Now know anything about MS, but I did research on the treatment. The primary focus seems to be on treatments that help in preventing the disease from getting worse and might put them in remission. These drugs are very toxic, but could be very helpful. They don't treat the pain but the disease.


That PCP was very wrong to rule out opiates. They don't mention opiates with MS on any website that I saw, but I haven't heard that it doesn't work/ Unfortunately some people believe that opiates are useless to treat muscle pain or nerve pain or headache pain and you do hear that type of thing. Opiates work on all pain although perhaps not all aspects of all pain. They work best sometimes in conjunction with other medications, like the ones he is already on that are not working by themselves.

Generally there is a stages to treating pain and you start out with other drugs and physical therapy and work your way up to short acting opiates and gradually to stronger opiates like methadone in combination with other drugs.

The methadone raised a red flag with me so I'm not surprised your brother's PCP didn't prescribe it. I think that was overkill and would knock him on this butt. The next step is opiates although usually a short acting opiate and perhaps gradually working your way up to something long-acting and perhaps methadone. Methadone is a good painkiller, but it's not usually a starter opiate.


This PCP needs to be aware just how bad your brothers pain is and I think you spoke so movingly about it, that you would be a very effective advocate if you went with him to his appointment. If you said just what you said I think the doctor understand it's time to go the next stage in treating his pain and might reconsider his attitude about opiates. If not you have to get it to somebody else.


Sorry if this didn't come out very well as I use dictation software and it just doesn't say what I want it to say. I try to edit it but I may have made it worse.