Low Back Pain in Multiple Sclerosis: A Systematic Literature Review

Objective(s): Multiple Sclerosis (MS) is a progressive neurodegenerative disease that affects approximately 1,000,000 individuals in the United States. Pain is common in MS and can manifest in varied fashion and intensity. One of the most common types of pain is musculoskeletal pain including low back pain (LBP), also known as nociceptive pain in MS. Although LBP is frequently reported in people with MS, there is a discrepancy in the literature concerning its prevalence, limited data on its etiology, and treatment options. The purpose of the present study is to review the literature focusing on LBP in MS, including its prevalence, etiology, and treatment options.

Data Sources: We searched the datasets, including Pubmed, Embase, Web of Science, Ovid, CINHAL, CENTRAL, and Scopus, using keywords such as Low back pain, and multiple sclerosis, limited to 2000-2024 (April), and English literature.

Study Selection: All original study designs, including epidemiological, observational, clinical studies, or trials that involved adult human participants with a confirmed diagnosis of MS which they considered LBP, were included. All reviews, book chapters, or protocol studies without results were excluded. A total of 4696 studies were found in the initial search, of which 16 articles were selected according to the purpose of this study.

Data Extraction: Among these 16 studies, 14 studies were related to the prevalence of LBP, and two articles were related to the treatment of LBP in people with MS (pwMS). Data related to the prevalence of low back pain in pwMS and the methods of low back pain treatment in these people were extracted.

Data Synthesis: The prevalence articles, included 3661 pwMS with a mean age of 40.36 and more women. The prevalence of LBP in MS was reported between 13.78% to 76.4%. Two studies reported treatment interventions, including Transcutaneous Electrical Nerve Stimulation (TENS) or electrical stimulation. None of these treatments were reported as significant or clinically effective.

Conclusions: LBP is common in pwMS. The etiology of LBP is unclear and there is no solid or tentative treatment option to treat people with LBP and MS. Roboust studies to evaluate the difference between the etiology of LBP between pwMS and the general population and appropriate treatment option is warranted in the future.

Author(s) Disclosures: This work was supported in part by a Mentor-based Rehabilitation Research Post-doctoral fellow grant and other funding from the National Multiple Sclerosis Society (MB-1807-31633; RG-1701-26862), and MS Run the US.