What treatment options are available for pain?

ALS is generally not a painful condition, as the sensory nervous system is not affected. Nevertheless, pain can occur in ALS. Paralysis (paresis) and muscle wasting (atrophy) can lead to increased mechanical stress on joints, tendons, and bony structures, as well as pain related to movement and body position.

Exercise therapy (e.g., physical therapy) and improved positioning techniques (e.g., orthotics) are used to reduce the causes of pain. If complete pain relief cannot be achieved through these methods, targeted medication may be prescribed. Treatment begins with anti-inflammatory medications (diclofenac, ibuprofen, novalminsulfon, etc.). The next stage of pain management involves opioid-containing medications (tramadol, tilidine, etc.) and, in some cases, opioids (morphine, fentanyl, etc.). In pain management, the treatment goals (pain reduction) must be weighed against the expected side effects (e.g., constipation or daytime drowsiness).