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

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.