The multiple sclerosis (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, holding your ribs in place and helping 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.

But this girdling isn’t 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.

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 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. 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.

Heat, stress, and fatigue — all conditions that can lessen your body’s efficiency — are common triggers for MS symptoms, including the MS hug. An increase in symptoms doesn’t 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 destress

Part of managing pain is knowing what causes pain. Talk with your doctor about any triggers you’ve noticed.

Drug therapy

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. These are approved to treat neuropathic pain in diabetes and are used “off-label” for MS.

Lifestyle adjustments

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 people with MS find that warm compresses or a warm bath help with MS hug symptoms. Heat makes the symptoms worse in other people.

Keep track of which remedies work for you.

Managing unpredictable symptoms that impact your everyday life can be difficult and intimidating. 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.