The pain is so hard to talk about as we fear the DIHALS folk complaining of their aches and pains.
Pain is not a 'symptom' of ALS Mike, that is completely true. The sensory nerves are not involved that is true. Early in ALS there is no pain, but as the muscles waste, especially if there is spasticity of the muscles, the pain is cruel.
The muscles that are wasting are shrinking, and so trying to use a limb with wastage can cause sudden severe cramps because muscles are not solitary creatures. eg to reach forward to pick up something in front of you involves many muscles, some contracting and some stretching. If one that needs to stretch has wasted, then the stretch causes pain, and often also causes a sudden cramp as the poor muscle can't take the stretch that is being forced on it by opposite muscles contracting.
I noticed how Chris's pain changed as his arm wastage progressed. eg while he had some use of his arms he would experience a lot of pain from the reasons above as he reached just a fraction to far forward, and would get shocking cramps in particular muscles (always the same muscles). As his arm wastage progressed further and he could no long lift his arm to reach forward, he no longer had pain or cramps in those particular muscles. However, the shoulder join pain increased as the shoulder froze more, and elbow pain started happening as they were no longer flexing often and as his hands drew in to claws the finger pain was plain cruel. When he finally let me start splinting his hands (would not allow it until he could no longer use them and they were very clawed) we were able to stem a lot of that finger pain if he would allow massage and splints on regularly.
We used panadol and oxynorm (liquid endone) for the pain, but he mostly refused anything other than panadol as he was paranoid about taking any opioids or opiates and preferred to sit in constant pain
Janie massage, ROM and positioning are really important for relieving pain as well as meds that you find work for you. eg when you sleep you may need to use pillows or wedges to help keep your legs and feet in better placement.
We also used a magnesium gel from Ancient Minerals to rub into painful muscles and joints. I've used it myself for some years, and the magnesium being absorbed directly into those areas does often help give some extra relief.