The Relationship Between Pain and Clinical Features in Multiple Sclerosis

Abstract

OBJECTIVE: Multiple Sclerosis(MS) is an autoimmune-neurodegenerative disease of the central nervous system. The pain prevalence differentiates between 29% and 86 % in this disease and besides the neuropathic, somatic pain types might emerge together or separately.

In this study we aimed to analyse the relationship between pain and other clinical featuresin MS.

METHODS: 100 cases,of whom are followed in MS polyclinic and who have complaints of pain, have been included to this study.By ensuring the forms that we prepared to be filled by the cases, we examined the pain type and localization. Thereafter we applied Visual Pain Scale (VPS), Ashworth Spasticity Scale (ASS) and Beck Depression Scale(BDS).

RESULTS: When female and male patients are compared, significant difference has not been observed statistically among age, disease period and EDDS scores. 77 % of the cases have suffered from neuropathic pain, 21 % of the cases have displayed Lhermitte symptoms, trigeminal neuralgia has been observed in 1 % of the cases and 55 % of the cases have had complaints of neuropathic extremity pain. In 60 % of the cases nociceptive pains, in 12 % of the cases joint-extremity-muscle pain, in 47 % headache and in 1 % painful tonic spasms have existed. Pain depending on the treatment has been observed only in 2 % of the cases. The pain score has been detected significantly on patients with spasticity and depression (p= 0.008, p= 0.001 in return). While there has been reasonable positive correlation between age, EDDS score and VPS (p= 0.010, p= 0.002 in return), poor correlation has been obtained between disease period and number of attacks (p= 0.002, p= 0.045 in return).

CONCLUSION: These findings indicate that MS pain is related with spasticity, disability and depression and these clinical findings should be taken into account during pain treatment and the above factors should be treated.