Pain and multiple sclerosis

For many decades pain has been an underestimated problem in patients with multiple sclerosis (MS). Recent studies showed a prevalence of painful symptoms up to more than 80% with a high impact on activities of daily life and quality of life. Pain syndromes can be divided into four categories of origin: 1. pain directly related to MS, e. g. neuropathic pain; 2. pain indirectly related to MS, e. g. pain associated with spasticity; 3. pain related to MS therapy, e. g. side effects of disease modifying drugs; 4. pain not related to MS. Therapy should be tailor made weighing the individual benefit against possible side effects. Particularly the treatment of chronic pain requires a multidimensional approach that apart from medication consists of non-pharmacological strategies, like physiotherapy and cognitive behavioural therapy.