The MS Hug Explained: Description, Symptoms, and Causes

The MS hug is a painful symptom of multiple sclerosis (MS) that feels like a tight band squeezing the chest or ribs. Involuntary spasms in the small intercostal muscles between the ribs cause pain that feels like a girdle around the torso.

The MS hug is one of many pain symptoms affecting more than 55 percent of people with MS, according to the National Multiple Sclerosis Society. Between 15 percent and 25 percent of those with MS report experiencing this odd — and sometimes frightening — type of nerve pain, medically known as dysesthesia.

Because chest pressure and pain from an MS hug can arise suddenly, it can be mistaken for other conditions — such as gallbladder problems, heart or lung disease, or inflammation of the cartilage between the ribs (costochondritis). “I thought I was having a heart attack,” said one MyMSTeam member. Another member discovered after a year of hospital visits that she had a gallbladder problem. “It was the same type of pain, so it was tricky.”

Abdominal or chest pain can be a sign of a serious condition. It’s important to share the symptoms you’re experiencing with your doctor, so they can rule out other medical issues.

What Does the MS Hug Feel Like?

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.

Here’s how MyMSTeam members describe the MS hug:

• “It feels like a boa constrictor tightening around me.”
• “It feels like an elephant on my chest.”
• “A tightening pressure in my abdomen that’s sometimes so intense it takes my breath away.”
• “A HORRIFIC squeeze, like late labor contractions.”
• “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!”
• “MS is giving you a hug to show who has power over your body.”

MS Hug and Nausea

MS can cause nausea in different ways, such as constipation or bowel problems, dizziness and vertigo, or a side effect of MS medications. If an MS hug occurs across the stomach or torso, this may also cause nausea in some people. In fact, one of the common symptoms of MS or relapse is tightness around the stomach.

Some members shared their experience with this. “About 15 minutes after dinner, I feel very nauseated. It's like I’m wearing a belt that's too tight, but it’s across my stomach and not my waist,” wrote one member. Speak to your doctor if you begin to experience nausea so they can find the root cause and treat this symptom right away.

What Causes the MS Hug?

In multiple sclerosis, the body’s immune system attacks the central nervous system, which consists of the brain and spinal cord. MS symptoms are caused by damage to the myelin, a substance that protects nerves. When myelin is destroyed, it interferes with messages sent from nerves to the brain and body, causing a wide range of symptoms.

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 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, relapse, or even wearing tight clothing. As with many MS pain symptoms, neurologists recommend rest, cooling down, and reducing stress.

Members of MyMSTeam report that stress brings on their MS hugs — or makes them worse. “As soon as I get stressed, the hug symptoms get worse,” explained one member. Speak with your doctor about anything you think may be triggering your MS hug symptoms.

How Is the MS Hug Treated?

Although the MS hug is not life-threatening and generally passes with time, the spasms may be uncomfortable and interfere with your daily life. Because the hug is different for everyone, treatment will vary. Your neurologist may recommend one or a combination of medications to treat MS hug.

Anticonvulsant Medications

Gabapentin (Neurontin) is one of the first medications neurologists prescribe off-label to treat MS neuropathic pain. Pregabalin (Lyrica), an anticonvulsant and analgesic, is approved and prescribed for neuropathic pain. The drugs are believed to work by reducing pain signals sent by damaged nerves. “Taking gabapentin twice a day calms down my nerve and spasming pain,” said a MyMSTeam member. “Lyrica helped relieve the tingling sensations,” said another.

Antidepressant Medications

Amitriptyline (Elavil) is a tricyclic antidepressant sometimes prescribed to treat neuropathic pain and depression associated with MS. It’s believed to help by changing the balance of neurotransmitters in the brain. Many MyMSTeam members have been prescribed Elavil for pain and muscle spasms with mixed results. “Elavil helps the pain, but I feel drunk afterwards,” said one member.

Antispasticity Medications

Baclofen (Lioresal) is a muscle relaxant and the preferred drug for treating spasticity in MS. It may relieve cramping, muscle tightness, and spasms. “I've taken baclofen for years. It works about 50 percent of the time,” said one member of MyMSTeam. Another added, “I've been on it for years and went from multiple daily spasms to just a few a month.” Other medications, such as cyclobenzaprine (Flexeril), have also been known to reduce spasms.

Over-the-Counter Pain Relievers

Common painkillers are the first-line treatment for spasticity. Some members of MyMSTeam have found temporary muscular relief with aspirin, ibuprofen, or acetaminophen. Members also use topical pain-relief creams or ointments to loosen tight muscles.

Botox

Botox injections have typically been used in MS to treat bladder dysfunction. But some neurologists prescribe them as a muscle relaxant for the spasticity that occurs with an MS hug. “Today I really noticed the tension releasing; ‘frozen solid’ muscles beginning to ‘thaw,’” said one member who received Botox.

Medical Marijuana (Where Legal)

Several studies have shown evidence of cannabinoids’ potential in treating MS spasticity. Nabiximol (Sativex), a cannabis-based mouth spray found to help muscle spasms, is approved for use in the U.K.

Tips for Managing the MS Hug

Because the MS hug may last for a few seconds or hours, many members of MyMSTeam often do nothing and wait for symptoms to pass. When MS hug pain or discomfort becomes unbearable, members report some success with many of the same remedies and complementary and alternative medicine therapies that help with general MS pain.

Ice or Heat

Some MyMSTeam members have found that ice or heat applied to the affected area can help relieve symptoms. One member places a towel-wrapped ice pack on their ribs. “It feels really good and helps tremendously.”

Pressure

Applying pressure to painful areas with the palm of your hand — or wrapping your body with an elastic bandage — may help relieve tension that worsens the MS hug. Some people find that lightweight, loose clothing works best when the skin feels tingly or prickly.

Magnesium

Older studies suggest that magnesium, along with calcium and vitamin D, can reduce spasticity in MS. “The best relief I get is from magnesium. About 99 percent of the time it really works,” shared one member. Always talk with your doctor before starting any new supplements, as some can interfere with prescription medications.

Acupuncture

A 2014 literature review found that acupuncture may have the potential to relieve MS pain and discomfort, but more research is needed. Anecdotally, some members of MyMSTeam have had good results with the therapy. “I’m in my fifth month using Chinese medicine for MS and have more or less stopped all other meds. Feeling OK, and a lot less MS hug,” shared one member.

Meditation and Relaxation

Techniques such as deep breathing and meditation have been found to ease MS pain. A 2011 study reported that participants in a meditation program showed significant overall improvement in lowering pain levels. “I find that breathing techniques, rest, and some yoga poses actually help,” said one member. “I just try to relax even when it's hard to breathe. The hug pain eventually lets go,” said another.

Yoga and Stretching

Yoga, stretching, and other light exercise has shown to be beneficial in helping reduce MS pain and stress. Yoga postures can be adapted to any ability or performed while seated. “Yoga and stretching have been very helpful in keeping me mobile,” said one member who struggles with muscle spasms and tension.

Pain Diary

Keeping a diary of pain symptoms can help your doctor better manage and treat triggers and severity. Always consult with your neurologist or primary care physician before making any changes to your prescribed MS health care regimen.

Find Your Team

By joining MyMSTeam, members gain a community of more than 185,000 people living with MS who understand its challenges, including the MS hug. Members support each other and share ways they have found to manage MS symptoms.

Have you experienced the MS hug? How do you manage the discomfort? Share your experiences in the comments below or on MyMSTeam.