Pain in portuguese patients with multiple sclerosis

Abstract

Early reports often ignored pain as an important symptom in multiple sclerosis (MS). Pain prevalence figures in MS from European countries other than Portugal range between 40 and 65%. To our knowledge there is no published data in English on pain in MS in Portugal. We describe the demographic and clinical characteristics, with an emphasis on pain, of 85 MS patients followed-up in a Portuguese hospital, contributing to pain epidemiology in MS. Patients were interviewed sequentially after their regular appointments at the MS clinic; patients with pain completed The Brief Pain Inventory and The McGill Pain Questionnaire (MPQ). The prevalence of pain found was 34%. Headache and back pain were the most common anatomical sites described, followed by upper and lower limbs. Intensity of pain in an 11-point scale was, for the maximum pain intensity 6.7 ± 1.8, for the minimum pain intensity 2.2 ± 2.0, for the mean pain intensity 4.5 ± 1.5, and for the actual pain intensity 2.4 ± 2.9. Pain interfered significantly with general activity, mood, work, social relations, and enjoyment of life. All MS patients with pain employed words from both the sensory and affective categories of the MPQ to describe it. Patient pain descriptions' included the word "hot-burning" in 59% of the cases, common in the report of central pain, but neuropathic pain medications were only used by 10% of them. Pain is an important symptom in Portuguese patients with MS, not only because of the high prevalence found, concordant with other European countries, but also because of its interference with quality-of-life.

Keywords: Europe; epidemiology; multiple sclerosis; pain; quality-of-life.

Figure 1

Pain localization. Data obtained from the short version of the Brief Pain Inventory.

Figure 2

Pain intensity in an 11-point scale of the Brief Pain Inventory (0 = “no pain” e 10 = “the worst pain possible”). The horizontal line defines the median point of the scale (5).

Figure 3

Pain interference with general activity, mood, walking ability, work, social relations, sleep, and enjoyment of life in an 11-point scale of the Brief Pain Inventory (0 = “no interference” e 10 = “interferes completely”). The horizontal line defines the median point of the scale (5).