Is Hip or Knee Pain a Symptom of Multiple Sclerosis?

Here's what is causing your pain and how to manage it

Joint pain is a symptom of MS.
Joint pain is a symptom of MS.. SCIEPRO/Getty Images

Multiple sclerosis does not affect the joints directly, like other conditions such as rheumatoid arthritis, osteoarthritis, lupus or fibromyalgia, which can cause the degeneration of the cartilage or inflammation in the joints.

However, joint pain is very common in people with MS, specifically in the knees and hips. This pain is usually caused by people walking with an uneven gait (manner of walking).

The gait of a person with MS can be affected by:

In addition, if you rely on a cane or walker, this can also throw your gait off. A smooth, proper gait is a very delicate thing. Any disturbance in gait can cause the joints to be sore. For example, when experiencing the MS hug, you may clutch your side with one hand – after a full day of walking around like this, your knee and hip on one side might be a little sore.

Ways to Improve Your Gait

The good news is that you can do something to improve your gait and reduce associated joint pain. One study found that the gait of people with MS could be improved through resistance training after only 8 weeks, using regular, commercially-available resistance training equipment.

In addition to time in the gym, you may also want to consider taking up yoga. There aren’t many studies examining yoga’s effects on MS to rule it a slam-dunk symptom management tool. However, a pilot study had eight MS patients participate in a 12-week bi-weekly yoga program. At the end of the study, statistically significant achievements were made in fatigue, balance, step length, and walking speed.

Although sagittal plane pelvis and hip angles, ankle plantar flexor moment, powers generated at the hip and ankle joints at the pre-swing were improved, the improvements were nothing to celebrate — they were small.

Sometimes small changes make a difference. Since yoga is safe, it is worth considering as a pain management tool while science conducts larger studies to decide whether or not it will work for everyone.

In the meantime, if you are experiencing joint pain in your hips or knees (or anywhere else for that matter), ask your doctor about physical therapy. A physical therapist should be able to evaluate your gait and prescribe exercises to help you strengthen the right muscles. If you use a cane or other assistive device, the physical therapist can check to make sure that it is sized correctly for you and that you are using it correctly.

When Joint Pain Is a Side Effect

If you are using any interferon-based disease-modifying therapies, such as Avonex, Betaseron or Rebif, be aware that joint pain is a common side effect of these medications.

Make a special effort to notice if your joint pain is worse in the 24 to 48 hours following your injections and if it is more generalized (in your whole body), rather than concentrated in the knees or hips. Many people find that a non-steroidal anti-inflammatory drug, like acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) taken a couple hours before the injection and a couple hours afterward helps with these symptoms.

Sources:

Crenshaw SJ, Royer TD, Richards JG, Hudson DJ. Gait variability in people with multiple sclerosis. Multiple Sclerosis. 2006 Oct;12(5):613-9.

Guner S, Inanici F. Yoga therapy and ambulatory multiple sclerosis Assessment of gait analysis parameters, fatigue and balance. J Bodyw Mov Ther. 2015 Jan;19(1):72-81. doi: 10.1016/j.jbmt.2014.04.004. Epub 2014 Apr 16.<

Gutierrez GM, Chow JW, Tillman MD, McCoy SC, Castellano V, White LJ. Resistance training improves gait kinematics in persons with multiple sclerosis. Arch Phys Med Rehabil. 2005 Sep;86(9):1824-9.

Morris ME, Cantwell C, Vowels L, Dodd K. Changes in gait and fatigue from morning to afternoon in people with multiple sclerosis. J Neurol Neurosurg Psychiatry. 2002 Mar;72(3):361-5.

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