Sudden pains are common with multiple sclerosis (MS). You might get a shocking, burning, squeezing, stabbing, cold, or prickly feeling out of nowhere. Some people call them zingers or stingers. These zaps usually last only seconds or minutes. They often affect your legs, feet, arms, and hands.
Random zingers aren’t a sign your MS is getting worse. But see your doctor if you get new symptoms or they last for more than 24 hours. This can be a sign of a new lesion (damage to your nervous system) or relapse.
You might not need treatment. But check with your doctor if zingers get in the way of your daily life or make it hard to sleep. Lifestyle changes or medication can help.
What Are Zingers?
They’re basically a “short circuit.” MS damages the insulation around the nerves in your brain and spinal cord. This protective cover is called myelin. When it doesn’t work the right way, your brain can’t send clear signals to the rest of your body. You end up with a glitch that causes sensations doctors call dysesthesias.
Here are some reasons you might get zingers:
Lhermitte’s sign. This is the name for a quick electric shock-like feeling that goes from the base of your neck down your spine and into your arms and legs. The buzzing might spread to your fingers and toes. Lhermitte’s tends to happen when you bend your head toward your chest, like when you sneeze or pick something up off the floor.
This zinger might be your first sign of MS. So see your doctor if you’ve never had one before. It should happen less often and get weaker over time.
Heat or cold sensitivity. You might feel worse during the summer, when you have a fever, or when you exercise. That’s because heat, humidity, or a rise in body temperature can make it harder for signals to move through your nerves.
It’s less common, but you might also get zingers in winter or when chilly water or an icy breeze hits your face.
Trigeminal neuralgia. This is a stabbing ache on one side of your face. You might confuse it with a bad toothache, but it could be the most intense pain of your life. It’s hard to predict when it’ll happen, but some causes include brushing your teeth, eating, or low temperatures.
Spasticity. You might feel this as tightness around your chest. That's sometimes called an “MS hug.” It can seem like a heart attack the first time it happens. Sometimes, your legs get stiff or painful all of a sudden, especially at night.
Nondrug Treatment
Your chances of zingers go up in certain situations, like when you’re hot, tired, or stressed out. Your symptoms will likely ease when you remove your triggers.
Here are some ways to feel better:
Cool off. If heat makes you feel worse, do things like:
- Get inside, or stay close to air conditioning.
- Wear cooling gear, like vests, neck wraps, or hats.
- Drink cold fluids.
- Exercise in the morning or evening.
- Swim in cool water.
- Take a cool bath or shower.
If you do get overheated -- like when you exercise -- remember that you’re not really hurting yourself. You’ll likely feel better a few hours after you cool down.
Don’t get too cold. You’re less likely to have a problem with the cold. But if you do, wash with warm water. Bundle up when you go outside in the winter. And protect your face and head from blasts of cold air. That can trigger pain from trigeminal neuralgia.
Take it easy. Many people with MS say their symptoms feel worse when they’re stressed out. You can learn to manage stress, even if you can’t get rid of it. If you’re not sure where to start, talk to your doctor or a mental health specialist.
To relax your muscles and mind, try:
- Mindfulness and meditation
- Yoga
- Acupuncture
- Deep breathing
- Progressive muscle relaxation, in which you tense each muscle, then release it
- Cognitive behavioral therapy with a counselor
Stretch. Your muscles can tighten as you relax at night. You might be able to prevent theses spasms if you stretch for 5 minutes or so before bed. Keep some resistance bands handy if you need to stretch in the middle of the night.
Connect with others. Sometimes, it helps to talk with people who are going through the same thing. Call 800-344-4867 to find MS groups in your area. You can also visit MSsociety.org/supportgroup to find a support group, or you can connect with people online through MSconnection.org.
Medical Treatment
Medicine might be right for you if your symptoms happen several times a day and lifestyle changes don’t help. You may need to take it only at certain times, like during summer, periods of high stress, or before bed. Talk with your doctor about that.
Your doctor might recommend:
Antidepressants. These can dampen the electrical signals from your nerves. That changes how your body responds to pain. For MS, you might get:
Anticonvulsants. These calm overactive nerves. Some of them include:
- Gabapentin
- Pregabalin
- Carbamazepine for trigeminal neuralgia
- Oxcarbazepine for trigeminal neuralgia
Muscle relaxers. You can take these before bed if stretching doesn’t help. You might need them more often if you get tightness several times a day.
Surgery for trigeminal neuralgia. If other treatments don’t help, your doctor can remove or burn certain nerves. That’s called ablation. You might have some numbness in your face after the procedure. It’ll feel similar to getting a shot at the dentist. It might take a few months or so for your feeling to come back.
Are Zingers Dangerous?
These sudden pains can come as a shock, literally, but they’re not harmful. Talk to your doctor if you don’t know what’s causing your symptoms. They can prepare you for future zingers and find out if something more serious is going on.
Here are some questions your doctor might ask:
- How often do you get zingers?
- What do they feel like?
- What possible triggers happened around the same time?
- Do they bother you only at bedtime?
