Hip and Knee Pain in Multiple Sclerosis

Nerve and musculoskeletal issues may be to blame

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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.

Causes of Hip and Knee Pain in MS
Verywell / JR Bee

Causes

The nerve and musculoskeletal symptoms that characterize MS can indirectly contribute to aching joints and body pains. Causes include:

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.

Diagnosis

In order for your healthcare provider 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 healthcare provider 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 healthcare provider identifies the reasons for your pain, you can work together on a plan to combat it successfully.

Frequently Asked Questions

  • Can MS cause foot pain?

    Yes, MS can cause foot pain. This might be felt as an acute or chronic (persistent) pain that causes sensations of burning, prickling, stabbing, or coldness. Some people with MS may experience foot pain daily or near daily.

  • Does MS pain come and go?

    Yes, MS pain can come and go in certain people. This is often associated with the MS hug - a type of pain that is felt on specific areas of the torso or its entirety. The pain caused by an MS hug can differ by day, time of day, and between people, and can vary in severity.

  • What is MS spasticity?

    Spasticity refers to an increase in muscle tone or tightness. The effects of MS can make these strengthened muscles less capable of relaxing, which can result in painful spasms. The effects of spasticity in MS can differ between people and range from mildly annoying to debilitating. For example, some people with MS occasionally have trouble climbing stairs, while others experience severe spasticity that affects their ability to walk.

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6 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.
  1. National Multiple Sclerosis Society. Gait or Walking Problems: The Basic Facts.

  2. Cleveland Clinic. Multiple Sclerosis and Pain.

  3. Socie MJ, Sosnoff JJ. Gait variability and multiple sclerosis. Mult Scler Int. 2013;645197. doi:10.1155/2013/645197

  4. National Multiple Sclerosis Society. Pain & Itching.

  5. 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

  6. American Association of Neurological Surgeons (AANS). Spasticity.