Is ALS associated with pain?

In general, the degeneration of motor neurons is not associated with pain. Technically, this makes ALS a “painless” disease. Although the sensory nervous system is spared, some patients experience pain of varying intensity.

Typical and common pain results from uncontrolled muscle tension (spasticity), pain upon pressure in muscles, tendons, and joints (due to lack of mobility), tendon shortening (contractures), and improper strain on the musculoskeletal system and joints. The loss of muscle mass (myatrophy) and body mass (adipose tissue due to malnutrition) can also lead to joints, tendons, and bones—which were previously protected by muscle and adipose tissue—being subjected to greater stress and experiencing painful irritation.

Managing pain and providing targeted treatment through medication, as well as through physical therapy, therapeutic exercise equipment, and assistive devices, is an important treatment goal for people with ALS.