Secondary Pain

Secondary Pain

Living with multiple sclerosis (MS) can mean dealing with a wide variety of types of pain. One of the most common forms is secondary pain—a type of discomfort that arises not from direct nerve injury, but from the physical changes, symptoms, and lifestyle adaptations that MS can bring. Nearly everyone with MS will experience some secondary pain at different times, whether mild and brief, or more persistent and disruptive to daily life.

Understanding what secondary pain is and knowing the steps you can take to manage it can make a big difference in maintaining your comfort and wellbeing.

What is secondary pain?
Secondary pain is also known as “musculoskeletal pain.” Unlike nerve (neuropathic) pain, which is caused by damage to the nerves themselves, secondary pain develops as a result of other MS symptoms. It’s usually due to changes in the way muscles, joints, and ligaments are used, or from the strain of compensating for weakness, imbalance, stiffness, or limited mobility. Secondary pain can range from mild aches to acute pain episodes and may be most bothersome after activity, prolonged sitting, or at night.

Common Causes and Types
Some typical causes of secondary pain in MS include:

  • Muscle Weakness or Imbalance: Having to rely on some muscles more than others can lead to overuse, strain, or muscle fatigue.
  • Spasticity: Muscle stiffness and spasms can cause discomfort in both affected and nearby areas.
  • Poor Posture or Gait Changes: Using walking aids or adjusting how you move can put extra stress on certain joints or muscles, especially the hips, knees, or back.
  • Limited Mobility: Being sedentary for long periods can lead to sore muscles, stiffness, or pressure pain (sometimes called pressure sores).
  • Overuse Injuries: If you use manual wheelchairs, crutches, or other aids, repetitive movement can lead to pain in the arms, shoulders, or wrists.
  • Falls and Injuries: Loss of balance or coordination can increase the risk of painful injuries.

Secondary pain can affect many parts of day-to-day living. It might become harder to sleep, exercise, focus, or manage other MS symptoms when pain is persistent.

Some people limit their activity to avoid pain, which can actually make things worse over time. That’s why it’s important to talk to your healthcare team about any new pain or changes, so the root causes can be addressed.

Managing secondary pain is often possible, and there are many strategies you can try:

  • Regular Movement: Gentle exercise, stretching, and physiotherapy help keep muscles flexible and joints moving smoothly.
  • Pain Relief: Over-the-counter medications, hot/cold packs, or relaxation techniques can ease symptoms.
  • Posture & Mobility Aids: Using proper seating, shoes, mattresses, and supportive devices can reduce strain.
  • Occupational Therapy: An occupational therapist can suggest practical changes to your daily routines to make tasks easier and less painful.
  • Rest & Pacing: Listening to your body and pacing yourself—alternating activity with rest—helps prevent flare-ups.
  • Referral: Sometimes referral to pain specialists or physiotherapists can help with tailored management and specific treatments.

Treatment includes physiotherapy, stretching, exercise, medications (to reduce spasticity but these can cause drowsiness), nerve blocks, or in severe cases, botox injections or surgery. Occupational therapists can assist with equipment for daily life.

General Information

Discuss pain regularly with your healthcare team and seek help early:

Sensory Symptoms