User login
Pain in multiple sclerosis (MS) is common, occurring in 63% of patients with the disease, researchers reported in the May issue of Pain. Headache and extremity neuropathic pain are the most common pain syndromes in patients with MS.
Peter Foley, MRCP, and colleagues based their findings on a systematic review and meta-analysis of 17 prospective studies (5,319 patients) that explored pain prevalence in definite MS. The percentage of females in the studies ranged from 55% to 96%, mean age ranged from 31 to 54, mean disease duration ranged from 2.5 to 23 years, and between 30% and 100% of subjects had relapsing-remitting MS (RRMS).
The researchers found a pooled overall pain prevalence of 62.8%. They quantified a prevalence of 43% for headache, 26% for extremity neuropathic pain, 20% for back pain, 15% for painful spasms, 16% for painful Lhermitte sign, and 3.8% for trigeminal neuralgia. The prevalence of pain at MS disease milestones—prior to onset, at onset, and at relapse—and during longitudinal follow-up was “poorly described,” according to Dr. Foley, from the Division of Clinical Neurosciences, University of Edinburgh.
Among the studies that were reviewed, one investigated pain prevalence soon after MS diagnosis and found a 73.5% prevalence of any pain, with a mean disease duration at assessment of 30.5 months. A separate study analyzed headache during relapse and found a prevalence of 38.9%. In addition, two studies prospectively examined overall pain evolution with disease progression—one study found a nonsignificant reduction in prevalence of pain over time in early MS, while another found an increasing prevalence of pain over time in later MS, particularly in those with worsening disability.
“Pain seems to affect approximately 63% of people with MS,” Dr. Foley told Neurology Reviews. “People with MS suffer from a complex variety of pain problems, with both neuropathic and nociceptive mechanisms, and we now have a clearer idea of how common these different pain problems are in MS. Looking at pain overall in these studies, although there was significant variability between studies, we didn’t find that patient disability scores, disease duration, gender mix, or mix of people with progressive MS and RRMS in the studies significantly affected the prevalence of pain.
“Because pain is so common, and seems to affect all groups of people with MS, doctors should strongly consider asking their patients about pain,” Dr. Foley concluded. “Future research studies using standardized designs might give us further evidence to identify who is most at risk of pain, and how this might relate to inflammatory, degenerative, or other processes in MS.”
—Colby Stong
Editor
Suggested Reading
Foley PL, Vesterinen HM, Laird BJ, et al. Prevalence and natural history of pain in adults with multiple sclerosis: systematic review and meta-analysis. Pain. 2013;154(5):632-642.
Pain in multiple sclerosis (MS) is common, occurring in 63% of patients with the disease, researchers reported in the May issue of Pain. Headache and extremity neuropathic pain are the most common pain syndromes in patients with MS.
Peter Foley, MRCP, and colleagues based their findings on a systematic review and meta-analysis of 17 prospective studies (5,319 patients) that explored pain prevalence in definite MS. The percentage of females in the studies ranged from 55% to 96%, mean age ranged from 31 to 54, mean disease duration ranged from 2.5 to 23 years, and between 30% and 100% of subjects had relapsing-remitting MS (RRMS).
The researchers found a pooled overall pain prevalence of 62.8%. They quantified a prevalence of 43% for headache, 26% for extremity neuropathic pain, 20% for back pain, 15% for painful spasms, 16% for painful Lhermitte sign, and 3.8% for trigeminal neuralgia. The prevalence of pain at MS disease milestones—prior to onset, at onset, and at relapse—and during longitudinal follow-up was “poorly described,” according to Dr. Foley, from the Division of Clinical Neurosciences, University of Edinburgh.
Among the studies that were reviewed, one investigated pain prevalence soon after MS diagnosis and found a 73.5% prevalence of any pain, with a mean disease duration at assessment of 30.5 months. A separate study analyzed headache during relapse and found a prevalence of 38.9%. In addition, two studies prospectively examined overall pain evolution with disease progression—one study found a nonsignificant reduction in prevalence of pain over time in early MS, while another found an increasing prevalence of pain over time in later MS, particularly in those with worsening disability.
“Pain seems to affect approximately 63% of people with MS,” Dr. Foley told Neurology Reviews. “People with MS suffer from a complex variety of pain problems, with both neuropathic and nociceptive mechanisms, and we now have a clearer idea of how common these different pain problems are in MS. Looking at pain overall in these studies, although there was significant variability between studies, we didn’t find that patient disability scores, disease duration, gender mix, or mix of people with progressive MS and RRMS in the studies significantly affected the prevalence of pain.
“Because pain is so common, and seems to affect all groups of people with MS, doctors should strongly consider asking their patients about pain,” Dr. Foley concluded. “Future research studies using standardized designs might give us further evidence to identify who is most at risk of pain, and how this might relate to inflammatory, degenerative, or other processes in MS.”
—Colby Stong
Editor
Suggested Reading
Foley PL, Vesterinen HM, Laird BJ, et al. Prevalence and natural history of pain in adults with multiple sclerosis: systematic review and meta-analysis. Pain. 2013;154(5):632-642.
Pain in multiple sclerosis (MS) is common, occurring in 63% of patients with the disease, researchers reported in the May issue of Pain. Headache and extremity neuropathic pain are the most common pain syndromes in patients with MS.
Peter Foley, MRCP, and colleagues based their findings on a systematic review and meta-analysis of 17 prospective studies (5,319 patients) that explored pain prevalence in definite MS. The percentage of females in the studies ranged from 55% to 96%, mean age ranged from 31 to 54, mean disease duration ranged from 2.5 to 23 years, and between 30% and 100% of subjects had relapsing-remitting MS (RRMS).
The researchers found a pooled overall pain prevalence of 62.8%. They quantified a prevalence of 43% for headache, 26% for extremity neuropathic pain, 20% for back pain, 15% for painful spasms, 16% for painful Lhermitte sign, and 3.8% for trigeminal neuralgia. The prevalence of pain at MS disease milestones—prior to onset, at onset, and at relapse—and during longitudinal follow-up was “poorly described,” according to Dr. Foley, from the Division of Clinical Neurosciences, University of Edinburgh.
Among the studies that were reviewed, one investigated pain prevalence soon after MS diagnosis and found a 73.5% prevalence of any pain, with a mean disease duration at assessment of 30.5 months. A separate study analyzed headache during relapse and found a prevalence of 38.9%. In addition, two studies prospectively examined overall pain evolution with disease progression—one study found a nonsignificant reduction in prevalence of pain over time in early MS, while another found an increasing prevalence of pain over time in later MS, particularly in those with worsening disability.
“Pain seems to affect approximately 63% of people with MS,” Dr. Foley told Neurology Reviews. “People with MS suffer from a complex variety of pain problems, with both neuropathic and nociceptive mechanisms, and we now have a clearer idea of how common these different pain problems are in MS. Looking at pain overall in these studies, although there was significant variability between studies, we didn’t find that patient disability scores, disease duration, gender mix, or mix of people with progressive MS and RRMS in the studies significantly affected the prevalence of pain.
“Because pain is so common, and seems to affect all groups of people with MS, doctors should strongly consider asking their patients about pain,” Dr. Foley concluded. “Future research studies using standardized designs might give us further evidence to identify who is most at risk of pain, and how this might relate to inflammatory, degenerative, or other processes in MS.”
—Colby Stong
Editor
Suggested Reading
Foley PL, Vesterinen HM, Laird BJ, et al. Prevalence and natural history of pain in adults with multiple sclerosis: systematic review and meta-analysis. Pain. 2013;154(5):632-642.
