Medication treatment options (listed in the bulletin)
- Tricyclic antidepressants.
- Serotonin-noradrenaline reuptake inhibitors.
- Antiepileptic drugs such as gabapentin.
- Lidocaine patches, capsaicin patches, and tramadol.
- Strong opioids and botulinum toxin.
- Cannabinoids were not recommended, however, that may be due to adverse effects, rather than lack of efficacy.
- Treatment by a pain psychologist.
- Behavioral self-management; relaxation training, cognitive-talk therapy, adaptive coping, etc.
- Social activities like a painting class or hippotherapy.
- Physical activity like yoga, tai chi, or aquatic exercises.
- Counter-irritation such as massage, the use of heat or cold, acupuncture, and reflexology.
- Mindfulness and meditation.
- Guided imagery, breathing, and progressive relaxation.
Clinicians are encouraged to evaluate pain at each clinical encounter and:
- This is information on Multiple Sclerosis for patients that Recognize and treat comorbidities and psychological factors of anxiety and depression.
- Enhance social factors of support and a trusting provider relationship.
- Use medications that target pain mechanisms.
- Combine low doses of several medications for greater efficacy with fewer adverse events.
- Refer to integrative health and wellness practices.
This is information on Multiple Sclerosis that Using low doses of multiple medications, physical activity, mindfulness, progressive relaxation, and other tools, I have days without pain. When the ants and bees invade, I take extra medication, curl up with a book or take a nap. I distract myself long enough for the worst to pass.