Treating and managing pain

It’s not always immediately obvious how best to treat pain, and you may need to try a number of therapies and drugs to find one effective for you.

Two MS nurses

It can be a frustrating process, but it’s important to persevere as people do manage to control and live with pain every day.

These tips might help:

  • Talk to a health professional so you can begin investigating the causes
  • Discuss your personal coping strategies with your doctor – these may be causing other difficulties, or some (for example relaxation techniques) may be helpful as part of a management programme
  • Mention any triggers that you are aware of

Remember, your circumstances and mood, both positive and negative, can affect the way you deal with pain.

Drug treatments for pain

Drugs alone are not usually the answer, partly because their usefulness has to be balanced against side effects. However, they are often an effective part of managing pain.

Pain patches that deliver a dose of painkillers can also be used. There are other drug treatments that can be applied directly to the skin where you feel the pain. 

Neuropathic pain 

  • Anticonvulsants Some of the most commonly used anticonvulsants are carbamazepine, gabapentin, lamotrigine and phenytoin. These help some people control the facial pain of trigeminal neuralgia and other acute neuropathic pains. 

    Some may also give some relief from 'burning', 'throbbing', or 'pins-and-needles' pains. Possible side effects vary between the different drugs, but can include a skin rash, dizziness, blurred vision and drowsiness. A recent study comparing three of these drugs suggested that gabapentin and lamotrigine may cause fewer side effects than carbamazepine. 
  • Antidepressants Amitriptyline is widely used. It belongs to a group of drugs called 'tricyclic antidepressants', and you may be prescribed other similar antidepressants from this group. These can be useful for treating certain types of longlasting pain, such as when skin becomes painfully sensitive to even the lightest touch. Possible side effects from tricyclic antidepressants include dry mouth, constipation and blurred vision. 

Drugs for musculoskeletal pain 

  • Analgesic painkillers Drugs like paracetamol, aspirin, ibuprofen, codeine and morphine can help control non-neuropathic pain (they are not usually effective for neuropathic pain).

Non-drug treatments for pain

  • Physiotherapy
  • Occupational therapy – there may be adjustments that can be made to your living or working space that help to reduce pain
  • Transcutaneous Electrical Nerve Stimulation (TENS) where electrodes are placed on the skin to stimulate nerves
  • Complementary therapies such as t’ai chi, yoga, acupuncture, meditation, relaxation or hypnosis
  • Surgery – usually only used when other approaches have not proved effective

Other approaches that may be useful when treatments do not bring complete relief: 

  • Pain clinics – where they are available – may be able to look at other methods of minimising the impact of pain. Ask your nurse or doctor.
  • Self management programmes – courses run by and for people with long-term conditions

For more detailed information, see our MS Essentials publication on Pain.

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