A 54 year old female patient, born in 1959, was diagnosed suffering from primary progressive multiple sclerosis more than 10 years ago, and retrospectively symptoms started already in 1992. She underwent various operations (3 times) to correct a fixed kyphosis and 2 years ago started to suffer from increasing pains and muscle spasms. She was treated with Cannabis, and clonazepam, but these therapies increased her problems, or induced side effects. She was unwilling to treatments with opoids or botulinum toxin and the first time we saw her, her painscore was 8-9 over 10 on the NRS. We started palmitoylethanolamide (PeaPure) three times daily and increased the dose after 2 weeks to 2000 mg/day in order to reach the optimal dose of 30 mg for each kg bodymass. At 3 times 400 the pains were reduced 30% compared to baseline, and patient could titrate up to 5 capsules a day, resulting in a reduction for more than 50% on the NRS. If she decreased the dose, pain increased, and repeatedly 3 times 400 mg lead to a 30% reduction on pain, while higher doses had greater analgesic effects.