MND-PAIN IN ALS
SUMMARY
1. Patients with ALS tend to experience nociceptive pain rather than neuropathic pain.
2. Common causes include muscle cramps due to dysfunction of the motor units, shoulder pain either secondary to overuse or from traction on peri-articular structures from unsupported weight of the arm due to weakness and wasting of the shoulder girdle musculature.
3. Also from immobility.
4. Pharmacologic management: paracetamol, anti-inflammatory agents, opioids, gabapentin, pregabalin, TCA, intra-articular steroid injection.
5. Non-pharmacologic management: positioning, armrests, splinting, sling TENS.
6. There is lack of evidence with any pain management with MND[1]
.
Reference(s)
- ↑ Brettschneider et al. 2013 Drug therapy for pain in amyotrophic lateral sclerosis or moto neuron disease. Cochrane.
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
