Unfair! MS Pain Causes Fatigue, Fatigue Amplifies MS Pain

What's a person with MS to do?

MS causes pain

For those who've had an MS diagnosis for a while, there's relief in knowing that specialists now mostly agree that MS does, in fact, cause pain.

Pain conditions associated with MS

Several pain conditions are associated with MS:

• facial or eye pain
• altered sensations in the arms or legs, fingers or toes
• stiffness and pain in the neck
• rib cage (the infamous "MS hug")
• lightning bolt sensations in different parts of the body that occur without warning
• headaches
• pain caused by spasticity and muscle cramps

Some of us treat our pain as it occurs. Others need regular therapy to alleviate ongoing problems with pain.

As with all other symptoms of MS, pain is one with a snowflake quality. No two experiences are going to be alike.

Pain is a response to demyelination

Pain is a symptom of inflammatory response in the body. In the case of people with multiple sclerosis, that inflammation is better known as demyelination. Those experiencing disease progression (either because they have progressive MS or because they are in relapse) are more prone to experience the symptoms of inflammation, which include pain.

The link between fatigue and pain

What researchers have found is that there's a link between pain and fatigue. Studies continue to examine this links using the fatigue-pain models demonstrated by those with Chronic Fatigue Syndrome, rheumatoid arthritis, and fibromyalgia.

Pain causes fatigue

From a common-sense perspective, it makes sense that pain can cause fatigue. Pain causes muscular tension in the body. Muscular tension that's not relieved leads to muscular fatigue. People who experience cramping and spasticity know this first hand.

Pain can also have an impact on moods. Emotional exhaustion happens when pain is steady and unrelenting. This can lead to periods of lassitude. More severe emotional imbalances caused by unremitting pain, such as clinical forms of depression, can lead to dips in energy and a lack of motivation to perform even the simplest of daily activities. Pain can lead to anxiety, as well (who hasn't feared the return of pain?). This, too, can also challenge positive moods and increase tension in the muscles, resulting in fatigue.

Ever feel like you've woken up some days so exhausted, it's like you never slept? Chances are, you were also experiencing inflammation and/or pain. Maybe it's related to your MS; maybe it's from something else entirely.

The body and brain don't discriminate between causes of pain, however; if you're in pain, and you can't find relief, you're likely to face physical and emotional fatigue as a consequence.

But wait, there's more!

Fatigue magnifies pain

Research has found that when you are fatigued, the pain you experience may be more intense. This doesn't mean you have more pain, but rather, a heightened perception of pain.

This is because fatigue can alter the way the brain and body experience and process pain, leading to hypersensitivity to it. Untreated fatigue will eventually magnify the sensations of pain you experience, leading to more and extended periods of physical and emotional fatigue.

Yes, it's a vicious cycle.

Unfair! How do we strike a balance?

Obviously, the best first step is to identify the root cause of the pain and address it. This might mean physical therapy, cognitive behavioral therapy, or medications.

Identifying the root causes of physical or emotional pain

Sometimes, it's a matter of practicing patience and giving your body time to do the work of healing. If you recently broke your foot, for instance, you will have obvious pain as your body works to heal itself. This will be a key reason why you are so tired. But once the foot is healed, you should expect to get your energy back.

In other cases, chronic anxiety, depression, or mood disorders may require some attention so that you can relax and reclaim an "even keel."

But this can be hard to do if you are in the midst of a divorce, reeling over external stresses like politics, or struggling with conflicts over insurance coverage or disability.

The problem with "avoiding stress"

Doctors tell their MS patients to avoid stress, but real life has a way of wreaking havoc with that ideal. These are real problems, nonetheless, and the emotional fatigue they cause is equally palpable. Locating support systems, talking it out with loved ones, and being proactive are all ways to reclaim  personal power to weather tough times.

Finally, if your pain is chronic (whether it is related to MS or to some other condition), then finding appropriate pain management solutions should be a top priority. Otherwise, it may mean falling victim to the vicious pain-fatigue cycle.

Hint: Pay attention to your sleep

One of the ways that pain also influences are physical, mental, and emotional health relates to the quality and quantity of our sleep.

It is well known that people who are chronic insomniacs are more sensitive to pain, and that such pain can push those with normal emotional health to dark places, even suicide.

If you're in pain and feeling exhausted by it, ask yourself:

• What's my sleep been like?
• Has pain kept me up all night so that I can't get any sleep?
• Does my pain frequently disrupt the sleep I do get?
• Do you feel lethargic during the day, and sleepy enough to need naps of substantial length (over an hour)?

If so, you may also have a sleep disorder such as sleep apnea, restless leg syndrome, circadian rhythm dysfunction, or other previously unidentified problem with the quality and/or quantity of your nighttime Zzz.

Sleep disorders are fairly common with MS

It is fairly common for people with MS to also have at least one sleep disorder. Don't be too quick to rule it out.

Ask your neurologist for advice if you struggle with getting good sleep. You don't have to live with fatigue or sleepiness.

Many patients who have MS, or a combination of MS and other conditions, often surrender to that reality, believing there are no options for them.

Relief can be found

As a person with MS, who also has rheumatoid arthritis and a sleep disorder, I can tell you first hand... there are solutions for pain and fatigue that can bring you much-needed relief. It's possible to reclaim as much of your energy and motivation, but only if you seek out help and treatment.

These solutions aren't just via medications. Meditation, physical therapy, behavioral therapy, and mechanical therapies are all part of a wide spectrum of options available that you, should seek out to address your pain and fatigue demons.

Don't be afraid to ask for help. Trust me, you'll be so glad you did!