Frequency, type, distribution of pain and related factors in persons with multiple sclerosis

Although there is accumulating evidence on neuropathic pain in persons with multiple sclerosis (pwMS), little is known about musculoskeletal pain. The aim was to examine the frequency, type, distribution of pain and related factors in pwMS.

This cross-sectional study included 223 pwMS. The Nordic Musculoskeletal Questionnaire and painDETECT Questionnaire were used to assess pain. Depression, fatigue, sleepiness, and health-related quality of life were assessed.

23.3% of participants did not have pain, 55.6% had musculoskeletal pain and 21.1% had neuropathic pain. There was no significant difference between the groups in age, gender, disease duration, employment status, marital status and education level (p > .05). The participants without pain had lower Expanded Disability Status Scale (EDSS) scores compared to those with neuropathic pain (p = .024). In addition, the participants with musculoskeletal pain had lower EDSS scores compared to those with neuropathic pain (p = .027). Depression, fatigue, sleepiness and quality of life scores were significantly different between the groups (p < .05). Participants with neuropathic pain had significantly lower quality of life, and higher fatigue, depression and sleepiness compared to participants with musculoskeletal pain and without pain (p < .05). Musculoskeletal pain was most common in low back (52.4%), neck (51.6%), and upper back (45.2%).

This study suggests that pain is a very common symptom among pwMS. Pain frequency is high as 76.7%. In particular, the presence of neuropathic pain is associated with lower health-related quality of life and higher levels of depression, fatigue and sleepiness. Musculoskeletal pain was most common in the spine area including neck, upper back, and low back.