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Multiple Sclerosis

Pain is more common in MS than has been recognized previously. The rates of pain vary in different studies, from 44% to 80%, depending on the sample and specific questions used to assess the incidence and severity of pain. Osterberg et al studied pain syndromes in 429 patients with definite MS; 58% of the patients reported pain during the course of their disease. One hundred patients (28%) had central pain, including 18 patients (5%) with trigeminal neuralgia. The majority of patients (87%) with central pain had symptoms located in the lower extremities, while 31% were in the upper extremities. It was mostly bilateral (76%) and constant. Aching, burning, and pricking were common qualities.

Other reported pain syndromes in MS include, Lhermitte’s sign, dysesthetic pain, back pain, headache and painful tonic spasms. Chronic pain in MS was found to have no significant relationship to gender, age of onset, disease duration or disease course. Chronic pain can have a significant negative impact on functions in persons with MS, such as the ability to engage in household work and psychological functioning. Chronic pain is significantly related to anxiety and depression in females. In the long-term care facility, residents with MS are more physically disabled and have more frequent pain. There also is a higher prevalence of pressure ulcers and depression than residents without MS.

Though pain is common, it is frequently overlooked in MS patients, and only one-third of MS pain patients are treated for pain.

Cannabis is now legally used in several states in the USA to treat pain, European studies indicate that cannabis-based medicines are effective in reducing pain and sleep disturbance in patients with multiple sclerosis-related central neuropathic pain and are mostly well tolerated. Oral ketamine, an NMDA receptor antagonist, has also been reported to be effective in the treatment of pain and allodynia associated with MS.

Meet the FLPNR Team

  • Richard Adkins, MD
  • Hoang (Wayne) T. Vu, D.O.
  • Lourdes Varela–Batista, M.D.
  • Vinh-Loc Nguyen, P.A.
  • Irene Aponte Moreno, N.P.
  • Sunny Park, N.P.
Anesthesiology Specialist in Ocala, FL Doctor of Osteopathic Medicine in Ocala, FL Physician in Ocala, FL Physician in Ocala, FL Nurse Practitioner in Ocala, FL Nurse Practitioner in Ocala, FL
Anesthesiology Specialist in Ocala, FL

Richard Adkins, MD

Anesthesiology Specialist

Dr. Richard Adkins has been in practice for more than 30 years. His specialty is in anesthesiology and pain medicine.

Doctor of Osteopathic Medicine in Ocala, FL

Hoang (Wayne) T. Vu, D.O.

Dr. Hoang (Wayne) T. Vu is board certified by both the American Board of Pain Medicine and the American Board of Physical Medicine and Rehabilitation. Dr. Vu earned his degree of Doctor of Osteopathic Medicine from Touro University College of Osteopathic Medicine in California in 2003.

Physician in Ocala, FL

Lourdes Varela–Batista, M.D.

Dr. Varela is a fellowship trained pain specialist and board certified PMR expert. Her specialities include physical medicine and rehabilitation and interventional pain medicine. She received her undergraduate degree from University of Puerto Rico and completed her medical degree from New York Medica College. Dr. Varela completed her physical medicine and rehabilitation residency at University of Texas Health Science Center San Antonio.

Physician in Ocala, FL

Vinh-Loc Nguyen, P.A.

Vinh-Loc Nguyen is a NCCPA certified physician assistant and is licensed by the State of Florida Department of Health. He received his Bachelor of Science degree in microbiology and Bachelor of Arts Degree in economics from University of Florida in 1994. He had a successful career in the financial industry before returning to his true passion for medicine.

Nurse Practitioner in Ocala, FL

Irene Aponte Moreno, N.P.

Ms. Irene Aponte Moreno is an Adult-Gerontology certified Nurse Practitioner and licensed by the State of Florida Department of Health. In 2014, she received her Master of Science degree in Nursing from the University of South Alabama. She completed her Bachelor of Science degree in Nursing from Jacksonville State University in December of 2006. In 2003, she received an Associates of Arts degree from Southwestern Michigan College. She also completed an Associate degree in Informatics from the University Institute Antonio Jose de Sucre located in Lara State, Venezuela.

Nurse Practitioner in Ocala, FL

Sunny Park, N.P.

Ms. Sunny Park is an AANP and ANCC certified Advanced Registered Nurse Practitioner, licensed by the State of Florida Department of Health. She graduated with Summa Cum Laude with Bachelor of Arts in Drawing from Southern Illinois University in 1999. She pursued nursing career and graduated with Associate of Science in Nursing in 2007 and started working as a registered nurse in Cardiovascular ICU in St.Luke’s Medical Center. She continued with her education and graduated with Magna Cum Laude obtaining Bachelor of Science in Nursing in 2010 from Cardinal Stritch University. During her nursing education, she was awarded multiple scholarships including the Lamplight scholarship by Milwaukee Nurses Association.


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