Nonparoxysmal central pain

This is probably the most common neurogenic pain manifestation in MS. It is typically burning and/or aching in quality4'5'7'11 and often anatomically extensive (e.g. from the waist down). Although it is impossible to exclude supraspinal mechanisms in the genesis of pains of this sort, it seems likely that demyelinating myelopathy is the primary cause in most cases. This may be inferred from the similarity of the pain to that described in many cases of traumatic spinal cord damage with no evidence of rostral neural injury.18 This type of pain is much more common in the lower extremities than the upper. A characteristic complaint is of a sensation of constriction of the painful territory, like wearing a tight corset or an undersized boot. Allodynia undoubtedly occurs but is uncommon in the author's experience and most published material.

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