Characterizing chronic pain phenotypes in multiple sclerosis: a nationwide survey study

Kratz, Anna L.; Whibley, Daniel; Alschuler, Kevin N.; Ehde, Dawn M.; Williams, David A.; Clauw, Daniel J.; Braley, Tiffany J.

doi:10.1097/j.pain.0000000000002136

Cited by 32 publications

(41 citation statements)

References 69 publications

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“…Öå ïîâ'ÿçàíî ç ¿õ âåëèêîþ ãåòåðî´åí-í³ñòþ. Ó õâîðèõ íà ÐÑ çóñòð³÷àþòüñÿ áîëüîâ³ ñèíäðîìè ð³çíèõ òèï³â òà âèä³â, à òàêîae ð³ç-íîìàí³òí³ ¿õ ïîºäíàííÿ [5]. Äëÿ áîëüîâèõ ñèíäðîì³â, ÿê ³ äëÿ ÐÑ õà-ðàêòåðí³ òèïîâ³ ïàòåðíè ïåðåá³ãó.…”

Section: âñòóïunclassified

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Pain syndrome patterns and their characteristics in multiple sclerosis patients

Боженко¹

2021

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Aim of the research is to analyze the patterns of pain syndromes and their characteristics in multiple sclerosis patients. Materials and Methods. A total of 104 multiple sclerosis patients complaining of pain during the last month were examined in Lviv Regional Multiple Sclerosis Center. We analyzed medical records, performed general medical and neurological examinations and compiled history of lifestyle, illness and pain. The VAS and PainDetect questionnaires were used to assess the characteristics of pain syndromes. The patients were asked to choose one of the 4 typical patterns of pain, which best described their feelings. Then the analysis of pain syndrome patterns and their characteristics was carried out. Results and Discussions. All 4 typical patterns of pain syndromes were registered in multiple sclerosis patients. However, only 26.92% of the participants experienced an intermittent pain pattern. The rest of patients suffered from patterns characterized by persistent pain. The evaluation of the patterns and their characteristics revealed typical features. The highest intensity of the severest and average pain during the last month was present in the patients suffering from constant pain with distinct attacks: 8.0 [7.0; 9.0] points (p<0.05) and 7.0 [5.0; 8.0] points (p<0.05), respectively. Persistent paroxysmal pain was more common in the multiple sclerosis patients with neuropathic pain (43.8±8.8% vs 20.4±5.8%, p<0.05). Irradiating pain is also characteristic to this pattern in 52.9±8.6% of patients (p<0.05). The head is the most common pain localization in the patients experiencing persistent pain with severe attacks - 82.4±9.2% of cases (p<0.05). Conclusions. Pain is a permanent symptom in a significant number of multiple sclerosis patients. It can have different patterns of progression. However, it has typical characteristics and their understanding will aid in the diagnosis, prognosis and treatment of pain syndromes in multiple sclerosis patients

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Section: âñòóïunclassified

“…This is due to their high heterogeneity. In patients with MS, there are pain syndromes of different types and kinds, as well as their various combinations [5].…”

Section: Introductionmentioning

confidence: 99%

Pain syndrome patterns and their characteristics in multiple sclerosis patients

Боженко¹

2021

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“…Відомо, що ноцицептивні болі при РС пов'язані з порушенням м'язового тонусу, патологічними позами, неправильним руховим стереотипом, довготривалою іммобілізацією, а також з розвитком артрозів та остеопорозу. В терапії ноцицептивних больових синдромів активно застосовують нестероїдні протизапальні препарати, з метою зменшення побічних ефектів яких (ульцерогенна дія, підвищення рівня глікемії тощо) рекомендовано, насамперед, використання селективних блокаторів циклооксигенази 2 типу (мелоксикам, теноксикам) [26].…”

Section: дніпровський медичний інститут традиційної і нетрадиційної медицини дніпро українаunclassified

Study of Correction of Somatic Pain under the Conditions of Experimental Pathology of Multiple Sclerosis

Nefоdov¹,

Myasoed²,

Solomenko³

et al. 2021

Ukr. ž. med. bìol. sportu

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The purpose of the study was to experimentally substantiate the ways of pharmacological correction of somatic pain syndrome in conditions of the experimental equivalent of multiple sclerosis through a comparative system analysis and the use of complex methodological approaches. Materials and methods. To study multiple sclerosis, we used an experimental model with autoimmune mechanisms of inflammatory demyelination – a model of experimental allergic encephalomyelitis. To assess the antinociceptive activity of painkillers, we used the method of electrical stimulation of the rats’ tail root. The activity of the enzyme prostaglandin H-synthetase was also determined. Results and discussion. A comparative analysis of the analgesic activity indicators of combinations of methylprednisolone with analgesics under the condition of the formed experimental allergic encephalomyelitis showed that their antinociceptive potential (taking into account the basic therapy with methylprednisolone) decreased in the series meloxicam > lornoxicam ≈ ketorolac ≈ paracetamol > celecofenacoxib ≈ sodium diclofupene ≈ diclofupene ≈ diclofupene. Accordingly, the maximum effect on the threshold of nociception under these experimental conditions was exerted by meloxicam and lornoxicam. The combined administration of methylprednisolone with diclofenac sodium, celecoxib and meloxicam reduced the activity of prostaglandin N-synthetase in the brain structures by 49.8% (p <0.05), 50.4% (p <0.05) and 51% (p <0.05), respectively, compared with the indicators of the control group. The same drugs markedly reduced the activity of prostaglandin N-synthetase in the spinal cord by 23.9% (p <0.05) (Methylprednisolone + diclofenac), by 34% (p <0.05) (Methylprednisolone + celecoxib) and by 47.4% (p <0.05) (Methylprednisolone + meloxicam) compared with the control group. Our analysis of the analgesic activity of antidepressants and anticonvulsants as means of correcting nociceptive pain in experimental allergic encephalomyelitis found that their antinociceptive potential was inferior to the severity of the analgesic effect of nonsteroidal anti-inflammatory drugs. Conclusion. Among the studied non-steroidal anti-inflammatory drugs, antidepressants and anticonvulsants, the maximum therapeutic efficacy as a means of correcting nociceptive pain in experimental allergic encephalomyelitis against the background of basic methylprednisolone therapy was shown by meloxicam, which gives grounds to recommend it as the analgesic of choice for eliminating somatic pain syndromes

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“…Several studies reported that central neuropathic (dysesthetic) extremity pain is the most common type of pain associated with MS, followed by back pain, headache, and painful tonic spasms [9][10][11]. Although its physical, psychological, and social impact is not well-understood [11].…”

Section: Introductionmentioning

confidence: 99%

Pain Prevalence in Multiple Sclerosis in a Lisbon Tertiary Hospital: A Cross-Sectional Study

Junqueira¹,

Farraposo²,

Cruz³

et al. 2022

Cureus

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Background: Multiple sclerosis is a chronic neurological disease with increasing incidence and prevalence worldwide being the main cause of non-traumatic disability in young adults. Both acute and chronic pain have been mentioned as the most common symptoms among those patients.Objective: This study was designed to evaluate the pain experience among patients with multiple sclerosis by describing its prevalence, characteristics, analgesic treatment and its efficacy, and also the impact of pain on quality of life.Methods: A cross-sectional observation survey was carried out on patients with multiple sclerosis followed in a tertiary hospital. Data were collected between December 2019 and March 2021 from a structured telephone inquiry, applying two questionnaires, the Brief Pain Inventory and the McGill Pain Questionnaire (MPQ), to evaluate the prevalence of pain and its impact on quality of life (QoL). Clinical records were also consulted to obtain data on disease duration, year of diagnosis, MS type, Expanded Disability Status Scale (EDSS) score.Results: Our sample included 305 patients in a universe of 1500, mainly women, with mean age of 44.27 years, and most of them presented with an outbreak-remission subtype of disease. One hundred twenty-four patients experienced pain which corresponds to 41% of the patients. Considering the patients who experienced pain, 67.7% were under treatment and of these, 64.3% with only one painkiller. Pain significantly interfered with general activity, mood, and regular work. Conclusion:Pain was an important symptom in this group of patients with MS and significantly interfered with mood, general activity, and regular work. The maximum intensity of pain felt by patients was significant and only 67.7% of patients were under analgesic treatment with mean pain relief of 54. NSAIDs were the most used drugs followed by gabapentinoids and acetaminophen for the management of pain. Medical community must continue to study this population in order to improve the approach to pain in these patients and improve quality of life.

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Characterizing chronic pain phenotypes in multiple sclerosis: a nationwide survey study

Abstract: Chronic pain in multiple sclerosis most commonly shows characteristics consistent with nociceptive mechanisms or can be described as a mixed pain state, with characteristics of nociceptive, nociplastic, and/or neuropathic pain.

Cited by 32 publications

References 69 publications

Pain syndrome patterns and their characteristics in multiple sclerosis patients

Pain syndrome patterns and their characteristics in multiple sclerosis patients

Study of Correction of Somatic Pain under the Conditions of Experimental Pathology of Multiple Sclerosis

Pain Prevalence in Multiple Sclerosis in a Lisbon Tertiary Hospital: A Cross-Sectional Study

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