Hi,
I am 26 years old and have just been diagnosed with MS. I do not get to see a specialist for a couple months and there is so much going on with me that I don't know what to do. I too have so much joint pain that it hurts to do daily activities. My pain is mostly in my legs (Hips, Knees, Ankles). I do every once in a while get it it my elbows. I don't know if I should call my regular Dr, or if this isn't even related to the MS. Just looking for some input....thank you so much!

Not everything is related to MS, so if you have this pain and don't know whether or not it IS related to MS then the safe bet is always to call your doctor. It would be preferable to call your neurologist (if you have one) first, but lacking a regular neurologist, call your normal doc. I know when I had problems with pain and my neurologist wasn't giving me anything for it, my family doc did and man, did it make a world of difference!

Good luck with the pain! As CayoKay put it, "It sucketh!"



P.S. And sorry to hear about your recent diagnosis. Be kind to yourself for a while. it's a bit of a mental adjustment!

Hello, I have joint pain too. I like stretching and I take a mineral for anti-inflammatation (sp). As crazy as it sounds progesterone cream seems to help too. Good luck!

Hi Elizabeth! Welcome to NeuroTalk. I'm glad you joined the group.....there's lots of very caring and supportive people here.

Thank you for your help. I have called my regular Dr. and she did give me some pain medication. Unfortunatley it makes me sleepy so I can only take it at night. I am just dealing with things day by day until I can see someone. Again, thank you all!!

In addition to the tendon insertion point pain throughout the body there is also a REAL connection to the classic osteoarthritis (OA) and rheumatoid arthritis (RA). Since MS involves inflammation process and ALL the little ""thingies" that involves, it is NOT unexpected that other INFLAMMATORY conditions can pop up their ugly heads.

My greatest benefit from my supplement program to reduce MMP-9s has been the relief from my arthritis(OA). I have not used my crutches in over 8 years and my finger joints and thumb no longer cause me SEVERE PAIN.

This abstract from Lebanon says the the MMPs eat the "cartilage, tendon, and bone". Main problem is they eat the cartilage!!!
'

MMP = Matrix MetalloProteinases

1: Front Biosci. 2006 Jan 1;11:529-43.

Matrix metalloproteinases: role in arthritis.
Burrage PS, Mix KS, Brinckerhoff CE.
Department of Biochemistry, Dartmouth Medical School, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA.

The irreversible destruction of the cartilage, tendon, and bone that comprise synovial joints is the hallmark of both rheumatoid arthritis (RA) and osteoarthritis (OA).

While cartilage is made up of proteoglycans and type II collagen, tendon and bone are composed primarily of type I collagen.

RA is an autoimmune disease afflicting numerous joints throughout the body; in contrast, OA develops in a small number of joints, usually resulting from chronic overuse or injury. In both diseases, inflammatory cytokines such as interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) stimulate the production of matrix metalloproteinases (MMPs), enzymes that can degrade all components of the extracellular matrix. The collagenases, MMP-1 and MMP-13, have predominant roles in RA and OA because they are rate limiting in the process of collagen degradation. MMP-1 is produced primarily by the synovial cells that line the joints, and MMP-13 is a product of the chondrocytes that reside in the cartilage. In addition to collagen, MMP-13 also degrades the proteoglycan molecule, aggrecan, giving it a dual role in matrix destruction.

Expression of other MMPs such as MMP-2, MMP-3 and MMP-9, is also elevated in arthritis and these enzymes degrade non-collagen matrix components of the joints.

Significant effort has been expended in attempts to design effective inhibitors of MMP activity and/or synthesis with the goal of curbing connective tissues destruction within the joints.

To date, however, no effective clinical inhibitors exist.

Increasing our knowledge of the crystal structures of these enzymes and of the signal transduction pathways and molecular mechanisms that control MMP gene expression may provide new opportunities for the development of therapeutics to prevent the joint destruction seen in arthritis.

PMID: 16146751

These Lebanonese fools have obviously not read my postings.

jackD

"Things" that reduce MMP-9s (AKA gelatinase B)

This list of GOOD "things" for MS should seem familiar - This is WHY???

QUERCETIN..........................REDUCES MMP-9s

VIT D3 .................................REDUCES MMP-9s

RESVERATROL (Grape Skin Extract) ...REDUCES MMP-9s
(NOT GRAPE SEED EXTRACT)

GREEN TEA EXTRACT(EGCGs)... REDUCES MMP-9s

ALPHA LIPOIC ACID (R-lipoic/ R-Dihdro-LipoicAcid) ... REDUCES MMP-9s

NAC N-Acetyl-L-Cysteine .......REDUCES MMP-9s

STATIN DRUGS (i.e Zocor) .....REDUCES MMP-9s

Omega-3s (ie Fish oil) ...........REDUCES MMP-9s

Minocycline/Doxycycline.........REDUCES MMP-9s

Curcumin.............................REDUCES MMP-9s

Pycnogenol (Pine bark extract)..REDUCES MMP-9s

Chondroitin sulfate (CS) and CS plus glucosamine sulfate (GS) ..REDUCES MMP-9s

Interferon Betas 1a/1b...........REDUCES MMP-9

(of course Steroids ....REDUCES MMP-9s)


P.S. Lowering the MMP-9s will greatly help your MS also.


1: Neuroscientist. 2002 Dec;8(6):586-95.

Matrix metalloproteinases and neuroinflammation in multiple sclerosis.

Rosenberg GA.
Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131, USA. grosenberg@salud.unm.edu

Matrix metalloproteinases (MMPs) are extracellular matrix remodeling neutral proteases that are important in normal development, angiogenesis, wound repair, and a wide range of pathological processes.

Growing evidence supports a key role of the MMPs in many neuroinflammatory conditions, including meningitis, encephalitis, brain tumors, cerebral ischemia, Guillain-Barré, and multiple sclerosis (MS).

The MMPs attack the basal lamina macromolecules that line the blood vessels, opening the blood-brain barrier (BBB).

They contribute to the remodeling of the blood vessels that causes hyalinosis and gliosis, and they attack myelin.

During the acute inflammatory phase of MS, they are involved in the injury to the blood vessels and may be important in the disruption of the myelin sheath and axons. Normally under tight regulation, excessive proteolytic activity is detected in the blood and cerebrospinal fluid in patients with acute MS. Because they are induced in immunologic and nonimmunologic forms of demyelination, they act as a final common pathway to exert a "bystander" effect.

Agents that block the action of the MMPs have been shown to reduce the damage to the BBB and lead to symptomatic improvement in several animal models of neuroinflammatory diseases, including experimental allergic encephalomyelitis. Such agents may eventually be useful in the control of excessive proteolysis that contributes to the pathology of MS and other neuroinflammatory conditions.

PMID: 12467380

WHAT IS A MMP??

ans:
Simply put MMPs are a family of about 27 (mmp-1 to MMP-27) enzymes that share a common characteristic function and structure of cutting "THINGS" up into little pieces.

Unfortunately for MS folks they (MMP-9s) like to cut a hole in our BBB Blood Brain Barrier and then enter the brain and cut our myelin into three components that the other hungry characters like to dine on.

They (MMPs) all have a zinc ion tip that allows them to break down hydrogen bonds in tissue thus allows absorption of dead or dying tissue to be reabsorbed or sent via the lymph system to others places to exit out the poop shoot.

The MMP-9s usually have an accompanying regulator protein that is suppose to make sure that it only "eat/cuts up" BAD stuff. This is called a TIMP-1. For NORMAL folks there is a one-to-one ratio of MMP-9 to TIMP-1s.

Sad to say for us MS folks that we have lots of MMP-9s that I call ROGUE MMP-9s that have no accompanying regulating timp-1. Just before and during a MS relapse the total MMP-9s level rise significently. The first thing they do is cut a BIG hole in our BBB Blood Brain Barrier!! They then enter and do the following...

They just wander around the brain cutting up anything "active" and when they run into an active transmission cable the eat through it, The outside of that cable is called myelin. (a fatty insulating substance)

The advantage of taking an Interferon Beta is that after about 4 to 6 months of starting beta treatment that the ratio of MMP-s to TIMP-1s goes back to the desirable one-to-one ration.

There are NO effective drugs to lower just MMP-9s. Some drugs were developed but they shut them all (all 27) down and killed the host.

Some antibiotics seem to lower MMP-9s quite well but taking those for long periods of time can be deadly. Likewise taking some steroids can lower the MMP-9s quite well but can be equally deadly over the long haul.

http://www.nationalmssociety.org/abo...ain/index.aspx

CLICK ON THIS LINK FOR IT HAS MUCH MORE INFORMATION THAN JUST PROVIDED HERE

Pain syndromes are common in MS. In one study, 55% of people with MS had “clinically significant pain” at some time. Almost half (48%) were troubled by chronic pain. This study suggested that factors such as age at onset, length of time with MS, or degree of disability played no part in distinguishing the people with pain from the people who were pain free. The study also indicated that twice as many women as men experienced pain as part of their MS.

Several Sources and Types of Pain in MS

Acute Pain

Trigeminal neuralgia is a stabbing pain in the face. It can occur as an initial symptom of MS. While it can be confused with dental pain, this pain is neuropathic (caused by damage to the trigeminal nerve) in origin. It can usually be treated with medications such as the anticonvulsants carbamazepine (Tegretol®) or phenytoin (Dilantin®).

Lhermitte’s sign is a brief, stabbing, electric-shock-like sensation that runs from the back of the head down the spine, brought on by bending the neck forward. Medications, including anticonvulsants, may be used to prevent the pain, or a soft collar may be used to limit neck flexion.

Burning, aching or “girdling” around the body are all neurologic in origin. The technical name for them is dysesthesias. These pains are often treated with the anticonvulsant medication gabapentin (Neurontin®). Dysesthesias may also be treated with an antidepressant such as amitriptyline (Elavil®), which modifies how the central nervous system reacts to pain. Other treatments include wearing a pressure stocking or glove, which can convert the sensation of pain to one of pressure; warm compresses to the skin, which may convert the sensation of pain to one of warmth; and over-the-counter acetaminophen (Tylenol® and others) which may be taken daily, under a physician’s supervision.

Duloxetine hydrochloride (Cymbalta®) was approved by the FDA in 2004 for treatment of depression and treatment of pain associated with diabetic peripheral neuropathy. Cymbalta® belongs to the group of medications known as selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Although not specifically approved for use in MS, its effectiveness in diabetic neuropathy makes it a suitable candidate for the treatment of neuropathic pain in MS, and MS specialists consider it a good treatment option for people with MS.

Pregabalin (Lyrica®), also approved by the FDA in 2004, is recommended for the treatment of neuropathic pain associated with diabetes, fibromyalgia and certain types of seizures. Although not specifically approved for use in MS, it is also considered a good treatment option for people with MS.
Chronic Pain

Burning, aching, prickling or “pins and needles” may be chronic rather than acute. The treatments are the same as for the acute dysesthesias described above.

Pain of spasticity has its own subcategories. Muscle spasms or cramps, called flexor spasms, may occur. Treatments include medication with baclofen (Lioresal®) or tizanidine (Zanaflex®), ibuprofen, or other prescription strength anti-inflammatory agents. Treatment also includes regular stretching exercises and balancing water intake with adequate sodium and potassium, as shortages in either of these can cause muscle cramps. Tightness and aching in joints is another manifestation of spasticity, and generally responds well to the treatments described above.

Back and other musculoskeletal pain in MS can have many causes, including spasticity. Pressure on the body caused by immobility, incorrect use of mobility aids, or the struggle to compensate for gait and balance problems may all contribute. An evaluation to pinpoint the source of the pain is essential. Treatments may include heat, massage, ultrasound, physical therapy and treatment for spasticity.

Pain and the Emotions

Most pain in MS can be treated. But not all pain a person with MS has is due to MS. Whatever the source, pain is a complex problem that should not be ignored. Many factors may contribute, including fear and worry. A multidisciplinary pain clinic may be able to treat chronic disabling pain with medication in combination with such alternative therapies as biofeedback, hypnosis, yoga, meditation or acupuncture. Self-help may also play an important role in pain control. People who stay active and maintain positive attitudes are often able to reduce the impact of pain on their quality of life.

Good post; I'm not dxd with MS, but have much joint pain, stiffnes, sometimes in tears...I'm stretching to try to loosen up, but still wish I could move better
Thanks for all the info...

I believe that I have MS. I haven't been formally diagnosed yet, but have an appt. on Wednesday. I have been diagnosed with carpal tunnel, arthritis and CFS. In the last month I have been experiencing muscle stiffness in my legs and lower back which make me walk funny, ringing in my ears, and being "dingy" as my husband and kids say. This morning when I got out of bed the heel on my left foot was very painful. The pain got less severe as the morning went on, but it is still there. I am so worried that I will go for years without being formally diagnosed. I am trying to ease pain and symptoms by diet and exercise, but some days I can't exercise because my body won't let me be coordinated!

I have had the same kind of pain in nearly every joint in my body for years. I have also been tested for everything on earth and nothing (except ms). My doc says it is unusual for someone my age to this kind of joint pain. I am 41, granted not a spring chicken but I have had this for years. I do know I have a little arthritis in hte knees but no explaination for the rest other than ms sx.