Brain & Nervous System Multiple Sclerosis Symptoms Hip and Knee Pain in Multiple Sclerosis Nerve and musculoskeletal issues may be to blame By Julie Stachowiak, PhD facebook Julie Stachowiak, PhD, is the author of the Multiple Sclerosis Manifesto, the winner of the 2009 ForeWord Book of the Year Award, Health Category. Learn about our editorial process Julie Stachowiak, PhD Medically reviewed by Medically reviewed by Claudia Chaves, MD on May 19, 2019 Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology. Learn about our Medical Review Board Claudia Chaves, MD Updated on December 11, 2019 Print Table of Contents View All Causes Diagnosis Treatment Joint pain, specifically in the knees and hips, is very common in people with multiple sclerosis (MS). It is usually due to a nerve-related or muscle-related manifestation of MS rather than degeneration of cartilage or inflammation of the joints, as seen in rheumatoid arthritis, osteoarthritis, or lupus. Verywell / JR Bee Causes The nerve and musculoskeletal symptoms that characterize MS can indirectly contribute to aching joints and body pains. Causes include: Spasticity of the leg musclesLack of coordinationBalance problems (caused by a disturbance in proprioception)Numbness and tingling in the feet, which cause you to be off-balance or lose coordination (sensory ataxia)FatigueMuscle weaknessFoot dropMuscle spasms In addition, if you rely on a cane or walker, this can throw off your gait, which can cause the joints to be sore. For example, when experiencing what's known as the MS hug, you may clutch your side with one hand; after a full day of walking around like this, your knee and hip on one side might be a little sore. Joint pain is also a common side effect of interferon-based disease-modifying therapies, such as Avonex, Rebif (interferon beta-1a), and Betaseron (interferon beta-1b). Pay special attention to whether or not your joint pain is worse in the 24 to 48 hours following your injections and if it is more concentrated in the knees or hips, as opposed to more generalized. Low Back Pain in MS Diagnosis In order for your doctor to conclude that your joint pain is due to MS, they will rule out any other potential causes, such as osteoarthritis, rheumatoid arthritis, or an injury. Diagnostic tests may include X-rays and blood tests, as well as a physical exam. Your doctor may also evaluate your gait and balance, or the degree of spasticity and muscle weakness to see how that may be affecting your joints. Treatment Addressing the underlying causes of your joint pain—such as spasticity and muscle weakness—can improve your gait, and, consequently, reduce joint pain. Another way to improve your gait and reduce associated joint pain is to embark on an exercise program that includes aerobic, resistance, and balance exercises. You may also want to consider taking up yoga. There is some evidence that yoga can improve balance and functional strength, as well as fatigue and possibly muscle spasticity. Analgesics, such as acetaminophen, or a non-steroidal anti-inflammatory drug like ibuprofen can relieve pain temporarily. Finally, if you are overweight, losing excess weight may put less stress on your hips and knees. A physical therapist should be able to evaluate your gait and prescribe exercises to help you strengthen the right muscles. If you use a cane or other assistive device, the physical therapist can check to make sure that it is sized correctly for you and that you are using it correctly. A Word From Verywell Joint pain can interfere in leading an active life. Fortunately, once your doctor identifies the reasons for your pain, you can work together on a plan to combat it successfully Was this page helpful? Thanks for your feedback! Get tips and advice on how you can live a full and happy life with MS. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Multiple Sclerosis Society. Gait or walking problems: the basic facts. 2010. Cleveland Clinic. Multiple sclerosis and pain. February 28, 2019. Socie MJ, Sosnoff JJ. Gait variability and multiple sclerosis. Mult Scler Int. 2013;2013:645197. doi:10.1155/2013/645197 National Multiple Sclerosis Society. Pain & itching. Frank R, Larimore J. Yoga as a method of symptom management in multiple sclerosis. Front Neurosci. 2015;9:133. doi:10.3389/fnins.2015.00133