The MS hug is a painful symptom of multiple sclerosis (MS). It can feel like a tight band squeezing your chest or rib cage. It’s caused by involuntary spasms in the small muscles between your ribs, which can make your torso feel tightly wrapped. About 1 in 4 people with MS report this type of nerve pain, also called dysesthesia.

Chest pressure and pain from an MS hug can show up suddenly. These symptoms 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.”

Tracking your symptoms of MS in a pain diary can be a good way to keep this information handy to discuss at your next doctor’s visit. However, abdominal or chest pain can sometimes be a sign of a medical emergency. You should share these symptoms with your doctor right away.

1. What Does the MS Hug Feel Like?

MS hug can cause a feeling of tightness anywhere between the neck and waist. It may be felt on one or both sides of the body. Symptoms can range from an annoying tickle to a viselike grip that makes breathing difficult.

Here’s how MyMSTeam members describe the MS hug:

• “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!”

“My MS hug felt like a tightening pressure in my abdomen that was sometimes so intense it took my breath away.”

— A MyMSTeam member

2. How Long Does MS Hug Last?

The MS hug generally lasts for a few seconds or minutes, depending on the person. For some people, it can last for a few hours or days.

3. Can MS Hug Feel Like a Heart Attack?

MyMSTeam members have worried that MS hug symptoms were a sign of a heart attack. This isn’t an unreasonable fear. Large studies show that people with MS have about a 28 percent higher risk of acute coronary syndrome (heart attack or unstable angina). They also have about a 32 percent higher risk of macrovascular disease (conditions that affect large blood vessels), which includes cerebrovascular disease such as stroke.

“Does anyone else have the MS hug where it’s so bad it feels like a heart attack?” asked one member.

“Does anyone else have the MS hug where it’s so bad it feels like a heart attack?”

— a MyMSTeam member

“The MS hug shocked me; I thought I was having a heart attack,” another member said.

MS hug is not a heart attack, but you should seek medical attention right away for any of the following symptoms:

• Chest pain or tightness
• Pain radiating through the upper body
• Shortness of breath
• Sudden cold sweats
• Heart skipping beats or a fast heart rate
• Nausea and vomiting
• Dizziness or feeling lightheaded

4. Is It MS Hug or Anxiety?

Things can go from bad to worse when concerns about a possible heart attack lead 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.

Panic attacks and heart attacks can cause chest pain, tightness, and rapid heart rate. Anxiety can affect the way the heart works, 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,” another member said.

Here are some key differences between a heart attack and a panic attack to keep in mind:

• Heart attacks tend to feel like pressure in your chest that gets worse over time.
• Panic attacks may cause sudden pain or discomfort that resolves within a few minutes to an hour.
• Heart attack pain radiates into the neck, jaw, left arm, back, or belly.

When in doubt, don’t hesitate to contact your healthcare provider.

5. Can MS Hug Cause Nausea?

People with MS can develop nausea for different reasons, such as:

• Constipation or bowel problems
• Dizziness and vertigo
• As a side effect of MS medications

An MS hug across the stomach or torso may cause nausea in some people. “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,” said another member.

6. What Causes MS Hug?

In MS, the body’s immune system attacks the central nervous system (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, symptoms can come from nerve damage, muscle spasms, or both. Heat, stress, and exertion are common triggers of MS symptoms, including the MS hug. A flare (worsening symptoms), a relapse (returning symptoms), or even wearing tight clothing could also lead to the MS hug. As with many MS pain symptoms, neurologists recommend resting, cooling down, and reducing stress.

“As soon as I get stressed, the hug symptoms get worse,” explained one member.

7. How Is MS Hug Treated?

MS hug is not life-threatening and generally passes with time. Your neurologist may recommend one medication or a combination to treat the MS hug.

Anticonvulsant Medications

Gabapentin (Neurontin) or pregabalin (Lyrica) are usually the first medications neurologists prescribe for neuropathic pain with MS. They’re believed to work by reducing pain signals sent by damaged nerves.

Antidepressant Medications

Doctors sometimes prescribe antidepressants to treat long-lasting pain associated with MS. If your doctor recommends an antidepressant, it doesn’t necessarily mean they think you’re depressed. Instead, the medication may ease your MS hug symptoms, like painfully sensitive skin. Antidepressants are believed to help with neuropathic pain by changing the balance of neurotransmitters (your body’s chemical messengers) in the brain.

Antispasticity Medications

Baclofen is a muscle relaxant and the preferred drug for treating spasticity in MS. It may relieve cramping, muscle tightness, and spasms. Some people might find it slightly helpful for MS hug as well. “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.”

Over-the-Counter Pain Relievers

Some members of MyMSTeam have found temporary relief by taking aspirin, ibuprofen, or acetaminophen. However, these medications aren’t found to help with neuropathic pain. Topical pain relief creams may also help loosen tight muscles.

8. Can MS Hug Be Managed at Home?

Many members of MyMSTeam do nothing and wait for symptoms to pass. Others report some success with 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.”

Don’t use heat if it’s a known trigger for your MS symptoms.

Pressure

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

Acupuncture

Acupuncture may help relieve MS pain and discomfort, but more research is needed. “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

Meditation may help reduce MS pain and depression. “I find that breathing techniques, rest, and some yoga poses actually help,” one member said.

“I find that breathing techniques, rest, and some yoga poses actually help.”

— A MyMSTeam member on finding relief from MS hugs

“I just try to relax even when it’s hard to breathe. The hug pain eventually lets go,” another member shared.

Yoga and Stretching

Yoga, stretching, and other exercises can be adapted to any level for MS pain and stress. “Yoga and stretching have been very helpful in keeping me mobile,” said a member who experiences muscle spasms and tension.

Talk With Your Doctor

The MS hug can be painful, confusing, and sometimes scary — especially when it affects the chest or stomach. Knowing what it feels like, what can trigger it, and when to seek medical care can help you respond with more confidence. If MS hug symptoms change, worsen, or worry you, talk with your healthcare provider about the best ways to manage them.

Join the Conversation

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

Do you have any experience with MS hugs? Let others know in the comments below.