Multiple sclerosis (MS) affects the central nervous system and can cause indirect joint pain by affecting your muscles, balance, and energy levels.

Multiple sclerosis (MS) is a progressive condition that causes your body to mistakenly attack your central nervous system (CNS). Specifically, MS inflammation damages myelin — the protective sheath that covers nerve fibers.

Damage to the myelin and nerve fibers can affect how your CNS sends signals. This can cause various symptoms, including pain, numbness, and tingling throughout your body.

MS nerve damage cannot specifically cause joint pain, but this can be a secondary symptom of other damage.

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The two types of pain people with MS experience are neuropathic (nerve pain) and musculoskeletal pain.

  • Neuropathic pain: This occurs due to direct nerve damage and can cause burning, stabbing, or squeezing pain sensations.
  • Musculoskeletal pain: This secondary pain occurs due to muscle weakness, stiffness, or issues with coordination due to interruptions in nerve signals.

Indirect joint pain associated with MS is usually more severe around the hips and back, as well as the legs. Energy, posture, flexibility, and balance all play important roles in joint pain.

Some potential causes include:

  • favoring one limb over the other due to weakness may cause pain in the stronger overused limb joints
  • weakness in back muscles can affect posture and result in painful pressure in the lower back
  • frequent muscle spasms can affect mobility and general flexibility that supports the joints
  • loss of energy can decrease activity levels and muscle strength, resulting in weakened and vulnerable muscles around surrounding joints
  • staying in positions for long periods due to weakness or coordination problems can cause joints to feel stiff

Other symptoms

The nerve and musculoskeletal damage from MS results in progressive pain that can leave a person with a variety of symptoms, such as:

Learn more about the effects of MS on your body.

There is no single test that doctors use to diagnose MS. A combination of assessments can help rule out other conditions and confirm an MS diagnosis.

Doctors will complete a full medical history and ask about current symptoms. Then, they will order further tests, such as:

  • neurologic exams to test nerve and vision capabilities
  • MRI scans to look for signs of nerve damage
  • cerebrospinal fluid analysis to check for MS markers
  • blood tests to rule out other potential causes

Learn more about the tests for diagnosing MS.

While there’s currently no cure for MS, there are ways to manage the condition and related pain with medications, physical therapy (PT), and lifestyle changes.

According to the Multiple Sclerosis Association of America, about 50% of people identify pain as a major symptom after being diagnosed with MS, and about 48% of people report experiencing chronic pain.

While everyone with MS experiences pain differently, some general remedies, therapies, and medications are available to find what’s right for you.

Home remedies

Some everyday habits can improve symptoms of joint and muscle pain, including:

Physical therapy

Physical therapy can improve MS symptoms, such as muscle stiffness, balance, and joint function. It can benefit someone’s overall quality of life.

A physical therapist can help pinpoint problems with weak or tight muscles that can lead to joint pain in MS.

The physical therapist can also teach you stretching and strengthening exercises to improve joint pain. They can also evaluate gait problems and even recommend modifications that will help you walk better and put less stress on your joints.

Read more about PT for MS.

Medication

Treatment for MS primarily focuses on slowing the progression of the disease and managing symptoms.

Disease-modifying drugs are a primary treatment option for MS. These medications can reduce the severity and frequency of MS symptom flares and may slow MS progression.

Doctors may also prescribe any of the following to help manage your day-to-day symptoms:

  • pain medications
  • muscle relaxants
  • anti-inflammatory steroids
  • anti-spasticity drugs

Always discuss any changes in your treatment or pain management plan with your doctor.

Learn more about the different medications for MS management.

Balance, energy, and muscle problems are all very common with MS, and nerve and musculoskeletal damage can contribute to the development of painful joints and aching muscles.

With the right combination of physical therapy, medication, and lifestyle changes, you can manage your MS and lead a rich, enjoyable life.