Pain and MS
A lot of people with MS experience pain at some time. It varies from person to person and over time, but drug treatments and other therapies can help you cope and find MS pain relief.
Pain can be associated with stiffness or spasms in muscles, or symptoms like Lhermitte's sign, trigeminal neuralgia, optic neuritis or headaches. It may also include symptoms affecting the senses that are not always thought of as ‘pain’, like numbness or pins and needles, or a tightness in the chest known as the 'MS hug' or 'MS girdle'.
Pain can be one of the most difficult 'invisible’ symptoms to describe and manage. Only the person experiencing it knows how it feels. It has an emotional element – it can cause distress, fear, anger and frustration, which in turn affect how you deal with it.
Pain can be exhausting, can affect your mood and your ability to do everyday activities. But although you can’t always get rid of pain completely, there are ways to treat and manage it.
- How to describe pain and unusual sensations
- Doctors’ definitions for MS pain
- What's causing my MS pain?
- Types of pain caused by MS
- Treating MS pain
How to describe pain and unusual sensations
Pain relief for MS can depend on what type of pain it is. So if you can describe pain well, both to health professionals and those around you, that helps find ways to manage it.
Sensations change, so try to describe the level at which they affect you. For example, a tingling 'pins and needles' in the hand might sometimes be a niggling inconvenience. Or it might make holding things difficult or very painful.
When describing it, use whatever words seem best, even if they seem odd. Some words people use to describe pain:
- squeezing or crushing
- cold
- hot or burning
- sharp
- stabbing
- dull
- like ants under my skin or ‘creepy crawlies’
People with MS also describe their pain as:
- like a build up of pressure
- creeping
- like an electric shock
- aching
- pins and needles
- vibrating feeling or internal tremor
- a wet feeling, even with completely dry skin
Doctors’ definitions for MS pain
Doctors and other care professionals might use other words to describe painful or unusual sensations. You don’t need to use these words yourself. And it’s always OK to ask for things explained in a way you understand.
Paresthesia
Paresthesia is just the medical word to describe the strange, often painful sensations listed above. MS can cause paresthesia when it affects the messages being passed by nerves in the brain or spinal cord. Mixed up messages can cause unusual, unpleasant or painful sensations in the body.
Dysesthesia
Dysesthesia is one reason that you might get the sensations listed above. It’s when the sensations don’t match with the stimulus. For example, if you have a burning feeling when there’s nothing hot near your skin. Or your leg feels wet when there’s no moisture or any sweat running down it.
With MS, dysesthesia happens when messages about touch sensation don’t get passed on correctly in the brain or spinal cord. So even if the nerves in the skin work fine, the brain misinterprets the message.
Allodynia
Allodynia is another reason you might feel some of the sensations listed above. It’s when the touch sensation is extremely sensitive. So even gentle touch, or small changes in temperature can be unpleasant or painful.
With MS, allodynia happens because messages about touch get misinterpreted in the brain or spinal cord.
Read about how Eleni manages the pain of allodynia in her blog
Medical words for pain – acute, paroxysmal and chronic
Doctors and other medical staff often define pain according to how long it lasts. With any of these types of pain, it could be mild, severe, or changeable.
Acute pain
Acute pain is short-term, but it may come back. It comes on suddenly and usually lasts less than 12 weeks.
Paroxysmal pain
Paroxysmal pain happens in sudden attacks. Lasts only a few seconds or minutes but usually comes back later. This could happen several times a day.
Chronic pain
Chronic pain is long lasting. It never completely goes away and usually lasts more than 12 weeks.
What's causing my MS pain?
When you’ve got MS, pain can be caused directly, from nerve damage, or indirectly because of other MS symptoms.
Pain could also be:
- from your spine or joints
- linked to an accident or other health condition not related to MS
- caused by internal symptoms, such as a bladder infection
Nerve pain or ‘neuropathic pain’
Nerve pain or ‘neuropathic pain’ is caused by MS nerve damage in the spinal cord or brain. MS damages nerve fibres or their protective outside layer called ‘myelin’. That means messages in the brain or spinal cord slow down, get mixed up or stop altogether. When messages aren’t clear, this can cause unusual and painful sensations.
Nerve damage might cause a range of sensations, from minor irritations to intense sharp or burning pains. You might hear doctors use words like paresthesia, dysesthesia or allodynia.
MS can damage the nerves in your spinal cord or brain that control your muscles. That can cause painful muscle spasms.
Nerve pain can also cause painful or unusual sensations on the skin. These types of pain can happen anywhere but are usually in the face, arms and legs. It could feel like:
- extreme sensitivity to touch (allodynia)
- pins and needles
- unusual sensations like: burning, stabbing, electric shock, aching and tightening
Read about Jenny's experience with nerve pain in our community blog
Musculoskeletal pain
Musculoskeletal pain is pain in muscles and joints. It can come from living with the stresses and strains MS places on the body. For example, difficulties with balance, fatigue or muscle weakness could lead to problems with posture, putting a strain on joints, ligaments or other muscles.
Muscles spasms or stiffness caused directly by MS can also be painful.
Sciatica and MS pain
Lots of people have sciatic nerve pain at some time in their life – whether they have MS or not. Sciatica is the name for pain or numbness from this nerve. It’s a good example of why it’s important to look into the cause of pain.
The sciatic nerve runs from the spine down the leg. Sometimes it can get squeezed by the muscles or bones around it and that causes pain or numbness in someone’s buttocks or leg.
Those unpleasant sensations can be very similar to nerve pain caused directly by MS. And sciatica usually happens only on one side of the body, which can also happen with MS.
Treating sciatica often involves relaxing the muscles or reducing inflammation where the nerve is being squeezed. But if the pain, numbness or tingling is caused by MS, the way to treat it will be different.
Finding the cause of the sensation helps find the right treatment.
Types of pain caused by MS
MS can cause different kinds of pains, which can be described in various ways:
- Acute, paroxysmal or chronic - these describe how long the pain last
- Paresthesia, dysesthesia or allodynia - these describe unusual and painful changes in sensation
- Nerve pain or neuropathic pain - this is the type of pain MS causes directly
- Musculoskeletal pain - this is the type of pain MS can cause indirectly
Some types of pain people with MS can experience have their own names, including optic neuritis, Lhermitte's sign, trigeminal neuralgia, the 'MS hug' and headaches.
Optic neuritis
This is often one of the first symptoms of MS. It’s caused by inflammation of your optic nerve and usually only affects one eye. Problems with sight, like blurred or double vision, might come on with a sudden sharp pain behind your eye. The pain might be aggravated when you move your eye to look around. You might feel a headache at the front of your head.
Lhermitte’s sign
Lhermitte’s sign (pronounced "lair-meets") is a sudden brief pain or electrical buzzing sensation. It runs down your neck into your spine and might then spread into your arms or legs.
It can be triggered when you bend your neck forward, or after a cough or sneeze. Lhermitte’s sign is a sharp but short-lived pain (usually lasting a few seconds). You might hear it described as an acute or paroxysmal pain.
Read more about Lhermitte's sign
Read about Chloe's experience with Lhermitte's sign in our community blog
Trigeminal neuralgia
Trigeminal neuralgia is an uncommon symptom that affects only about 2 to 5% of people with MS at some time. It presents itself as a sudden severe pain in your face that comes and goes.
It’s caused by damage to the trigeminal nerve inside your head. Or damage to parts of the brain which send and receive messages from this nerve. This large nerve has three main branches so the place you feel pain depends on which branches of the nerve are damaged.
Read more about trigeminal neuralgia
Squeezing or banding ('MS hug' or 'MS girdle')
This is caused by the small muscles between your ribs, called the intercostal muscles, going into spasm. It can feel like a tight band around the trunk of your body. It’s not dangerous but can be very scary. The MS hug can last for a short or long time, and it can come and go.
More about the MS hug and how to manage it
Headaches
There’s no clear evidence that MS directly causes headaches. But two types of headache seem to be more common for people with MS than other people: migraine and tension headaches. Headaches can also be a side effect of medication.
If you get headaches, your doctor or MS team can help you manage them.
Read more about headaches and MS
Treatments for MS pain
There are lots of different ways to help treat and manage pain and unusual sensations. For example, a combination of drug treatment, physiotherapy, and complementary therapies might all help. Health professionals can work with you to find what works best for you.
Last full review: 1 October 2025
Next review date: 1 October 2028
We also update when we know about important changes.
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