order to assist clinicians in every-day clinic practice.

Materials and Methods: PubMed, Medline, and Cochrane library were searched using the keywords ‘symptom management’, ‘symptomatic treatment’, ‘spasticity’, ‘pain’ and ‘Multiple Sclerosis’. The published guidelines from the American Academy of Neurology (AAN), the European Academy of Neurology (EAN)/European Federation of Neurological Societies (EFNS) and the United Kingdom National Institute for Health and Care Excellence (NICE) were also reviewed.

Results: We present an evidence-based guidance for pharmacological and non-pharmacological treatment of pain and spasticity in patients with MS.

Conclusions: Symptomatic treatment of pain and spasticity in MS can be difficult and may lead to polypharmacy which can cause serious side effects and worsening of other MS symptoms. An individualised and holistic approach that includes non-pharmacological treatments such as physical exercise, physiotherapy, occupational therapy and cognitive behavioural therapy is suggested. There is an increased need for randomised controlled trials, to find which specific exercise interventions are the most helpful, and to look for medicines that can be effective in more than one MS symptoms.