We asked our expert MS nurses about shoulder pain and upper back pain in MS

What does MS shoulder pain and upper back pain feel like?

People with MS who have shoulder pain or upper back pain describe it in different ways, including: 

• a sharp and sudden pain
• a dull ache that lasts a long time
• a feeling like the shoulder is dislocated
• a twitch or spasm

We all feel pain differently, and it can change from one time to another. Lots of things influence how we feel pain. It’s not always easy to describe, so use whatever words make sense to you. 

The cause of the shoulder or upper back pain can affect how it feels. Nerve pain caused by the MS directly might feel quite different to a painful joint that doesn’t get much movement. But it isn’t always easy to know the cause by how it feels. A healthcare professional can help look into the cause and suggest ways to manage and treat it. 

Sometimes people with MS experience an electric shock feeling in their neck or lower back when they bend their neck. This is known as ‘Lhermitte’s sign’. 

And some people experience a squeezing feeling around their chest or upper body which is often called the ‘MS hug’.

Can MS cause shoulder pain and upper back pain?

Studies suggest around a third of people with MS have shoulder or upper back pain at some time. This could be caused directly by MS nerve damage in the spinal cord or brain. 

Shoulder pain and upper back pain can also be the result of living with MS. For example, if you sit for longer periods of time than you're used to, this might lead to upper back pain. Or if the MS makes it harder to use your arm so much, the shoulder joint and muscles might be painful from lack of regular movement. Muscles can be painful because of MS spasms or stiffness. And your posture when you sit, stand or walk might have an effect too. 

But it’s worth remembering too that other things unrelated to MS can cause shoulder or upper back pain. MS might be the cause, but aches and pains shouldn’t always be put down to the MS in case there’s another cause to treat. 

Read the research about MS and shoulder pain on the National Library of Medicine’s website

MS shoulder pain and back pain treatment

Treating pain in MS is as unique as the person experiencing it. So it’s always best to discuss your options with your doctor or MS team. Depending on the likely cause, they might recommend: 

• a referral to a physiotherapist to advise on movement and exercises. They might suggest deep tissue massage, or yoga for example
• topical treatments (applied directly to the painful area)
• pain medication, like ibuprofen for example
• steroids to reduce inflammation
• muscle relaxants
• hot and cold therapy (for example, ice packs or warm compresses)

If your pain in your shoulders and upper back comes and goes, it might be worth keeping a pain log - a record of how it affects you. Describe the pain in your own words. And try to note anything else impacting you when the pain arrives. Are you experiencing fatigue? Have you been stressed lately? Noticing connections between these kinds of things and your pain can help find the best ways to manage it.

At work, some people experience pain through repetitive movements or staying a long time in a fixed posture. If you think your pain might be related to the job you do, you can speak to your manager about adjustments that may help.

If you’re having difficulty managing your pain, you might be referred to a pain clinic.

When to get support with MS shoulder pain

You don’t have to ‘just live with’ aches and pains. If you get pain anywhere in your body, including the shoulder or upper back, you can ask for help to manage and treat it. Speak to your GP or MS team.  

And we're here on the MS Helpline - MS nurses available to give information, support and talk to you about how to get help. Call 0808 800 8000. 

Our MS community share their own experiences with pain in our forum, helping others feel less alone. You might discover some tips worth exploring with your own healthcare team.