“What does it mean if I have leg pain that feels like a bruise, but no bruising is evident?” one MyMSTeam member asked. If you’re living with multiple sclerosis (MS) and experience mysterious leg pain, you’re not alone.

MS is a neurological condition that can send random and painful messages between the brain and the body — sometimes for no reason. Although MS is best known for causing muscle spasticity, tingling, chronic pain, the “MS hug,” numbness, and fatigue, it also causes people to experience paresthesia — altered sensations. When you have leg soreness without a bruise, it may be challenging to determine whether what you’re experiencing is one of the signs of MS.

Read on to better understand the “invisible bruise” sensation and how to tell if you’re experiencing paresthesia.

MyMSTeam Members Describe Painful Altered Sensations

Many members of MyMSTeam have described painful paresthesia, like burning, shocking, and stabbing sensations. They might arrive out of the blue, or they could be triggered by an outside factor. One type of paresthesia is called allodynia. This pain is caused by something that doesn’t normally create pain — like a rough fabric or a light touch. Another type of paresthesia is called dysesthesia. This term describes a painful abnormal sensation that usually occurs in the legs or abdomen of people with MS.

One member discussed the invisible bruise sensation: “I noticed about a week ago that my lower legs around my calf are sore to the touch,” they explained. “The best way I can describe it is the type of pain you feel when you’ve bumped into something and get a really bad bruise. But I don’t remember bumping into anything, and my skin isn’t bruised at all!”

Others explained the same phenomenon further. “I experience leg pain in the same area! Sometimes it is almost like the start of a charley horse — but my legs and feet are always in pain!” One member described it as “tender to the touch and tender to pressure.” Another suggested, “I recognize that tender-to-the-touch, slight pain you speak of. Could it be swelling? That’s what it is with me.”

Some members say their pain feels more like a severe spasm or cramp, while others compare it to shin pain that’s different from shin splints.

Leg pain in MS may occur for many reasons, and everyone experiences it differently. The next time you experience pain, ask yourself the following:

• Did anything trigger it?
• What does it feel like?
• How long does it last?
• Does anything help to resolve it?

This information can help you uncover patterns in your paresthesia and take steps to prevent and manage it.

Common MS Paresthesia Symptoms

Common descriptions of paresthesia include feelings of:

• Itching
• Pins and needles
• Wetness or trickling
• Stabbing or prickling
• Static tingling
• Burning

Most of the time, these sensations aren’t triggered by anything in your environment, so you won’t see any signs of what’s causing your discomfort. Whether it’s an invisible bruise or the feeling of something crawling on your skin, these sensations can be disturbing. However, just knowing that paresthesia is one of the common symptoms of MS can help you better handle it in the future.

What Causes Altered Sensations in the Legs?

There are several reasons why someone with MS might experience feelings of soreness, pressure, or pain in their legs and feet. As a disease of the brain and spinal cord, MS disrupts the messages sent between your brain and body.

MS damages the myelin (protective layer) around each nerve cell. This process is called demyelination. Like live wires without a rubber coating, demyelinated pathways may be more prone to picking up and sending random signals to the brain. Your brain cannot distinguish these abnormal signals from more familiar outside sensations, such as the feeling of having a bruise.

Some people with MS experience leg pain due to muscle spasms. Although spasms can affect any part of the body, the legs are among the most common areas where this occurs. “I get the twitchy muscle spasms in both of my calves,” one MyMSTeam member wrote. “This is a daily event.” Another member said, “Mine are very bad — it feels like something jumping inside my leg.”

One study found that half of people living with MS experience some — not necessarily painful — abnormal sensations. Researchers have found this was true whether individuals had an early, mild form of MS or if they had more severe MS.

Managing Neuropathic Pain and MS

You can manage these altered sensations without relying solely on neuropathic medications by trying the following:

• Managing other MS symptoms
• Using cold, heat, and compression
• Engaging in meditation and physical activity
• Seeking mental health support

Managing Other MS Symptoms

Paresthesia can be a residual (leftover) symptom from previous attacks, but it can also represent a new relapse, especially if it affects a part of your body that had not been attacked in the past. One MyMSTeam member said, “I experience leg pain when my MS starts to act up.”

Speak to your neurology expert about all of your MS symptoms, including specific altered sensations. It may be hard for you to tell the true cause of your leg pain. As one MyMSTeam member suggested, “I would advise only medical opinion because all cases are different.”

By sharing new symptom information with your neurologist, you and your health care team can adapt your treatment plan to your unique needs.

Cold, Heat, and Compression

For some people, using hot or cold packs can bring temporary relief from uncomfortable altered sensations. Applying heat can help relax tense muscles, while cold packs may numb the area, reducing the intensity of nerve pain. Some people find that alternating between heat and cold provides the best relief for their MS-related discomfort.

If you suspect your pain could be linked to swelling, compression socks may help. “My primary care provider had me start wearing them for my leg pain, and it made a big difference for me,” wrote one MyMSTeam member. “They even made me feel a little less fatigued.”

Meditation and Physical Activity

Consider practicing mindfulness meditation, a physical and psychological technique that has been linked to greater awareness and control over one’s physical sensations.

Physical activity has also been shown to reduce MS paresthesia. One MyMSTeam member suggested light exercise to counteract stiffness and pain in the legs: “My leg pain was caused by inactivity and constant sitting, so my circulation was limited and blood settled in my lower legs.”

Research studies have confirmed the benefits of exercise for MS pain relief. Physical activity reduces paresthesia, as well as many other symptoms, for people with MS.

Mental Health Support

Mental health problems have been linked to worse MS symptoms. Don’t hesitate to seek out counseling — it’s important to have your experiences validated as you face this chronic condition. In one study, researchers found that cognitive behavioral therapy — a form of talk therapy — provided long-term improvements in MS pain and symptom severity, as well as quality of life.

When To Worry About Leg Pain

Leg pain with MS isn’t usually a sign of a serious MS complication, but it’s still important to mention it to your neurologist. Tell your doctor about any uncomfortable or painful sensations in your legs. They can provide guidance and possibly treatment options to help.

If you’re experiencing any unusual symptoms of MS, others have likely had a similar experience. One member said, “It’s all totally normal! It happens to most of us, promise!” If you’re part of an online support community like MyMSTeam, you can also reach out for support and tips from others who’ve faced this common MS symptom.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 216,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you experienced sore legs while living with MS, or it felt like you had a bruise but nothing was there? Have you spoken to a health care provider about painful sensations? What advice do you have for other people living with MS? Share your story in the comments below, or start a conversation by posting on your Activities page.