Are Patients with MS More SusCeptible to Increased Levels of Chronic Pain?

Here is my question:
​Are Patients with MS More Susceptible to Increased Levels of Chronic Pain? I have had MS for a few years and I have noticed that since the disease first manifested, I have experienced chronic, unremitting pain that is out of proportion to the original injuries. Before this, I had a very high pain tolerance and never needed pain medication or ibuprofen beyond a couple of days after being injured or having surgery. For example: Since I have developed MS, I have had shingles along my trigeminal nerve and developed bilateral sciatica due to foraminal stenosis (no cord involvement). Doctors have assumed that, due to my age (early 30’s) I would have a relatively uneventful recovery from both. This is not the case. It’s as if the pain signals have been switched on permanently. Neither of these conditions were caused by MS, but I am wondering if having MS makes us more susceptible to something like a central pain syndrome even with injuries sustained outside of the CNS. Could it be caused by sub-clinical damage to the tracts within the CNS that regulate pain, even if no lesions appear in those areas on MRI?

Answer:
Your question and observations are extremely astute. MS specialists have observed for years that MS patients experience pain differently and chronic pain in MS patients modifies pain thresholds and responses to other non MS related conditions and injuries.

The best approach is to work on modifiable risk factors for chronic pain. This includes doing the following:

1. Treatment any underlying affective disorders (anxiety and depression) 
2. Improve your  sleep
3. A regular exercise program following guidelines of 150 minutes per week of moderate vigorous exercise
4. Learn Meditation and/or  mindfulness and perform regularly
5. Improving your social support network if necessary
6. Never smoke or stop smoking
7. Avoid narcotics

Revere (Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego