Symptom Management

Give Me A Hug, But Not an MS Hug

By MSF Staff and reviewed by the Multiple Sclerosis Foundation Medical Advisory Board

As a rule, most people agree that a hug is warm greeting in a cold world. But there are exceptions to every rule – and in this case that exception is the MS Hug. 

The MS Hug is the name given to a “band-like” sensation that feels like a tight strap or girdle wrapped around the torso area. This sensation, which can be felt from as low as the waist to as high as the neck or jaw, is the result of the tiny muscles between the ribs – known as intercostal muscles – going into spasms. While small, these muscles are important because they help to keep the ribs in place, while also allowing for flexibility and movement.

The severity and sensation of the MS Hug may vary from person to person.  Some may describe a constricting sensation or intense pressure, whereas others may experience a tickling or tingling feeling, a sharp, dull, or burning pain. These sensations may be localized or spread throughout the torso area. Rarely, this sensation can become so severe that it may interfere with breathing and cause chest pains, similar to the feelings caused by a panic attack or a heart attack. Stress, fatigue, and an increase in core body temperature can trigger this symptom, which may last a few seconds or persist for minutes to hours or longer.

The MS Hug is not specific to MS. It can also occur with spinal cord inflammation, as in transverse myelitis. If you are experiencing the MS Hug, talk to your doctor. An MRI may be required to rule out other conditions, such as heart or gallbladder problems, lung disease, gastro-intestinal disorders, or inflammation of the cartilage between the ribs.

TREATMENT OPTIONS

Medications are available to treat the symptoms of the MS Hug. These include antispasticity medications such as Baclofen (lioresal), Valium (diazepam), Lorazepam, and Zanaflex. Also, neuropathic pain relief medications such as Lyrica (pregabalin) and Neurontin (gabapentin) can provide some relief. When the MS Hug is associated with relapse, solumedrol, IVIG or Novantrone may be prescribed.

COMPLEMENTARY TREATMENT OPTIONS

Deep breathing, creative visualization, meditation, yoga, Alexander Technique, and massage can prove helpful for some people. Others gain relief by wearing loose clothing and increasing fluid intake. Analgesic creams and ibuprofen, used moderately and in combination, can be beneficial at symptom onset. Heat, such as a warm bath or heating pad, improves the symptom for some people and exacerbates it for others. Applying pressure, either with the flat of your hand or by wrapping the area with an Ace bandage, has also been known to provide some degree of relief.

Talk to your doctor and see if you can develop a management plan to help keep the MS Hug at arm’s length.

 (Last reviewed 8/2009)