Pain and Quality of Life in the Early Stages After Multiple Sclerosis Diagnosis

A 2-year Longitudinal Study

Abstract

Background 

Pain is a frequent symptom during the course of multiple sclerosis (MS) but its frequency and impact at the early clinical stages remain unknown.

Objectives 

The aim of this study was to establish prevalence and severity of pain in a cohort of patients recently diagnosed with MS and to determine the evolution of pain prevalence over 2 years. Other objectives were to investigate the presence of baseline clinical predictors of pain after 2 years and to establish its impact on quality of life (QOL).

Methods 

In a population-based sample of 69 patients recently diagnosed with MS (<6 mo), pain was measured using questions from the SEP-59 QOL questionnaire. A standardized bedside neurologic examination was performed to establish sensory function, sensory Kurtzke functional system score, and disability scales. Patients were reassessed after 1 and 2 years.

Results 

Pain was reported by 73.5% of MS patients at baseline and by 70.6% and 61.8% at 1 and 2-year follow-ups, respectively. Clinically significant pain (grades between 3 and 6 using a 6-graded verbal scale) was reported by 63.2% of patients at baseline and by 51.5% and 45.6%, at 1 and 2-year follow-ups, respectively. Pain significantly altered daily activities in 44% of patients. Low overall QOL scores were significantly associated with pain. At 2 years time point, occurrence of pain was associated with baseline depressive symptoms after controlling for the presence of pain at baseline.

Conclusions 

Pain is frequent in the early stages of MS and affects the daily QOL.