Pain can be associated with stiffness or spasms in muscles, or symptoms like Lhermitte's sign, trigeminal neuralgia or optic neuritis. It may also include symptoms affecting the senses that are not always thought of as ‘pain’, like numbness or pins and needles, or a tightness in the chest known as the 'MS hug' or 'MS girdle'. Pain can be one of the most difficult 'invisible’ symptoms to describe and manage. Only the person experiencing it knows how it feels. It has an emotional element – it can cause distress, fear, anger and frustration, which in turn affect how you deal with it.