Does als cause pain?

YES: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative illness with progressive loss of motor neurons, muscle wasting, and respiratory dysfunction. As the disease progression, secondary symptoms can arise creating pain. Although not a primary symptom of ALS pain occurs in a substantial number of individuals.

Yes, not unusual: ALS can cause spasticity, spasms, muscular strains, etc due to the nature of the disease and often the pain does require aggressive analgesic intervention.