Because these symptoms are caused by the nerve damage that is a part of multiple sclerosis, anyone with MS is at risk of developing them. But a range of strategies can help with managing these types of symptoms.
Types of Sensory Symptoms
People with MS experience three basic types of sensory symptoms, says Fred D. Lublin, MD, professor of neurology and director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai Hospital in New York City: loss of sensation, abnormal sensations, and painful sensations. Loss of sensation is experienced as numbness in the affected area or body part. Abnormal sensations may include:
Pins and needlesTinglingCrawling sensationsItching (without a rash)
Painful sensations include:
Hypersensitivity to touchBurning sensationsThe “MS hug,” a band-like tightness or girdling feeling in the chest or abdomen that can be the result of nerve damage or spasms in the small muscles between the ribsLhermitte’s sign, an acute, electric shock–like sensation running down the spine and into the limbs that occurs when the head is bent forward
Numbness, abnormal sensations, and pain can affect virtually any part of the body: the face, torso, arms, hands, legs, or feet. The symptoms may come and go, or they may come and stay. “If they’re symptoms caused by old nerve damage, they may flare up during periods of fatigue or illness, and then go away with rest and recovery,” Dr. Lublin says. RELATED: When Multiple Sclerosis Causes Skin Symptoms “My first MS symptom was numbness in my right hand, but that was well before my diagnosis,” says Jennifer, who was diagnosed with MS in 1997, eight days after her 23rd birthday. She describes the feeling as “like that tingly, pins-and-needles feeling you get when your hand falls asleep and the rest of your body is awake, only no matter how hard you try to shake and wake it up, the feeling won’t go away.” Dan, who writes for the couple’s blog, A Couple Takes on MS, also experiences numbness and tingling in his hands and feet. “When I first was diagnosed, I was concerned how that would affect my ability to type, as that’s a huge part of my job as a writer,” he says. Dan was diagnosed with MS on Valentine’s Day in 2000, at age 27. “I quickly realized you don’t actually have to feel the keys when you type. Just put your fingers into the proper position and type away!” While sensory symptoms rarely become permanent, they can be dangerous. Loss of sensation in your legs, for example, can cause a fall. Numbness in your hands can cause you to drop things and may put you at risk of being burned by scalding water. Numbness in your face may be dangerous when chewing. In some cases, it may be necessary to receive occupational therapy, physical medicine/rehabilitation, and palliative care (such as through a multidisciplinary MS center). Dan says his main concern about his symptoms was that they would interfere with his ability to care for his wife. “My biggest concern with my numb feet is that I will try to run or walk too fast and fall down, because I can’t completely feel them underneath me,” says Dan. “The fear isn’t the fall so much as it is: What damage will it do to me, and will I still be able to be Jennifer’s caregiver?” RELATED: Numb Feet: Is It MS? Or Something Else?
Treating and Managing MS Sensory Issues
In some cases, medication can help treat sensory symptoms. Neuropathic (nerve) pain may respond to anticonvulsant drugs, such as Neurontin (gabapentin) or Lyrica (pregabalin), Lublin says. Antidepressants are also sometimes used to treat some types of nerve pain, such as burning and tingling, per the NMSS. There is also some evidence that topical capsaicin creams and patches can be helpful. However, while these treatments may help relieve neuropathic pain, they do not treat numbness. If sensory symptoms are due to a relapse or to new MS attacks, steroids may help to control them, according to the NMSS. RELATED: How to Spot the Signs of an MS Flare Like the symptoms themselves, though, responses to the various drugs vary from person to person. “In the beginning, steroid infusions helped to alleviate some of these issues,” says Jennifer. Dan has been able to find relief by running his hands under cold water and clenching his hands into tight fists and opening them quickly. “Oh yeah, and regularly asking Jennifer to massage my hands.” Applying heat may help too, according to the NMSS. Some other ways to avoid or manage sensory symptoms include:
Avoid becoming overheated.Get plenty of rest and do your best to stay healthy. Fatigue, infections, and fever are common triggers for pseudoexacerbations, per the NMSS.Ask your doctor about wearing pressure stockings or a tight glove, which may convert painful sensations into pressure sensations, notes the NMSS.Wear a soft cervical collar to prevent Lhermitte’s sign.Try cognitive behavioral therapy, hypnosis, or meditation, per the NMSS.
Triggers and Help for MS Sensory Symptoms
Learning your unique triggers for sensory symptoms may be the best way to manage them. For Jennifer, tiredness has caused her head to itch. For Dan, stress is the trigger he’s aimed to avoid. “Whether it’s a lot of work-related deadlines or projects we need to complete,” he says, “the more stress I have, the more numb my hands get. And the more numb my hands get, the more stressed I am. It just keeps going.” To help keep stress at bay, Dan does his best to make a plan and take care of what needs to be done in the moment, without focusing on all of the other tasks ahead of him. The couple also urges people living with MS to give themselves time to adjust to any new symptoms or sensory issues. “Reach out to other people, including your doctor and members of the MS community, for insight and advice,” says Jennifer. “The reality is, you more than likely aren’t the only person with MS who’s encountering your issue or concern.” Additional reporting by Susan Jara.