Prevalence of pain in patients with multiple sclerosis and its association with anxiety, depressive symptoms and quality of life.

Beata Łabuz-Roszak,Krystyna Tyrpień-Golder,Anna Majewska,Michał Skrzypek,Katarzyna Kubicka-Bączyk,Anna Matejczyk,Paweł Dobrakowski,Ewa Niewiadomska,Krystyna Pierzchała

doi:10.12740/pp/94469

Abstract

Pain is one of the most frequently reported symptoms of multiple sclerosis (MS). It affects the daily functioning of patients, limits the ability to work and reduces the joy of life. The aim of the study was to analyze the impact of pain on quality of life as well as symptoms of anxiety and depression in patients with MS. The study included 144 patients with diagnosed MS (mean age 41±12 years, mean illness duration 10.3±8.6 years). The study was carried out on the basis of the author's survey on current and previous pain - the Quality of Life Self-esteem Questionnaire (EuroQol5D) and the Hospital Anxiety and Depression Scale (HADS). Among all respondents, 117 (81.3%) reported current pain, and 120 (83.3%) declared the occurrence of pain in the past. Currently, patients have reported: pain in one or more extremities - 79 people (54.9%), headache and facial pain - 72 (50%), back pain - 72 (50%), painful muscle spasms - 54 (38.6%), ocular pain - 37 (25.7%), Lhermitte's sign - 32 (22.2%). Patients reporting pain experienced significantly more severe symptoms of anxiety and depression (HADS-L: 8.0±4.3 vs. 5.1±4.3; p< 0.01; HADS-D: 6.0±4.2 vs. 3.4±3.7; p< 0.01), and had significantly worse quality of life (EQ 5D: 8.1±1.9 vs. 6.3±1.4; p< 0.0001). An association between presence of pain and gender (p< 0.01), age (p< 0.05), the degree of disability (p< 0.05), education (p< 0.001), and the professional activity (p< 0.01) was found. Pain in MS is associated with more severe symptoms of anxiety and depression, and worse quality of life. Female sex, older age, lower level of education, greater disability, and lack of occupational work predispose to the occurrence of pain in MS.

Highlights

Pain – as defined by the International Association for the Study of Pain (IASP) – is a subjective unpleasant and negative sensory as well as emotional impression arising under the influence of stimuli damaging tissues or threatening malfunctions
Pain in multiple sclerosis (MS) is associated with more severe symptoms of anxiety and depression, and worse quality of life
There are two types of pain: receptor – nociceptive pain, which is caused by irritation of the receptors of sensory nerve, e.g., by inflammatory mediators, and non-receptor – neuropathic pain, which is caused by compression or destruction of the structures of the nervous system [1,2,3]

Summary

Introduction

Pain – as defined by the International Association for the Study of Pain (IASP) – is a subjective unpleasant and negative sensory as well as emotional impression arising under the influence of stimuli damaging tissues (nociceptive) or threatening malfunctions. There are two types of pain: receptor – nociceptive pain (somatic or visceral), which is caused by irritation of the receptors of sensory nerve (nociceptors), e.g., by inflammatory mediators, and non-receptor – neuropathic pain, which is caused by compression or destruction of the structures of the nervous system [1,2,3]. Pain is one of the most frequent symptoms accompanying patients who suffer from neurological diseases. It is reported by patients with multiple sclerosis (MS), a chronic inflammatory disease of the central nervous system (CNS). Sensory abnormalities, damage of cranial nerves, fatigue, vegetative, and psychological symptoms can be present [4,5,6]

Objectives

Methods

Results

Discussion

Conclusion