What is MS?

Multiple sclerosis (MS) is a chronic and unpredictable disease of the central nervous system. MS is believed to be an autoimmune condition in which the body attacks itself. The target of the attacks is myelin, a protective substance that covers your nerves. This damage to the myelin causes symptoms ranging from double vision to mobility problems and slurred speech. Nerve damage also leads to neuropathic pain. One type of neuropathic pain in people with MS is called the “MS hug.”

The MS hug 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 a girdle. These involuntary muscle spasms are also called girdling or MS girdling.

It’s important to note that girdling, however, is not unique to multiple sclerosis. 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. Symptoms can last from a few seconds to hours at a time.

Some people report no pain but instead 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:

  • squeezing
  • crushing
  • crawling feelings 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. 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)

Heat, stress, and fatigue — all situations in which your body may not be running at 100 percent efficiency — are common triggers for MS symptoms, including the MS hug. An increase in symptoms does not necessarily mean your disease has progressed. You may need to:

  • rest more
  • cool off
  • treat a fever that’s increasing your body temperature
  • find ways to de-stress

Part of managing pain is knowing what causes pain. Talk with your doctor about any triggers you have 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, which can be difficult to resolve. 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 is not clear. According to the National MS Society, the drug classes approved to treat the nerve pain of the MS hug are:

Your doctor may also prescribe a medication like duloxetine hydrochloride or pregabalin. These are approved to treat neuropathic pain in diabetes and are used “off-label” in MS.

You can try lifestyle adjustments and home remedies combined 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 MS patients find that warm compresses or a warm bath help with MS hug symptoms. Heat makes the symptoms worse in other patients. Keep track of coping strategies that work for you.

Coping with unpredictable symptoms that impact your everyday life can be scary and intimidating. The UK MS Society reports that almost one-third of patients with MS will have some pain at various times. Although MS hug is not a life-threatening symptom, it can be uncomfortable and can limit your mobility and independence.

Learning to cope with MS hug may be a process of trial and error. Talk to your doctor about any new pain symptoms and keep track of the coping strategies that work for you. Speak to your team of medical professionals if the MS hug makes you feel discouraged or blue. Support groups can play a role in helping people with MS cope with their symptoms and live as healthy a life as possible.