Link between symptoms and lesions

I possibly haven’t read or understood the information correctly, but are symptoms of MS always related to new lesions? Or can you get symptoms from old/existing ones? My last MRI scan didn’t show any new lesions, so I assumed that meant the MS wasn’t currently active - can anyone confirm if that is correct?

Having no technical knowledge, I do not know the answer to your question.

For what it’s worth, my vague understanding is that any permanent damage left behind when a relapse has largely (but not completely) resolved will tend to hamper the smooth transmission of nerve messages for ever after. It’s a bit like a motorway that has been reopened after being shut by an accident, but with one lane still restricted. So the traffic can flow again, but not as smoothly and not as fast as before.

In my own experience, this means that, where there’s old damage that isn’t obvious day to day, the related bits will temporarily stop working sooner than the less damaged bits if I’m ill or get (for instance) overheated or overtired. Back to the motorway with the lane restriction: on a nice quiet day it runs more or less OK and you wouldn’t think there was a problem; heavy traffic or - worse - another accident, and it’s a different story.


I wish someone knew the answer to this… I am in so much pain at the moment, but I don’t want to go and see anyone about it. I can’t bear the thought of stripping off and as for physical touch, forget it… Taking painkillers for inflammation, have tried Amitriptyline for neuropathic pain but it just knocks me out so bad, I can’t function for about 3 days after taking it (not good for continuing to go to work or driving).

Would anyone on the helpline be able to answer this question? I haven’t found the courage to ring them yet.

I don’t know the answer either. I’m sorry. It sounds like you’re miserable with the symptoms you have.

I’m not convinced that a relapse always results in a lesion. A relapse definitely has a connection with a demyelinating period of inflammation though. I suspect this doesn’t always leave a scar, which is essentially what a lesion is (I think).

But with regard to your current pain, ordinary painkillers like paracetamol or ibuprofen won’t help. Cocodamol might help a bit (because of the codeine), but that doesn’t always help everyone. And you could be having pain that’s not even related to a current relapse.

Amitriptyline is a very good neuropathic painkiller, but you need to time it right. Take it by 7 pm in the evening, by the morning the drug should have metabolised in your system and you shouldn’t get a ‘hangover’ from the drug. And generally, it doesn’t have an effect days later because it’s life in the body just isn’t that long.

It might be worth giving in one more try, just be sure to take it early enough.

But if it doesn’t suit you, then it just doesn’t. Have you tried Gabapentin? Or Pregabalin? Or anything else?

Is your pain stopping you from sleeping? That will have an effect the next day. If you’ve been having spasms overnight, the effect the following day might be causing more pain, just as a result of spasms. If so, you could try something that will help you sleep as well as stop spasms. Like Cloneazepam, or even Diazepam.

Maybe you should see your GP and ask what drugs s/he is able to prescribe to help. If it makes it easier, see or speak to your MS nurse first and ask him/her to contact your GP surgery and suggest drugs to help you.

I hope some of this helps, the original question about lesions may be less important than just simply some help with your pain.


So I rang the MS helpline and they were very good. Sent me some information that answered my original question, but also just threw up more questions! But reading the material they sent was helpful.

@Sssue – no I haven’t tried Gabapentin or Pregablin. I think my next stop will have to be GP and/or MS Nurse. I was hoping to be able to take something which would act as both a painkiller and anti-depressant so that I don’t have to be on different lots of meds.

Last week I had (what I now assume from reading on here) to have been a silent migraine. I’ve had ordinary migraines in the past with visual aura then headache, but never just the visual aura on its own. It only lasted about 20 minutes and then went off, but because most of my MS problems have been with my vision, it was quite disturbing to have something new happen.