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All pain is not the same when it comes to MS
Pain can present itself in many forms for people battling multiple sclerosis, and one type can interfere with exercising, new research shows.
One class of pain experienced by MS patients is what the authors of the new study call nociceptive, caused by specific damage to tissues. Another form is neuropathic pain, caused by the loss of the protective myelin sheath around nerves that is a hallmark of the disease.
Exercise is still possible with those two types of pain, but a third type, called "widespread pain with nociplastic features," or WPNF, could get in the way of therapeutic exercise for people with MS, reports a team from the University of Michigan.
"WPNF is a chronic and diffuse pain which can be challenging to localize or describe precisely," explained study lead author Libak Abou. He's a research assistant professor in physical medicine and rehabilitation at Michigan Medicine.
"In a person with MS, this type of pain arises from altered processing signals within the central nervous system," Abou explained in a university news release.
In the new study, the Michigan team surveyed 938 people with MS on their daily levels of pain and physical activity.
The study found that patients who reported high levels of WPNF pain were less likely to be active, compared to people with lower levels.
The findings were published recently in The Journal of Pain.
"There is a growing need to consider what type of pain MS patients are experiencing before giving them an exercise plan," Abou said. "The concept of considering WPNF when creating exercise plans for MS is newer, but could help many patients get to an activity level that will help ease symptoms without causing them intense pain."
He hopes that physicians and physical therapists caring for people with MS might tailor exercise programs to better help people battling WPNF pain.
"The end goal is to help those with MS maintain their functional independence," Abou said. "It is also important to remember that these patients will likely need extra support from their physical therapy team to keep them on a path with less pain."
More information: Find out more about the role of exercise in MS care at the National MS Society.
Libak Abou et al, Widespread Pain With Nociplastic Features is an Independent Predictor of Low Physical Activity in People with Multiple Sclerosis, The Journal of Pain (2023). DOI: 10.1016/j.jpain.2023.09.005
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