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Article written byWhat It Feels Like | Causes | Treatment | Management | Support
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 people 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 costochondritis (inflammation of the cartilage between the ribs). One MyMSTeam member discovered after a year of hospital visits that they 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 your symptoms with your doctor, so they can rule out other medical issues.
Each person experiences the MS hug differently, and MyMSTeam members often share their MS hug stories. 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 viselike grip that makes breathing difficult.
Here’s how MyMSTeam members describe the MS hug:
Many MyMSTeam members have shared the fearful experience of wondering whether MS hug symptoms were actually those of a heart attack. This isn’t an unreasonable fear: One study found that people with MS have a 60 percent higher risk for heart attack compared with those who don’t have MS. “Guys, does anyone else have the MS hug where it’s so bad it feels like a heart attack?” asked one member. “The MS hug shocked me; I thought I was having a heart attack,” related another.
Since the MS hug can feel like a heart attack, it’s best to take these symptoms seriously and seek medical care right away:
Read more about the connection between heart disease and MS.
Things can go from bad to worse when a person’s worry that they’re experiencing a heart attack leads to panic. “We have to be careful not to overthink it, because then our anxiety kicks in and it becomes a cycle,” advised a MyMSTeam member.
Like the MS hug, both panic attacks and heart attacks can cause chest pain, tightness, and rapid heart rate. Anxiety can affect heart function, and a heart attack can cause anxiety as a symptom. “I’m not sure if I’m having a panic attack at work or an MS hug,” shared one member. “Yesterday I had the worst anxiety attack I have ever experienced. The pain in my chest felt like I was having a heart attack. I was so scared,” said another.
There are some key differences between heart attacks and panic attacks. Heart attacks are more likely to cause pain that feels like aching or burning, whereas panic attacks tend to cause sharp, stabbing pains. With heart attacks, pain tends to radiate into the neck, jaw, arm, back, or belly, which doesn’t usually happen in anxiety attacks. Remembering these differences may help you stay calm and better evaluate what’s happening.
Read more about which remedies for anxiety are safe for people with MS.
Nausea can develop in people with MS from different causes, such as constipation or bowel problems; dizziness and vertigo; or a side effect of MS medications. An MS hug across the stomach or torso may also cause nausea in some people. In fact, one of the common symptoms of MS or a relapse is tightness around the stomach.
Some MyMSTeam members have 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.
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 the MS hug, pain symptoms are neuropathic (related to nerves), 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, a 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.
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 the MS hug.
Gabapentin (sold as Neurontin) is one of the first medications neurologists prescribe off-label to treat MS neuropathic pain. Pregabalin (Lyrica), an anticonvulsant and analgesic, is approved by the U.S. Food and Drug Administration (FDA) 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.
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 afterward,” said one member.
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.
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.
Botulinum toxin (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.
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.
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.
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.”
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.
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.
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.
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, stretching, and other light exercise have been 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.
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.
By joining MyMSTeam, members gain a community of more than 192,000 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.
Amit M. Shelat, D.O. is a fellow of the American Academy of Neurology and the American College of Physicians. Review provided by VeriMed Healthcare Network. Learn more about him here.
Laurie Berger has been a health care writer, reporter, and editor for the past 14 years. Learn more about her here.
