Drug treatments including muscle relaxants While movement, through physiotherapy and exercise, is important in managing stiffness due to MS, they are sometimes not enough on their own. Drug treatments can often help, especially when used together with physiotherapy.
Baclofen (Lioresal, Gablofen)
Baclofen is a skeletal muscle relaxant used as a first-line treatment for spasticity in patients with MS. It can effectively relieve spasms and has modest effects in improving performance. Intrathecal baclofen via an implanted pump can be effective against spasticity in suitable patients.
Musculoskeletal pain may be helped by common pain relieving drugs such as paracetamol, ibuprofen or aspirin. If the pain is due to muscle stiffness (spasticity), then treatments for spasticity may be offered. A physiotherapist can identify any changes in your posture or walking that may be causing pain.
Dr. Cross notes that these drugs include the anticonvulsants Neurontin (gabapentin), Tegretol (carbamazepine), and Dilantin (phenytoin), as well as the tricyclic antidepressant amitriptyline. For spasticity, the drugs baclofen and Zanaflex (tizanidine) can greatly reduce painful cramping and other symptoms.
MS can damage the nerves that affect your muscles. This can cause acute or paroxysmal pain in the form of spasms. Your arms and legs might shoot out uncontrollably and might have pain like cramping or pulling. Nerve pain can also be chronic in the form of painful or unusual sensations on your skin.
Intrathecal phenol is a nerve blocker that has been used for more than 60 years to treat severe muscle stiffness. It is recommended for people with MS who have failed to respond to all oral medications and other treatments.
Over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs), like Aleve (naproxen) and Advil (ibuprofen), can treat musculoskeletal pain and headaches common with MS. These medications can relieve pain and lower inflammation in the body, which can also help with the pain associated with MS.
Pain that comes from weakness, stiffness or other mobility problems from MS is considered musculoskeletal pain. Both types of pain can be acute, having a rapid onset and short duration, or chronic, starting gradually and persisting daily or almost every day.
Make sure your bedroom is cool, quiet and dark. Try a relaxation technique that you like (breathing, imagery or muscle relaxation) once the lights are off. Use your bedroom for sleeping and sex only. Don't read, watch TV, use your mobile device or talk on the phone in bed.
Baclofen (Lioresal) is a muscle relaxant and the preferred drug for treating spasticity in MS. It may relieve cramping, muscle tightness, and spasms. “I've taken baclofen for years. It works about 50 percent of the time,” said one member of MyMSTeam.
Both muscle spasms and stiffness can be painful, though they are not always. You might feel the dull ache of stiff muscles, or a sharper pain if they spasm. Muscle problems can also interfere with good posture, causing back pain, for example. If pain is an issue for you, let your doctor or MS nurse know.
MS spasticity, which makes for stiff or tight muscles, can cause muscles to spasm when the muscle is stretched, such as when you move your legs. Muscle spasms can be worse at night because spasticity is worse when there is less movement, such as when you are sleeping.
Ponvory (ponesimod) is an oral tablet taken once daily that works similarly to Gilenya, Mayzent, and Zeposia. It's approved for treatment of clinically isolated syndrome, as well as for relapsing-remitting MS and active secondary-progressive MS.
Spasticity may be aggravated by sudden movements or position changes, extremes of temperature, humidity or infections, and can even be triggered by tight clothing. Some degree of spasticity can provide benefit, particularly for people who experience significant leg weakness.
Strength exercises such as squats, lunges and leg lifts will all help you to strengthen your legs if you have been feeling heaviness. Hold onto something as you are doing these exercises at first and you will gradually build up the strength and balance.
Surveys for patient pain indicate that the most common pain syndromes experienced in MS are: continuous burning in extremities; headache; back pain; and painful tonic spasms.
It is most often seen in the hips, legs and arms and particularly when muscles, tendons and ligaments remain immobile for some time. Back pain may occur due to improper seating or incorrect posture while walking.
Lesions in the brain may affect cognitive abilities. Some people with MS have trouble with memory, attention and concentration, multitasking and decision-making, says Dr. Scherz. The changes are usually mild at the beginning, but can be frustrating as time goes by.
Longbrake says MS brain lesions are caused by inflammatory damage to nerves. This damage leads to neurologic deficits like weakness, numbness, or memory problems. Inflammation of the central nervous system is linked to the initial appearance of the disease as well as relapses.
Ocrelizumab is the only drug which has demonstrated efficacy in both relapsing and primary progressive forms of MS; alemtuzumab and cladribine have not been known to be used for primary-progressive MS.
Adjuvant drugs such as the tricyclic antidepressants (TCAs), serotonin/norepinephrine reuptake inhibitors (SSRIs), and some anticonvulsants, for example, gabapentin or topical lidocaine are utilized as first-line drug therapy for alleviation of MS-associated neuropathic pain (34, 37, 46).
Treatment of multiple sclerosis with Tramadol can considerably alleviate moderate to severe discomfort.
Sudden pains are common with multiple sclerosis (MS). You might get a shocking, burning, squeezing, stabbing, cold, or prickly feeling out of nowhere. Some people call them zingers or stingers. These zaps usually last only seconds or minutes.