Pain in multiple sclerosis -: modern resources of neurological rehabilitation

Pain occurs in up to 86% of multiple sclerosis patients, although it: is often not reported spontaneously at all. In addition to the paroxysmal syndromes (trigeminal neuralgia, tonic brain stem attacks), the majority of which can be dealt with only by medication, the commonest "direct" MS-related pains in inflammatory lesions of pain-transmitting or processing CNS structures include painful dysesthesias, mostly of the lower extremities. In our own experience, modified Stanger baths with brushing of the disordered areas produce good effects here; For spasticity-related pains as an "indirect" consequence of MS, physiotherapy concentrates on learning spasticity-inhibiting behaviour when resting, transferring and moving with adequately adapted aids,as well as the timely use of anti-spastic medication. Pains resulting from incorrect postures or overloading of muscles and joints require a-combined therapy;design. Pains not related to MS occur in the context of secondary diseases (peripheral neuropathies, osteoporosis). In this case, in the framework of physical therapy, it is necessary to pay attention to the special features of the basic illness, e.g. temperature sensitivity which is frequently simultaneously combined with a disordered trophicity and perception of pain and temperature. The headache problems of MS sufferers are also frequently underestimated and after more detailed diagnosis they can often be helped simply by counselling and education on possible therapies. Altogether, good control of symptoms can be achieved in the case of many MS patients through detailed analysis and instruction to avoid pain-triggering factors.