Understandng Dysesthesia in Multiple Sclerosis

More than half of people with multiple sclerosis (MS) experience pain at some point during the course of their disease. For many of them, this pain is neurogenic, meaning it occurs as a result of MS-related nerve fiber damage in the central nervous system.

One type of neurogenic pain in MS is dysesthesia, which refers to any abnormal sensation that is painful. often described as burning, like a sunburn or electric shock.

The discomfort or pain of dysesthesia most often affects the feet or legs, but it also can be felt in the arms and torso. While dysesthesias are unpleasant, for sure, it's important to note they are not usually dangerous.

In fact, abnormal sensations (painful and not painful) are common in MS and do not generally necessitate treatment unless they impair day-to-day functioning or are new, which may indicate an MS relapse or another health condition.

It's important to note that people describe dysesthesias in unique ways, so the painful sensation you are experiencing may feel different from someone else's. Different qualities of pain described by people with MS include:

• Burning like a sunburn or like an electric shock
• Tightening
• Aching
• Prickling
• Pins-and-needles
• Tingling

A classic example of a dysesthesia experienced by some people with MS is the "MS Hug ." This pain syndrome often causes an intense sensation of aching, burning, or “girdling” around the abdomen or chest area. For some people, this sensation can be quite debilitating whereas, for others, it's more of an annoyance.

Another classic example of a dysesthesia in MS is burning, hot feet. This painful sensation tends to flare at night or after exercise, a common finding with dysesthesias. Even so, instead of hot feet, some people actually experience the complete opposite—ice cold feet—a true testament to the utter uniqueness of MS sensory symptoms.

Lastly, sometimes dysesthesia manifests as pain caused by something that shouldn't hurt at all, such as a light touch or caress; this is called allodynia.

While there is no cure for your dysesthesias, most people can learn to manage them well. Here are some  simple, straightforward remedies that may ease your pain:

• If pain or burning is located in the hands or legs, you may consider wearing compression gloves or stockings. These convert the sensation of pain to a less uncomfortable feeling of pressure. It's like playing a trick on your brain, so to speak. These products are available at drugstores.
• Another way to make the pain feel like something else is to apply either a cool or warm compress to your skin—talk to your doctor about what would be best for you.
• Over-the-counter capsaicin cream may provide some relief for nerve pain, but again be sure to discuss this with your doctor first.
• Distraction can go a long way when it comes to moving forward with your burdensome sensations. Try becoming engrossed in a good book or movie, listening to music, or calling a friend as a means of literally ignoring your dysesthesias.

If these tactics don't provide enough relief, certain medications may help, especially if your painful sensations are impairing your everyday functioning and quality of life. Some medications that may be helpful include:

• Medications typically prescribed to treat seizure disorders, such as Neurontin (gabapentin) and Lyrica (pregabalin)
• Certain antidepressants like the serotonin-norepinephrine reuptake inhibitor Cymbalta (duloxetine ) or a tricyclic antidepressant Elavil (amitriptyline), Pamelor (nortriptyline), and Norpramin (desipramine)
• Anti-anxiety medications like the benzodiazepine Klonopin (clonazepam)

Of course, in addition to home remedies and/or medications, engaging in certain mind-body therapies can also help alleviate your discomfort. Some complementary therapies that may be particularly useful for managing dysesthesias in MS include:

• Mindfulness meditation
• Cognitive-behavioral therapy
• Hypnosis
• Animal-assisted therapy

While painful sensations can be physically and emotionally draining, the upside is that with the right interventions, you can feel better. In addition, sensory symptoms, including painful ones, are usually not dangerous, unlike motor symptoms like spasticity or muscle weakness.

In the end, be sure to see your doctor if you are experiencing new or worsening sensory symptoms. That way you can ensure a proper diagnosis and an effective treatment plan.