If you experience shoulder pain with multiple sclerosis (MS), it’s important to talk to your MS specialist about this symptom. Shoulder discomfort in people with MS may be chronic (long-lasting) or acute (short-term). It may be associated with nerve damage or muscle or joint pain. It’s also possible the shoulder pain is not related to MS at all. The doctor who treats your MS is the best person to help you identify the causes of shoulder pain and find effective ways to manage this symptom.

According to one study of 115 people with MS, pain in the shoulders and upper back is a common symptom. (The researchers also noted women were more likely to report pain in these areas.) Each person experiences pain differently, including those diagnosed with MS.

Shoulder pain can affect your day-to-day activities and quality of life. Here, we explore how shoulder pain can affect those who are newly diagnosed with MS and those who have had the condition for a while. Learn what others with MS say their shoulder pain feels like, and learn more about pain management options that could help.

Different types of pain can occur as symptoms of MS. No two people feel pain quite the same way, and shoulder pain is no exception. For some, shoulder pain may feel sharp and sudden, while others may feel a dull, steady ache that lasts through the day. Shoulder pain may also be unrelated to MS.

One MyMSTeam member reported feeling “tuckered out” due to MS spasms in their shoulders and shoulder blades. Other team members have described having lots of neck and shoulder pain. One even likened their pain to that of a dislocated shoulder.

Another member said the pain was in both of their shoulders and paired with arm spasms. That member posted about “bad nights” with little to no sleep and being tired in the days that followed. For some people, pain extends to the collarbone, neck, and jaw.

Just like there are countless ways those with MS may experience pain, there are many treatment options to manage and minimize shoulder pain.

For some, shoulder pain may feel sharp and sudden, while others may feel a dull, steady ache that lasts through the day.

Remember that even if your pain may be similar to someone else’s, their pain-management methods are not guaranteed to work for you. Ask your doctor for different pain management options to see which ones serve you best. Before you try any new pain management technique or treatment, first consult your neurologist or other healthcare provider. Discussing any new or worsening symptoms with your doctor is the first step to determine the cause and the best treatment options.

Pain Medication

Over-the-counter pain relievers, such as ibuprofen (a nonsteroidal anti-inflammatory drug, or NSAID) and acetaminophen can often manage the musculoskeletal pain commonly associated with (but not caused by) MS. However, the severity and frequency of your shoulder pain may determine whether your doctor prescribes stronger medications. This point emphasizes the importance of discussing your treatment options with your doctor long before the pain hits.

One MyMSTeam member posted that they knocked out their pain with acetaminophen. “My shoulders have really been bothering me,” they wrote. “And it’s been hard to sleep because I am a side sleeper.” Doing physical therapy and applying a menthol-based cooling gel made little difference, they continued. But, they shared, the over-the-counter drug acetaminophen eased their discomfort.

Topical Ointments

Another popular pain-relief option includes topicals such as pain creams, ointments, gels, and patches. However, members have reported varying levels of success with these products. Some have found the treatments temporarily ease their pain, while others report no relief. Some members had allergic reactions after applying certain products, like those with corticosteroids (steroids).

Even if your pain may be similar to someone else’s, their pain-management methods are not guaranteed to work for you. Ask your doctor for different pain-management options to see which ones serve you best.

Common nonsteroidal, over-the-counter topical pain relief options include those with active ingredients such as:

• Capsaicin
• Lidocaine

• Menthol

Steroids

Steroid medications are another pain relief option, and they play an important role in managing MS symptoms. During an MS flare, steroids — typically taken by mouth or given through an IV — can reduce inflammation and help relieve associated pain.

Steroids may also be used for other types of pain not caused by MS. For example, injected steroids are often recommended for joint pain or degenerative spinal conditions. These injections are less invasive than surgery and usually involve shorter recovery times.

Many MyMSTeam members have weighed in on their experiences with steroid medications. One member shared that steroids are a common treatment among people with MS — especially for those experiencing a flare that causes very intense shoulder pain.

“In my first 20-plus years with MS, I was prescribed an oral steroid two or three times a year due to an MS relapse,” posted one MyMSTeam member. “I then went into remission and have not required steroids since. Steroids can be considered a ‘miracle’ medication. However, they can also present difficult side effects.”

The member continued, “After a few days on them, you are feeling OK. Then you go through a period when you say, ‘Get me off of these steroids.’ I continue to be mobile today because my neurologist’s treatment for me included steroids.”

You may experience side effects associated with steroid medications. Some MyMSTeam members have reported experiencing sleeping problems while on steroids. However, these side effects are more likely if you take oral steroids. Steroids given as an injection into a sore joint are more likely to be limited to temporary side effects right around the injection site.

Muscle Relaxants

If you experience mild discomfort or stiffness in your shoulder muscles or joints, your doctor may recommend muscle relaxants. These can treat both muscle spasms and tightness.

One MyMSTeam member said over-the-counter muscle relaxants loosened their stiff shoulder. Muscle relaxants can be a convenient fit for those experiencing less severe pain. At that pain level, steroid injections and surgery might not be necessary.

Applying hot or cold packs can ease discomfort and relax numb, aching, or cramped muscles.

Hot and Cold Therapy

Some people find using an ice pack or a warm compress eases their shoulder pain. Although these don’t treat the underlying problem that causes the pain, they can soothe it. Applying hot or cold packs can ease discomfort and relax numb, aching, or cramped muscles. A hot bath can be helpful, too, but don’t overdo it — heat can cause symptoms to worsen in many people with MS. Others may have sensitivity to cold.

Adjustments to Movements and Posture

Chronic pain and other MS symptoms can make lying or sitting down for long periods preferable. However, it is beneficial to move around as regularly as you can.

If you experience difficulty when you move, ask your neurology provider for a referral to a physical therapist for help with gentle stretches or regular exercises. Try a moderate approach, as exercise that is too long or intense can make your MS symptoms worse.

Adjusting your posture can have a big impact on shoulder pain and back pain. When sitting, place a small cushion or a rolled-up towel at your lower back to align your spine and shoulders and to maintain that proper position.

When upright, you might use a device called a standing frame. Standing frames support you when you stand. Use them correctly to improve your posture and reduce strain on your muscles and ligaments.

Join the Conversation

On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.

How does MS pain impact your daily life and mental health? Let others know in the comments below.