The MS hug
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In multiple sclerosis (MS), the immune system mistakenly launches a response that damages the central nervous system. This can give rise to abnormal physical sensations, known as dysesthesias, and also can cause spasticity, or muscle spasms.
The MS hug, a feeling of pressure or pain around the chest, is a common symptom of MS that can be caused by dysesthesia and by spasms in the muscles between the ribs, called the intercostal muscles.
What is the MS hug?
The MS hug, also known as banding or girdling, is one of the most common abnormal sensations that people with MS may experience. As the term suggests, the MS hug usually involves sensations of tightness or squeezing around the chest or abdomen — as if someone were giving a tight hug.
This feeling of tightness around the rib cage can be caused by spasms in the intercostal muscles, which help expand and contract the chest wall during breathing. But the MS hug also can be considered a type of dysesthesia, where pain or other abnormal sensations are a result of nerve damage.
In these cases, the abnormal transmission of messages to and from the brain makes it difficult for the brain to interpret the signals it receives. Sometimes, the brain can respond with a sensation, or a mix of sensations, that include tingling, tickling, itching, tightness, burning, an electric shock-like feeling, or stabbing pain. These sensations are considered a form of neuropathic pain, or nerve pain.
Not everyone with multiple sclerosis will experience the MS hug, and as with other MS disease symptoms, the timing and severity of the MS hug can vary from person to person. Individual patients have said that the discomfort it generates ranges from “annoying to very painful.” The hug usually lasts a just few seconds or minutes, but it can persist for hours or longer in some patients.
What does the MS hug feel like?
The MS hug can feel different for each person who experiences it, but the sensation is usually described as a feeling of tightness around the chest, back, and/or stomach. It can be painful, or make it feel like it’s difficult to breathe. Some patients report a tight feeling around the ribs and back, or tightness around the rib cage — like their ribs or back are being squeezed, or like the muscles around their ribcage are spasming.
The sensation may wrap all around the body, or it can occur on just one side. Some patients also experience similar sensations of pressure on the hands, feet, or head, often reported as feeling like wearing tight clothing on the affected body part.
In addition to the characteristic feeling of squeezing or pressure, symptoms of the MS hug may include:
- shortness of breath
- pain or achiness
- tingling, burning, or “pins and needles” sensations
Some of the columnists at Multiple Sclerosis News Today have described their experiences with the MS hug and MS hug symptoms.
“One of the most frustrating aspects of my MS is a frequent feeling of tightness and pain. The sensations may be in my arms, legs, or even in the trunk of my body. … Gabapentin helps to keep the pain at a tolerable level, but it’s rarely entirely absent. I describe the tightness as a feeling of thick rubber bands pulling between various parts of my body,” Judy Lynn wrote in her column.
“This is no comforting hug,” wrote Tamara Sellman in another column, noting “you don’t want this hug — ever.” According to Sellman, “The muscles in these tight spots spasm in a way that makes you feel like you’re wearing a too-tight girdle that ‘hugs’ so intensely it can make it difficult to breathe or to find a comfortable posture. … My current hug is an intermittent one. While it comes and goes and it doesn’t take my breath away, it isn’t making it easy for me to sit in a chair, either.”
“My friend John tells me that his MS ‘hug’ feels like a charley horse on both sides of his ribs,” Ed Tobias wrote, adding, “‘It generally feels like someone is sitting on your chest,’ he told me in an instant message.”
Does the MS hug feel like a heart attack?
The MS hug commonly feels like squeezing and pain in the chest, or like a muscle spasm under the rib cage. Because these sensations are often also reported as symptoms of a heart attack, some MS patients say the MS hug can feel like having a heart attack. These symptoms also may resemble an anxiety attack for some individuals.
While the MS hug itself is not dangerous, heart attacks and other conditions that cause chest pain can be very serious.
There have been reports of people with MS who have chest pain that they misattribute to an MS hug, when they are actually having a heart attack or other serious health problem. It is recommended that anyone with chest pain for which the cause is unclear should seek prompt medical attention.
Is the MS hug painful?
The MS hug is usually characterized by feelings of tightness, as if there is a band squeezing around the body. Many patients report that their ribs feel like they are being squeezed. The intensity of the sensation varies from person to person, but some people experience substantial pain associated with the MS hug.
Does the MS hug feel like indigestion?
Indigestion, or upset stomach, is characterized by feelings of discomfort in the upper abdomen. The MS hug may manifest as feelings of unusual tightness and discomfort in this region, so for some people, the sensations of MS hug and indigestion may be similar. Diagnostic tests may be needed for patients with such symptoms to figure out whether the discomfort is due to the MS hug or to digestive issues causing stomach pain.
Can you experience an MS hug without MS?
Despite the name, it is possible to experience the MS hug without having MS. Other conditions in which there is inflammation in the spinal cord, such as transverse myelitis, also can cause the atypical sensations of MS hug.
How long does an MS hug last?
The MS hug usually lasts for a few seconds or minutes, but it may go on for days or even weeks in some patients. Like other forms of dysesthesia, such as Lhermitte’s sign, the MS hug usually starts and stops suddenly, and can occur several times a day. However, for some patients, it may appear gradually or be somewhat present at all times.
MS hug triggers
Some patients find that certain triggers cause the MS hug for them, although these specific factors vary from person to person. Tracking symptoms to identify this disease symptom and avoid triggers can be a useful strategy for managing it.
Some commonly reported triggers of the MS hug include:
- fatigue
- stress
- changes in temperature
- eating a large meal
- being ill or otherwise unwell
What to do if you experience an MS hug?
Because chest pain may be a sign of a heart attack or other medical emergency, patients who experience new chest banding or pain for the first time should seek immediate medical attention.
After experiencing a first MS hug, patients should work with their clinicians to understand how the sensation feels and to find strategies for management. Understanding a person’s individual triggers for MS hugs can help in possibly preventing them or minimizing their effects.
For patients who have experienced the MS hug before and know how it feels for them, medical attention is generally not required for a recurrence of MS hug, unless the pain is extremely severe or the symptoms cause difficulty breathing.
Is there treatment for the MS hug?
The MS hug often doesn’t require treatment, but if it becomes long-lasting or extremely painful, there are a number of medications used to manage nerve pain and/or muscle spasms that may help ease this symptom. These include:
- gabapentin, an anticonvulsant or anti-seizure treatment, commonly used off-label in MS to ease dysesthesia and spasticity
- amitriptyline, an anti-depressant available as a generic that can help with neuropathic pain
- duloxetine, used to manage depression and nerve pain in MS patients
- pregabalin, an anti-seizure medication that helps to manage spasticity and nerve pain
- baclofen, a muscle relaxant that can help relieve muscle spasms and cramps associated with spasticity
If the symptom arises as part of a disease relapse, medications used to manage relapses — such as glucocorticoids, hormones for treating inflammatory and autoimmune disorders — also may ease the MS hug.
Tips to manage MS hug pain
A number of strategies may help people avoid the MS hug, and to manage pain and other unpleasant sensations when it does occur. Common strategies include:
- avoiding MS hug triggers
- wearing tight or loose clothing (depending on what’s more comfortable when dealing with the symptom)
- moving around, stretching, or yoga
- applying heat or cold
- trying relaxation and breathing techniques
- using complementary and alternative medical approaches like acupuncture or aromatherapy
- resting more
- doing physical therapy
Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
FAQs about the MS hug
The multiple sclerosis (MS) hug is characterized by feelings of squeezing or tightness around the rib cage or across the chest. In more severe cases, the symptom may cause extreme chest tightness and pain that makes it harder to breathe. Medications that ease muscle spasms and nerve pain, in addition to relaxation techniques, rest, and other complementary approaches, may help manage this symptom in such circumstances.
As with other symptoms of multiple sclerosis (MS), the exact frequency and severity of the MS hug can vary considerably from person to person. Some people may experience the sensation only occasionally and for a few seconds, while for others it may be frequent and long-lasting. Some patients find that factors like temperature changes or stress can trigger their MS hug, so avoiding those triggers may help keep this symptom at bay for longer periods.
The multiple sclerosis (MS) hug may be among the first symptoms to develop in someone with MS, though it also may initially occur years after disease onset. Some people with MS, however, never experience the MS hug over the course of their disease.
The multiple sclerosis (MS) hug may occur as part of an MS relapse. However, some patients with relapsing forms of MS may experience the symptom even when they are not having a relapse; this symptom also may occur during the progressive stages of the disease.
The multiple sclerosis (MS) hug affects every person differently. Some patients report that this symptom gets worse at night, while others report it is less intense during this time of day. For those in whom the sensation may cause problems with sleep, adjusting sleep position — for example, being propped up on pillows — may be helpful for managing the MS hug at bedtime.
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