Pain in People with Multiple Sclerosis: Associations with Modifiable Lifestyle Factors, Fatigue, Depression, Anxiety, and Mental Health Quality of Life

Abstract

BackgroundPeople with multiple sclerosis (MS) often experience pain, which can interfere with mobility, employment, and quality of life (QOL).MethodsThis cross-sectional study explored associations between pain, demographic, disease, and modifiable lifestyle factors in an international sample of people with MS recruited online.ResultsSubstantial pain, of moderate/severe intensity and interfering at least moderately with work/household or enjoyment of life in the past 4 weeks, was reported by 682/2,362 (28.9%). Substantial pain was associated with fatigue (odds ratio (OR): 6.7, 95% confidence interval (CI): 4.9,9.3), depression (OR:4.0, 95% CI:3.2,5.1), anxiety (OR:2.4, 95% CI:1.9,2.9), and lower mental health QOL (Mean Difference: −14.7, 95% CI:−16.6,−12.8). Regression analyses showed that smoking (OR: 2.0, 95% CI:1.35,2.87) and obesity (OR:2.1, 95% CI: 1.5,2.8), moderate alcohol use (OR: 0.7, 95% CI:0.5,0.9), moderate (OR 0.7, 95% CI: 0.55,0.98) or high (OR 0.6, 95% CI: 0.4,0.8) physical activity level, and healthy diet (OR 0.8, 95% CI: 0.75,0.95, per 10 points) were associated with substantial pain.ConclusionOur results show clear associations with modifiable lifestyle factors and substantial pain in MS. These factors are already considered in the prevention and management of pain in other populations but have not previously been considered in MS. Conversely, pain and associated common MS comorbidities, such as depression, anxiety, and fatigue, may hamper efforts to start or maintain healthy behaviors. Strategies to overcome these barriers need to be considered. Further research should clarify the direction of these associations.

Difference in fatigue and pain between neuromyelitis optica spectrum disorder and multiple sclerosis

“…A previous study reported a similar incidence of fatigue in NMOSD and MS patients, with a strong correlation between depression and fatigue [9]. On the other hand, chronic pain is a common symptom causing deterioration of activities of the daily living in patients with MS and NMOSD [15][16][17]. However, the relationship between fatigue and pain has not been fully investigated, particularly in NMOSD patients.…”

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Den Flow erleben: Therapeutisches Klettern bei Multipler Sklerose

“…Die Sport-und Bewegungstherapie ist also eine zentrale Komponente des multidisziplinären Ansatzes, mit einer hohen Bedeutung für die Alltagsaktivität. Auch zeigten Marck et al [13], dass modifizierbare Lebensstilfaktoren wie Rauchen, Übergewicht und Bewegung einen Einfluss auf Schmerzen bei MS haben. Einer Adaptation des Gesundheitsverhaltens kommt also bei der Erkrankung MS eine große Bedeutung zu.…”