Date of Award

5-2022

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Julie Solberg

Keywords

Multiple sclerosis; Chronic pain; Pain management; Neuropathic pain; Nonpharmacological treatment

Abstract

Chronic pain associated with multiple sclerosis (MS) is prevalent in many phenotypes. Pharmacologic therapy of this pain often fails to provide analgesia. This research is intended to determine which nonpharmacological interventions may be recommended for treatment of chronic extremity pain in individuals with MS. This research was primarily conducted through a comprehensive literature review of publications within the past five years on three databases, PubMed, EMBase, and CINAHL. Additional resources were added from “similar” sections of the databases, directly from included studies, and when used to inform background information, for a total of 26 resources. Studies were excluded if not specifically addressing chronic pain treatment in MS or if beyond the scope of this research. Background information presented discusses pathophysiology of pain in MS and previously published literature regarding pharmacologic and nonpharmacologic interventions for MS-related pain. New data suggests that improving MS-related pain characterization has potential to alter current understanding of phenotype prevalence and subsequently impact selection of pharmacologic treatment agents for pain in pwMS, but impact on nonpharmacological intervention selection is unknown. Much of the research analyzed focuses on novel studies investigating various nonpharmacological modalities including physical interventions, mental and emotional cognitive strategies, and neuromodulation. Many of these nonpharmacological interventions show promise of analgesia for chronic MS-related pain but lack the large sample sizes and standardization necessary to generalize findings and make subsequent recommendations. Research into nonpharmacological MS-related pain treatment continues, and is currently investigating interventions like optimal psychotherapy techniques, on-demand MS programs, and telehealth group conferences.

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