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Lhermitte’s sign is a sudden, uncomfortable sensation that travels from your neck down your spine when you flex your neck. It can be a symptom of multiple sclerosis (MS) or other conditions that affect the spinal cord.

Experts classify Lhermitte’s sign, also called Lhermitte’s phenomenon or the barber chair phenomenon, as one of the paroxysmal pain symptoms of MS.

People often describe Lhermitte’s as an electrical shock or buzzing sensation.

A protective coating called myelin covers your nerve fibers. In MS, your immune system attacks and destroys myelin in your brain and spinal cord, which slows down the signal that travels between nerves.

Your nerves can’t relay messages due to the lack of myelin, which causes various physical symptoms, including pain.

Origins of Lhermitte’s sign

In 1917, French neurologists Pierre Marie and Charles Chatelin first described the symptom.

In 1924, French neurologist Jean Lhermitte published a study credited with making the symptom more widely known. The phenomenon is named after him.

Lhermitte was also the first to note that the occurrence is an early sign of MS and the first to note that it could occur due to other conditions affecting the spinal cord.

Lhermitte’s sign mainly causes an electric or wave sensation that travels down your neck and back. You may also feel this in your arms, legs, fingers, and toes. The shock-like feeling is often short and intermittent. However, it can feel quite powerful while it lasts.

The pain is usually the most prominent when you:

  • move your neck, such as bending your head to your chest
  • are stressed
  • experience fatigue
  • are overheated

While bending forward or causing the Lhermitte’s sensation is painful, it isn’t dangerous and won’t cause further damage to your spinal cord or worsen your MS.

Lhermitte’s sign is caused by nerves that are no longer coated with adequate myelin. This causes abnormal signals across the damaged area when pulling or extending the spinal cord, like when your neck is flexed.

Lhermitte’s sign is common in MS, but it’s not exclusive to the condition. People with spinal cord injuries or inflammation might also feel symptoms. Other common causes can include:

Talk with your doctor if you believe that these conditions may be causing you to feel the distinct pain of Lhermitte’s sign.

Some possible treatments that may help minimize Lhermitte’s sign’s symptoms include:

Talk with a doctor about which treatment options are best for you.

Medications and procedures

A doctor may prescribe antiseizure medications to help manage your pain. These medications help control your body’s electrical impulses. Some possible types that may help, based on anecdotal evidence, include:

  • gabapentin (Neurontin)
  • carbamazepine (Tegretol)
  • oxcarbazepine (Trileptal)

A doctor might also recommend steroids if Lhermitte’s sign is part of a general MS relapse. They may also recommend using muscle relaxers, antidepressants, or sodium channel blockers.

Medication can also lessen the pain that’s commonly associated with MS.

Another procedure to consider is transcutaneous electrical nerve stimulation (TENS). TENS produces an electrical charge that may help reduce inflammation and pain.

Electromagnetic fields directed at areas outside your skull may also help treat Lhermitte’s sign and other common MS symptoms.

More conclusive research on this method and TENS is needed.

Lifestyle changes

Lifestyle changes that may make your symptoms more manageable include:

  • wearing a neck brace, which can keep you from bending your neck too much and worsening pain
  • working with a physical therapist on improving your posture, which can help prevent an episode
  • practicing deep breathing and stretching exercises to help lessen your pain
  • practicing mindfulness, meditation, yoga, or other ways to help manage stress

MS symptoms like Lhermitte’s sign, especially in the relapsing-remitting form of MS, often worsen in times of physical or emotional stress.

Try to get plenty of sleep and monitor your stress levels to help manage your symptoms. It might even be helpful to talk with others about what you’re going through.

If you’d like to connect with others who have MS and get support, try our free MS Healthline app on your iPhone or Android.

Research shows that mindfulness-based interventions can help you manage stress, anxiety, and depression associated with MS.

Before making major changes to address your symptoms, consider talking with a doctor.

Studies on prevalence are scarce. However, one 2015 study found that 16% of people with MS experienced the symptom.

Another study from 2015 found that about one-third of people with MS experience Lhermitte’s sign.

Lhermitte’s sign can be jarring, especially if you’re unfamiliar with it. You may want to see a doctor immediately if you begin to feel sensations like electric shocks in your body when you bend or flex your neck muscles.

Lhermitte’s sign is a common symptom of MS. If you’ve been diagnosed with MS, you should seek regular treatment for the condition. Lhermitte’s sign can be managed if you’re aware of the movements that trigger it and may not need specialized treatment options since it will often resolve.

The following sections provide answers to frequently asked questions about Lhermitte’s sign.

Once there’s a diagnosis of MS, the best way to prevent Lhermitte’s is to start an effective disease-modifying therapy (DMT). If you’re already on one, discuss switching to a different DMT with your doctor.

What does a positive Lhermitte’s sign indicate?

Though it can indicate other potential underlying issues, Lhermitte’s sign often occurs with MS. It can also be an early sign, which means you should contact a doctor if you develop the sensation before having a formal diagnosis of MS.

Can you have Lhermitte’s sign without MS?

The short, intense pain or electric shock feeling often occurs with MS. However, you can also experience the sensation without MS. Other underlying conditions can cause it, such as transverse myelitis or trauma to the neck.

Lhermitte’s sign causes a painful, electric shock sensation. Though it can occur for other reasons, it is considered one cause of pain associated with MS and may be an early indicator of the condition in some people.

Management may include medical and nonmedical interventions. In some cases, managing potential triggers can help improve quality of life. This may include managing stress and wearing braces.

The condition does not mean MS is worsening, and it resolves on its own.

Read this article in Spanish.