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Pain Management

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By Editorial Team

3 min read

Reviewed by: HU Medical Review Board | Last reviewed: July 2025 | Last updated: August 2025

Pain is a common symptom of neuromyelitis optica spectrum disorder (NMOSD). In fact, it occurs in more than 80 percent of people with the condition. NMOSD pain can be intense, and treatment approaches for pain are often limited. This has a significant impact on the quality of life for those living with pain from NMOSD.1

Living with chronic pain from NMOSD can be an uphill battle. But the right combination of medical and nonmedical therapies, along with building a support system, can help you manage your pain.1

Pain and stigma

Chronic conditions can be painful and isolating. Pain is a symptom that can carry stigma or negative judgment from others. Judgments can come from friends, family members, employers, or even doctors.2

Since others cannot judge your pain level just by looking at you, they may not understand your pain. These misunderstandings may lead them to stereotype you. This may make you want to hide your pain, making it even harder to live with.2

Medicines for pain

Neuropathic pain, or nerve pain, is often described as shooting, tingling, or burning pain and can, in some cases, be severe. This type of pain is common after an NMOSD attack. Some prescription medicines can help control this type of pain. Musculoskeletal pain (pain in the muscles and joints) is also common in people with NMOSD. Your doctor may use a combination of drugs to help ease pain associated with NMOSD.1

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Antidepressants

Some medicines used to treat depression may also help treat symptoms related to pain. There are many types of antidepressants available. Your doctor can tell you if this is a good treatment choice for you.1

Anti-seizure drugs

Medicines used to treat seizures may help treat some types of pain. These drugs work to decrease the excitability of nerve cells in the brain and spinal cord. They are also called anticonvulsants.1

Low-dose opioid drugs

Opioids are narcotic pain medicines. These drugs decrease the action of nerve cells in the brain. However, these drugs do not work well to manage nerve pain. Also, they can be dangerous and habit-forming, so they require close monitoring. If your pain is very severe, you may be referred to a pain medicine doctor or clinic to receive opioids.1

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that reduce pain and inflammation. They can help treat muscle pain from NMOSD, but they may not be effective at treating nerve pain. Examples of NSAIDs include naproxen and ibuprofen.1,3

Muscle relaxants

NMOSD may also cause spasticity (muscle stiffness) or painful muscle spasms. Doctors may prescribe medicines to help relax the muscles, which can help with this type of pain. Examples of muscle relaxants that may be used for NMOSD include baclofen and tizanidine. These drugs are also called antispasticity drugs.1,3,4

It is important to know that all drugs have side effects, and side effects vary depending on the specific drug you are taking. Some drugs listed above can have serious side effects. Talk to your doctor about the risks and benefits of each treatment before you begin taking it.

What other kinds of therapy might help?

Pain is more than just physical discomfort. Pain can lead to emotional, social, and spiritual distress. So, treatment strategies should focus on more than just physical pain relief. Nonmedical therapies to help you deal with pain may include:1,5-8

  • Biofeedback – This is a technique used to make subtle changes in your body. Biofeedback can help train your brain to react differently to pain.
  • Behavioral therapy – This therapy can help you think in a healthier way about pain and cope with it better.
  • Physical or occupational therapy – These therapies can improve pain and may help you become more able to perform daily activities.
  • Transcutaneous electrical nerve stimulation (TENS) – This treatment uses low electrical energy to locally relieve nerve pain.

Finding those who provide positive support

Building your emotional support network will help you live with NMOSD. While some people judge others who are in pain, many do not. It may be a challenge to determine who the supporters in your life are, but they are out there.1

If you are not getting the support you need and deserve, consider finding a support group. This group may be online or in person. Being surrounded by others who understand what you are going through can give you the emotional boost you need.1

Pain and NMOSD can go hand in hand. You may have good days and bad days. But with planning and adjustments, you can live a life full of meaning and purpose. Partnering with your doctor and surrounding yourself with your support team will help you find your own balance.1

The pain you are feeling is valid. If your body and mind are telling you that something is wrong, listen. Trust yourself and your personal experiences. You know your body best and what it is telling you.1

Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.