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DEVELOPMENT OF MULTIPLE SCLEROSIS ALONGSIDE PREVIOUS PSORIASIS AND MECHANICAL LOW BACK PAIN
Author(s):
Smith, S.*
Affiliations:
Gwynedd Hospital, Anasthetic, Bangor, United Kingdom
ESRA Academy. Howard I. Sep 13, 2017; 190786
Topic: PAIN THERAPY (ACUTE - CHRONIC)
Dr. Indre Howard
Dr. Indre Howard

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Abstract
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Background and Aims:

The aim of this case report is to highlight  the importance of pain as a symptom and as a life quality factor for  patients with multiple sclerosis (MS). The pain in MS has many challenges when diagnosing as clinical pain presentation is usually complex and to manage the pain effectively is hard to achieve. 

Methods:

We wrote this case report retrospectively –taking medical history of the patient, using medical records  (medical specialist’s consultation letters, MRI scans and other investigations results). 

Results:

A 56 year old gentleman had psoriasis for 20 years and he had a history of lumbar back surgery (complicated by foot drop) when he presented in pain clinic with mechanical low back pain, an upward going right plantar and left meralgia paraesthetica. Later on he developed lower limb weakness. The MRI scan showed demyelination plaques. The medications that he took for pain control are as follows: paracetamol, pregabalin, low dose morphine and ibuprofen. He also had facet joint injections, physiotherapy and pain management plan.

Conclusions:

The importance of pain in multiple sclerosis has been underestimated for a long time. Now, it is well recognised that pain has a major influence on the quality of life in nearly half of MS patients and one-third believe that pain is their main problem. Even though damaged demyelinated areas in the brain can be seen in the MRI scan, and symptoms are widely described in the literature, the diagnosis of MS is still challenging most of the time due to its complex clinical presentation.

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