ASSOCIATION BETWEEN SPASTICITY AND PAIN INTENSITY IN MULTIPLE SCLEROSIS PATIENTS

Abstract

Background: Multiple sclerosis (MS) is a chronic autoimmune disorder affecting the central nervous system, leading to neurodegeneration, disability, and a range of debilitating symptoms. Among these, spasticity and pain are highly prevalent, significantly impacting patients' quality of life. Spasticity, characterized by involuntary muscle stiffness and spasms, often exacerbates pain, further limiting mobility and daily activities. Understanding the relationship between these symptoms is crucial for improving symptom management and optimizing therapeutic interventions for individuals living with MS.

Objective: This study aimed to assess the association between spasticity and pain intensity in individuals diagnosed with multiple sclerosis.

Methods: A cross-sectional study was conducted over six months at multiple tertiary care hospitals, including the University of Lahore Teaching Hospital, Jinnah Hospital, Services Hospital, and Central Park Teaching Hospital. A total of 171 MS patients were recruited using a non-probability purposive sampling technique. Spasticity was measured using the Modified Ashworth Scale (MAS), while pain intensity was assessed using the Visual Analogue Scale (VAS). The association between spasticity and pain was evaluated using the Chi-Square test, with statistical significance set at p<0.05. Data analysis was performed using SPSS version 20, and demographic details, as well as symptom severity, were analyzed through descriptive and inferential statistics.

Results: The study included 171 MS patients, with a mean age of 31.44±7.979 years. Among them, 103 (60.2%) were female, and 68 (39.8%) were male. Spasticity was observed in varying degrees: mild (24.0%), moderate (38.0%), and severe (38.0%). Pain intensity assessment revealed that 21 (12.3%) patients had no pain, 53 (31.0%) experienced mild pain, 56 (32.7%) reported moderate pain, and 41 (24.0%) had severe pain. The Chi-Square test demonstrated a statistically significant association between spasticity and pain (p=0.000), confirming that increased spasticity levels correlated with heightened pain intensity in MS patients.

Conclusion: The study established a strong association between spasticity and pain intensity in multiple sclerosis patients, emphasizing the need for comprehensive symptom management. Patients with higher spasticity levels were more likely to experience severe pain, highlighting the importance of integrated treatment approaches. Targeted interventions combining pharmacological management, physiotherapy, and rehabilitative strategies are essential to improving the quality of life in individuals with MS.