Costochondritis vs. MS Hug: What’s the Difference?

If you’re living with multiple sclerosis (MS), you may have experienced a common symptom of the condition called the “MS hug,” also known as girdling or banding. Those who’ve had it describe it as feeling like a tight band being squeezed around your chest or ribs. Sometimes, the MS hug can be confused with another common pain symptom, called costochondritis, which is inflammation of the cartilage between the ribs.

People’s experiences with MS can vary so much, and many types of pain can be described similarly. Therefore, trying to communicate to your doctor what you’re going through to determine the cause can be frustrating and confusing.

“Anybody else battle with costochondritis?” asked one MyMSTeam member. Another member responded, “I don't know what that is, or maybe I know it by a different name. What does it do?”

If you’re living with MS and have experienced unexplained pain or tightness in your torso, this article may shed some light on potential causes and better equip you to talk to your doctor about your symptoms.

What Is the MS Hug?

Each person experiences the MS hug differently. The symptom can cause tightness anywhere between the neck and waist. It may be felt on one or both sides of the body, and it can range from an annoying tickle to a vise-like grip that makes it difficult to breathe.

What Causes the MS Hug?

With MS hug, pain symptoms are related to nerves (neuropathic), muscles (nonneuropathic), or both. Nerve damage produces the abnormal sensations of the MS hug and muscle spasms create the pressure, tightness, and aching.

Heat, stress, and exertion are common triggers of multiple sclerosis symptoms, including the MS hug. The hug can also be triggered by a flare or relapse. And in some cases, costochondritis can trigger an MS hug.

How Does the MS Hug Feel?

MyMSTeam members have described the MS hug in various ways, ranging from mild discomfort to severe pain:

• “It feels like a boa constrictor tightening around me.”
• “Mine are on the mellow side but very annoying!”
• “Feels like my bra is on too tight, then I realize I’m not wearing one!”

What Is Costochondritis?

Costochondritis occurs due to an inflammation of the cartilage between the ribs. The term “costochondritis” comes from “costosternal” — which means “relating to the ribs and sternum” — and “chondrodynia,” which refers to pain felt in cartilage.

Other terms for costochondritis include:

• Chest wall pain
• Costosternal syndrome
• Costosternal chondrodynia

The names all provide ways of describing the painful effects the condition has on your intercostal muscles, or the muscles in between your ribs.

What Causes Costochondritis?

In most cases, doctors don’t believe there is any clear cause for costochondritis. There are, however, a few risk factors to consider:

• An acute injury, like a hard blow to your chest
• Physical strain, including heavy coughing or overly strenuous exercise
• Joint conditions including osteoarthritis, rheumatoid arthritis, or ankylosing spondylitis
• Infections including tuberculosis, syphilis, and aspergillosis
• Both cancerous and benign tumors

Researchers haven’t determined exactly how common costochondritis is for people with MS.

How Does Costochondritis Feel?

MyMSTeam members have shared their own experiences with it.

“Guessing it is possible to have the hug and costochondritis,” wrote one member. “Horribly painful.” Another member said, “I was told by my neuro that [costochondritis] was part of my MS hug in that it involved part of the rib cage ... such terrible pain, I thought I was having a heart attack. The attack lasted about two weeks and hasn’t ever returned.”

Other members have discussed the randomness with which costochondritis symptoms can come on. “For two months now, I’ve had dull chest pain near my sternum that my GP diagnosed as costochondritis,” a member wrote. “During this time, the pain comes and goes, no rhyme or reason. However, in the past two weeks, the pain can be anywhere on my chest, and I'll also feel it in the same location on my back. At times, my shoulders and neck have been tense.”

When you’re already dealing with symptoms of MS, the painful effects of costochondritis can feel overwhelming. Talk to your doctor if you start experiencing new symptoms that concern you.

Telling the Difference Between Costochondritis and MS Hug

It can be hard to tell the difference between MS hug and costochondritis, given that they can both cause an uncomfortable or painful squeezing sensation around the chest and can both make breathing difficult.

A few key things to remember about costochondritis are:

• It usually occurs on the left side of your breastbone.
• It affects more than one of your ribs.
• It gets worse when you cough or take deep breaths.

However, it is important to check in with your doctor to rule out other conditions if you’re still unsure.

How To Manage Symptoms

Usually, costochondritis has to run its course until it goes away on its own. There are a few strategies doctors may recommend to help manage your symptoms:

• Medications such as gabapentin (Neurontin) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
• Physical therapy, such as stretches or nerve stimulation
• Surgical procedures or the injection of numbing medication over the joint

There are also do-it-yourself strategies you can use if your symptoms aren’t severe. For example, using heat or ice or simply resting your body could help make you feel better. Mindfulness and cognitive behavioral therapy could also help you shift your focus and ride out the painful symptoms. Ultimately, it’s important to check with a medical professional before deciding on a management approach.

Learn more about ways to manage MS hug symptoms.

Seeing a Doctor About Your Symptoms

If you’re feeling any uncertainty about your symptoms or if they’re persisting for a long period of time, it may be a good idea to speak with your doctor.

Some things you can do ahead of your appointment to make the most of your time include:

• Try to pinpoint a time when your symptoms started or worsened.
• Think about major physical or emotional stressors that have occured recently in your life.
• Note what kinds of activities you’re most concerned about the pain affecting, such as a job function or hobby.

While this is by no means an exhaustive list, coming prepared to your appointment will help you give your doctor an idea of how exactly your costochondritis symptoms have been impacting your life. They can also provide a segue to the more specific medical follow-up questions your doctor may ask, or discussions about the best ways to move forward while managing symptoms.

Additionally, remember that you are not alone in this struggle.

Talk With Others Who Understand

On MyMSTeam — the social network for people with multiple sclerosis — more than 185,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you experienced costochondritis symptoms? Share your experience in the comments below, or start a conversation by posting on MyMSTeam.