September is Pain Awareness Month

The World Health Assembly (WHA), a subsection of the World Health Organization (WHO), has declared September Pain Awareness Month. Up until the 1980s, many people, including those in the medical profession, believed there was no pain associated with MS. Thankfully, research has caught up with patients. Surveys show that as many as two thirds of people with MS experience pain on some level. Yet, only this week when I was explaining my pain to a physio, her first reply was that pain is an unusual symptom of MS!

As usual when I am asked to write something I automatically think “Yes I can do that!”, but when I try to put my thoughts down on paper it's a totally different story. It's hard not to write about my pain- it is constant, relentless, present all day, every day. It could be at Level 1 (niggling) this minute and at Level 10 in an hour (unbearable/impossible). Pain may be caused by nerve damage due to MS or indirectly due to other symptoms. It can be caused by the side effects of the drugs you are taking or a bladder infection or another condition unrelated to your MS.

Your muscles and joints could cause pain from the strain they are under if your mobility is poor. This is called musculoskeletal pain; there is also neuropathic pain caused by nerve damage in the brain or spinal cord. This pain can be sudden and sharp, minor or intense.

The types of pain in MS include:

1. Acute pain: short-lived but it may come back.
2. Chronic pain: usually lasts three months or more and can range from mild to severe.
3. Paroxysmal: a sudden attack or recurrence of symptoms or an intensification of existing symptoms.

Even with all of the textbook descriptions of pain, with all the vocabulary, it can be so very hard to describe and therefore to treat. One of the reasons for this is the sensation and the level of the pain can constantly change- it can be just a niggle or it may feel like a bad sunburn.

It’s important to use descriptions to help describe it such stabbing, shooting, burning, aching, radiating, throbbing or cramping. These descriptions help guide your medical professional on how to treat it.  
Pain affects us physically, mentally and emotionally; it can make us feel very angry and afraid. It can so very isolating, completely stopping a person from enjoying a full life. Work, family and friends are impacted; pain can greatly reduce the quality of a person's sleep which in turn impacts on their mood and in turn their relationships.  

It’s not always obvious how to treat your pain, and it can be a case of trial and error until an effective method is found. There isn't a one treatment that fixes it all and it can be extremely frustrating; sometimes you may feel you are not heard.

Treatment and Management options
• Drugs are one very effective method and there are many types depending on the type of pain. Their usefulness has to be balanced against the side effects.
• Pain patches are placed on the skin and absorbed into the area
• Physiotherapy can help to keep your muscles moving, easing spasticity
• Meditation can help you through your pain with breathing techniques
• Self management courses which help you to manage your pain symptoms
• A Pain Specialist is vital so when your pain becomes difficult to manage their role is how to manage your pain.

In the past I have tried many different methods in order to get a handle on my pain and a better quality of life. Some of them worked, some didn’t and on difficult days or nights I tell myself it will pass. If I can, I will remember the breathing techniques I learnt from the online mindfulness classes with MS Ireland. When my muscles are stiff and tired, I do the exercises taught to me by the physio in MS Ireland and the community physio.

When the pain brings me to that lonely dark place, I call my psychologist and have a good talk. That helps me back in control of my self & my response to the pain.
I am no different to anyone else- when pain starts, I just want it gone. Now, with my experiences, I use all the different methods so I can keep getting up, keep showing up and doing my best with the help from my family and friends and the resources available. 

Chronic Pain Ireland is running a range of brilliant events throughout the month. Click here for more details.