It is a demyelinating disease involving the central nervous system. Onset is usually seen mostly after the second decade of life. Prevalence in Europe is 4–8/100 of population. Various pain syndromes are seen in multiple sclerosis. Most commonly seen are paraesthesias. The pain felt may be continuous or paroxysmal. Paroxysmal pain responds better to anticonvulsants. Continuous pain is typically of burning or aching type and seen more in lower extremities than in upper extremities. It responds better to antidepressants and NMDA receptor antagonists. Trigeminal neuralgia is commonly seen. It is seen at a younger age and is mostly bilateral. It responds well to medical management but is refractory to surgical intervention. Patients may present with spasticity due to the involvement of corticospinal or corticobulbar tracts. A classical sign is Lhermitte’s phenomenon seen due to involvement of the dorsal horn. Painful muscle spasms are seen on flexion of the neck, spreading down to the back and legs. Headaches may be seen during the course of illness. The most common location of pain are the legs, hands and feet. Optic neuritis may be seen. One third of patients become disabled due to involvement of the musculoskeletal system.