Pain in multiple sclerosis

Pain is a common feature of well-established multiple sclerosis. Acute, subacute, and chronic pain syndromes have been defined. Chronic pain syndromes are usually associated with a myelopathy and are more common in women and in older individuals with a duration of disease greater than 5 years. The major chronic pain syndromes are dysesthetic extremity pain, back pain, and painful leg spasms. Treatment involves a variety of pharmacologic and nonpharmacologic approaches, but therapy must be individualized for each specific pain syndrome according to its own pathophysiology.