Objective: To appraise current knowledge, screening and treatment habits on pain in multiple system atrophy (MSA) among allied healthcare professionals (HCPs).
Background: Pain is a frequent non-motor symptom in people with MSA1, but its recognition and management remain heterogeneous due to the lack of disease-specific screening tools and treatment guidelines2.
Method: Informed by the pre-existing literature, a panel of pain, movement and autonomic disorders experts developed a survey to ascertain prevalence and characteristics, screening and treatment habits on pain in MSA. The questionnaire was disseminated among HCPs through MSA professional and advocacy networks and was accessible online from January 7th to February 15th, 2026.
Results: One hundred and ninety HCPs accessed the survey. After removing duplicated and incomplete entries, 140 questionnaires were retained for final analysis. Participants were mostly doctors, nurses and physiotherapists (74%, 12% and 9%) based in Europe (85%) and North America (12%). According to HCPs, pain affected mostly the head/neck/shoulders, back, and legs (90%, 66%, and 56%,). Musculoskeletal, followed by pain due to postural deformities and dystonia (73%, 63% and 59%) were the most common types of pain. Pain detection relied on medical history (53%) and semi-structured questions (41%), while validated pain questionnaires were rarely used (8%). Pain was managed both by pain-specific pharmacological and non-pharmacological measures (85% and 81%) but also by adjusting the dopaminergic medications or optimizing the symptomatic treatment of non-motor features (56% and 61%). Gabapentinoids, antidepressants, and paracetamol were the most used medications (78%, 70%, and 63%), while physical therapy, massage, and mindfulness/relaxation the most common non-pharmacological approaches (85%, 43%, and 22%). Time constraints and the lack of disease-specific recommendations were the most common barriers for pain detection and treatment in daily practice.
Conclusion: Aligning the experience of persons with MSA, pain was reported to affect most the neck, shoulders, back and legs, with musculoskeletal pain being the most common type of pain1,3. Treatment habits partially diverged across HCPs’ and patients’ experiences1. The results of this survey, along with the patients’ experience and evidence from the pre-existing literature, will inform the development of tailored screening tools and treatment strategies for pain in MSA.
References: 1 Campese N, Göbel G, Wanschitz J, et al. Pain in Multiple System Atrophy: A Community-Based Survey. Mov Disord. 2024;39(10):1784-1798. doi:10.1002/mds.29961
2 Campese N, Caliò B, Leys F, et al. Pain in Multiple System Atrophy a Systematic Review and Meta-Analysis. Mov Disord Clin Pract. 2023;10(12):1738-1749. Published 2023 Oct 18. doi:10.1002/mdc3.13897
3 Campese N, Qamar MA, Chiriac MA, et al. Types of Pain in Multiple System Atrophy. Mov Disord. Published online January 24, 2026. doi:10.1002/mds.70194
To cite this abstract in AMA style:
N. Campese, B. Caliò, F. Leys, D. Bendetowicz, G. Calandra Buonaura, K. Ray Chaudhuri, E. Coon, JC. Curtis, G. Deuschl, G. Devigili, R. Eleopra, M. Fabbri, C. Falup-Pecurariu, R. Freeman, F. Gandor, G. Göbel, P. Guaraldi, G. Höglinger, H. Kaufmann, A. Pavy-Le Traon, J. Levin, S. Lorenzl, WG. Meissner, V. Mylius, MT. Pellecchia, W. Poewe, A. Schlager, A. Schrag, K. Seppi, M. Tinazzi, J. Wanschitz, L. Zamarian, A. Fanciulli. Pain in Multiple System Atrophy: a healthcare professionals’ survey [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/pain-in-multiple-system-atrophy-a-healthcare-professionals-survey/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/pain-in-multiple-system-atrophy-a-healthcare-professionals-survey/