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.



  Non-pharmacologic treatments

  • 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.

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