Multiple sclerosis (MS) can cause spasms in the muscles around the ribs. It can feel like pain or pressure and may occur with other sensations.
The “MS hug,” which is also referred to as girdling or banding, is a collection of symptoms caused by spasms in the intercostal muscles.
These muscles are located between your ribs. They hold your ribs in place and help you move with flexibility and ease. The MS hug gets its nickname from the way the pain wraps itself around your body like a hug or girdle.
But this pain isn’t unique to MS. You might also experience symptoms consistent with the MS hug if you have other inflammatory conditions, such as transverse myelitis, an inflammation of the spinal cord.
Costochondritis, the inflammation of the cartilage that connects your ribs, can also trigger an MS hug.
The MS hug is a tight, uncomfortable, sometimes painful sensation that wraps around your body like you are being squeezed.
Some people report no pain. Instead, they feel pressure around their waist, torso, or neck. Others experience a band of tingling or burning in the same area. Sharp, stabbing pain or dull, widespread aching can also be symptoms of an MS hug.
You may experience the following sensations during an MS hug:
- crawling sensations under the skin
- hot or cold burning
- pins and needles
As with other symptoms, the MS hug is unpredictable, and each person experiences it differently. Some people also experience these symptoms and feelings of tightness in their hands, feet, and head.
Be sure to report any new pain symptoms to your doctor.
You can also experience symptoms similar to an MS hug with these other inflammatory conditions:
- transverse myelitis (inflammation of the spinal cord)
- costochondritis (inflammation of the cartilage that connects your ribs)
Symptoms can last from a few seconds to hours at a time. Some rarer cases of MS hug last for several days.
Heat, stress, and fatigue are common triggers for general MS symptoms, including the MS hug. An increase in symptoms doesn’t necessarily mean your disease has progressed.
One symptom of MS is dysesthesia, an unusual tingling sensation caused by nerve trauma. Dysesthesia could be causing your MS hug.
Part of managing pain is knowing what causes it. Talk with your doctor about any triggers you’ve noticed.
Although the MS hug is the result of a muscle spasm, the pain you feel is neurologic in nature. In other words, it’s nerve pain, not muscle pain. Over-the-counter pain relievers such as ibuprofen and acetaminophen are unlikely to bring relief.
Many of the drugs used to treat nerve pain were originally approved for other conditions. The exact way they work against nerve pain isn’t clear. The drug classes approved to treat the nerve pain of the MS hug are:
- antispasticity medications (diazepam)
- anticonvulsant medications (gabapentin)
- antidepressant medications (amitriptyline)
Your doctor may also prescribe a medication like duloxetine hydrochloride or pregabalin. They are approved to treat neuropathic pain in diabetes and are used “off-label” for MS.
Although there is no medication that can completely avoid having MS hugs, you can avoid triggers.
You can minimize MS hugs by:
- resting more
- cooling off
- treating a fever that’s increasing your body temperature
- finding ways to de-stress
You can try lifestyle adjustments and home remedies with medical treatment to stay comfortable during an MS hug episode.
Some people with MS feel better when they wear lightweight, loose clothing.
During an episode, try applying pressure to the area with the flat of your hand or wrapping your body with an elastic bandage. This may help your nervous system translate the feelings of pain or burning into pain-free pressure, which may make you feel better.
Relaxation techniques like deep breathing and meditation can sometimes ease discomfort during an episode.
Some people with MS find that warm compresses or a warm bath help with MS hug symptoms. Heat makes the symptoms worse in other people, so it may take some trial and error to find what works for you.
Managing unpredictable symptoms that affect your everyday life can be difficult and frustrating. Although the MS hug isn’t a life threatening symptom, it can be uncomfortable and can limit your mobility and independence.
Learning to live with the MS hug may be a process of trial and error. Talk with your doctor about any new pain symptoms, and keep track of the coping strategies that work for you.
Reach out to your healthcare team if the MS hug makes you feel discouraged or depressed. Support groups can help people with MS manage day-to-day life with their symptoms and maintain their mental well-being.