If you’re living with multiple sclerosis (MS), you may have experienced a symptom known as the MS hug, also called girdling or banding. This sensation is a common symptom among people with MS and is described as feeling like a tight band being squeezed around the 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. That’s why explaining your symptoms to your doctor and figuring out the cause can feel frustrating and confusing.

If you’re living with MS and have had an unexplained feeling of tightness or pain in your torso, this article may help explain possible causes and help you 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 the 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, pain symptoms may be caused directly by MS damage to the nervous system, the result of damage to muscles or joints due to disability, or both. Nerve damage produces the nerve pain of the MS hug, and muscle spasms create the pressure, tightness, and aching.

“It feels like a boa constrictor tightening around me.”

— A MyMSTeam member

Heat, stress, and exertion are common triggers of MS symptoms, including the MS hug. In people with relapsing forms of MS, the hug can also be triggered by a flare or relapse. And in some cases, members report that they’ve had costochondritis triggering an MS hug.

Some people with relapsing MS eventually develop secondary progressive MS (SPMS). Even if you develop SPMS, you may or may not still experience some relapses. Even between relapses, MS may still get worse over time.

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 develops when the cartilage between the ribs becomes inflamed. The term “costochondritis” comes from Latin and Greek roots: “costo-” meaning “rib,” “chondr-” meaning “cartilage,” and “-itis,” indicating inflammation.

What Causes Costochondritis?

In most cases, there’s no clear cause for costochondritis. There are, however, a few risk factors to consider:

• An injury, like a hard blow to your chest
• Physical strain, including heavy coughing or overly strenuous exercise
• Illness or infection

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

How Does Costochondritis Feel?

MyMSTeam members have shared what costochondritis has felt like for them.

“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 talked about how costochondritis symptoms can show up suddenly and without warning. “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.”

“Such terrible pain, I thought I was having a heart attack.”

— A MyMSTeam member

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

The Difference Between Costochondritis and MS Hug

It can be hard to tell the difference between the MS hug and costochondritis because both can cause a painful squeezing feeling around the chest and make breathing difficult.

A few key points to remember about costochondritis are:

• It often affects the left side of your breastbone, but it can also occur on the right side or both sides.
• It can affect more than one of your ribs.
• It gets worse when you cough or take deep breaths.

It’s important to check in with your doctor to rule out other conditions if you’re still unsure whether your pain is a symptom of MS.

How To Manage Symptoms

Costochondritis often gets better on its own, but it can take weeks or longer. There are a few strategies doctors may recommend to help manage your symptoms. Treatment options for costochondritis typically include nonsteroidal anti-inflammatory drugs (NSAIDs), rest, and physical therapy. In some cases, your doctor may suggest other medications based on your needs.

You can also try simple self-care strategies if your symptoms aren’t severe. For example, using heat, ice, or simply resting your body could help you feel better. Mindfulness and cognitive behavioral therapy, a type of talk therapy that helps you spot and change unhelpful thoughts, may also help you shift your focus and cope with painful symptoms.

Keeping MS Flares Under Control

If you experience rib pain during MS relapses — periods of new or worsening neurological symptoms — it may be a sign that your MS isn’t being fully controlled. More than 20 disease-modifying therapies (DMTs) have been approved to help lower the number of MS relapses and slow down disability. If you’re still having flares even while following your treatment plan, talk to your neurologist about whether a different approach might help.

Ask Your Doctor

If you’re unsure about your symptoms or they’ve been going on for a while, it’s a good idea to seek medical advice.

Here are some ways to prepare before your appointment to help make the most of your time:

• Try to pinpoint when your symptoms started or felt worse.
• Reflect on any major physical or emotional stressors that have happened recently in your life.
• Think about which daily activities are hardest because of the pain, such as work or hobbies.

This isn’t a complete list, but coming prepared to your appointment can help your doctor understand how costochondritis is affecting your life. It can also lead to more specific questions your doctor may ask and help guide the conversation about the best next steps for managing your symptoms.

Join the Conversation

On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.

Have you had costochondritis symptoms? What has helped you manage the pain? Let others know in the comments below.