To determine the prevalence of chronic pain in people with multiple sclerosis (PwMS) and spasticity, and whether participation in an education and lower extremity stretching program (STC) is associated with a significant reduction in pain severity and interference after six months.

Over 50% of PwMS report chronic pain that interferes with daily activities, employment, and quality of life. Non-pharmacologic therapies, including exercise, are important for pain management. Spasticity is a known contributor to MS pain, but the effectiveness of stretching for pain, as commonly prescribed for spasticity, has not been investigated.

Sixty-six ambulatory PwMS and spasticity were randomly assigned to STC or a program focused on education and range of motion (ROM), both with two 2-hour group classes. At baseline, chronic pain prevalence was reported. At baseline and 6 months after the classes, pain severity and interference were measured with the Brief Pain Inventory – Short Form (BPI-SF). Reduction in scores between baseline and 6-months within each group was assessed using one-tail paired t-tests.

At baseline, 35 of 66 subjects (53%) reported chronic pain. Twenty-five of 35 (9 STC, 16 ROM) completed the BPI-SF at baseline and at 6 months. In STC, both pain severity and interference were significantly decreased at 6 months (severity mean change = -1.33, 90% CI= -2.61 to -0.053, t= -1.94, p=0.045; interference mean change = -1.57, 90% CI= -3.14 to -0.0009, t= -1.57, p=0.05).  In ROM, reductions were much smaller and not statistically significant (severity mean change = -0.17, 90% CI= -0.92 to 0.58, t= -0.40, p=0.35; interference mean change = -0.36, 90% CI= -1.11 to 0.39, t= -0.84, p=0.21).

Stretching exercise may help reduce pain severity and interference in PwMS and spasticity. A fully-powered study is needed to better understand the impact of different types of exercise on pain severity and interference in MS.