MS hug

MS can make your chest tighten. Let’s tighten up on ways to fix that.

The MS hug is a type of abnormal sensation or pain, which is often described as a tight sensation around the chest.^1,2 It can feel like someone is squeezing or hugging you tightly, which is where the term ‘MS hug’ comes from.^1–3

These feelings can also be experienced in your arms, legs, head or just one side of your body.^4–6 As well as these feelings of tightness, you might also have other abnormal sensations in your chest or torso, such as:^3,4,7

• A sharp, stabbing pain in your ribs
• A dull ache
• Tingling or burning
• Pain when you breathe

One of my best friends often experiences the MS hug when she has a relapse and she said it can be quite painful. She often gets treated with steroids via an IV infusion. Apparently, it’s quite hard to breathe and the muscles between your ribs feel very tight.

Katie

Living with MS since 2016

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If you’ve never felt an MS hug before it can be quite alarming, but try not to worry, as it’s not dangerous and doesn’t usually last longer than several minutes.^6–8 Although for some people it may last longer.^4,8

If you experience chest pains, you should report these to your doctor to rule out other conditions and talk about how to best manage it.⁴

The MS hug is caused by spasms in the tiny muscles between the ribs.⁷ This happens when nerve damage caused by MS interrupts communication between the brain and the muscles, which can give your chest muscles an incorrect signal to tighten.^6,7

An MS hug can happen on its own and without an obvious trigger. However, things like heat, stress, infection and fatigue have been shown to be bring it on, so it could be caused by one of these.^4,6,7 Similar symptoms to the MS hug have also been seen in other inflammatory conditions that cause damage to nerves in the spinal cord, so talk to your doctor so other causes can be ruled out.^2,4

Ways to ease pain during an MS hug

There are several things you can try to help relieve the feelings of an MS hug when it strikes. Everyone is different, so you may need to experiment to find out which methods work best for you. Examples include:^4,6,7

• Wearing tight OR loose clothing – for some people, tight clothing like aclose-fitting top can trick the body into feeling pressure rather than pain.⁴ For others, wearing looser clothing can help ease the discomfort of the MS hug, so experiment to see what method works best for you.⁴
• Apply a hot or cold compress – applying a compress to your chest (or wherever you feel pain from the MS hug) can help relieve pain.^6,7 Be aware that for some people heat might make the feeling worse, so experiment to see what works for you.⁸
• Apply pressure – you may find it helps to press on the painful area with the palm of your hand.⁷
• Move, stretch or change position– you might find that when the MS hug happens, shifting to a more comfortable position can feel better.⁸ For example, some people find that lying down or propping themselves up with pillows can help.

Ways to help with an MS hug over the long-term

There are also some steps you can take to help manage your MS hug over the long term. These are things you can do over time that can make the feelings of an MS hug less uncomfortable and easier to cope with^6,9:

• Exercise – this can help with lots of MS symptoms, including an MS hug. It can strengthen your muscles and make it easier to deal with the pain. Exercises that might help include walking, swimming and yoga^7,9
• Relaxation – relaxation techniques can help reduce physical tension and take the edge off your muscle pain. Taking time to unwind and destress (e.g. by reading, seeing friends and family, getting fresh air outside) can also help with ongoing pain⁹
• Mindfulness and talking therapies – these can help reduce tension and change the way you think about pain. This is based on the idea that your thoughts and feelings are connected to how you feel physically^8,9
• Physiotherapy – a physiotherapist can give you exercises that make it easier to cope with the pain associated with MS symptoms such as an MS hug⁸
• Complementary therapies – some people find that things like acupuncture can help with their pain. However, these therapies are not part of mainstream medicine and more research is needed to confirm how well these work^9,10
• Medical devices – TENS (transcutaneous electrical nerve stimulation) is a type of treatment where a device gently stimulates your nerves through your skin. Some people find that it helps relieve pain and discomfort^9,11,12

Prescribed medications

There are also medications that your doctor can prescribe to help. These can give you some relief if you have long-lasting or very painful MS hugs.^9,12 Medications that can help include:

• Muscle relaxants – these are used to help reduce muscle spasms and can relax the muscles between your ribs⁹
• Steroids – these are used to treat relapses. If your MS hugs are happening during a relapse, these can help^4,9
• Botox – for people who get severe pain or are particularly bothered by their MS hug. Botox injections can prevent selected muscles from contracting⁷
• Antidepressants or anticonvulsants – these are usually used to treat depression and epilepsy. However, they can also be used to treat nerve pain and muscle spasms¹²

Everybody’s experience of the MS hug is different, so your management plan will need to be tailored to you. Try some of these different approaches and speak to your healthcare team to find what might work best for you.

1. Feketova S, et al. J Mult Scler. 2016;3:2376–89.
2. Gelfand JM. Handbook of Clinical Neurology. 2014;122:269–90.
3. Multiple Sclerosis Foundation. Symptom Management. https://www.msfocusmagazine.org/Magazine/Magazine-Items/Give-Me-A-Hug,-But-Not-an-MS-Hug [accessed July 2020].
4. MS Trust. MS Hug. https://www.mstrust.org.uk/a-z/ms-hug#how-is-the-ms-hug-treated [accessed July 2020].
5. Galey T, et al. Int J MS Care. 2004;4:144–7.
6. Medical News Today. MS hug: What you Need to Know https://www.medicalnewstoday.com/articles/320146 [accessed July 2020].
7. Very Well Health. The Multiple Sclerosis ‘Hug’. https://www.verywellhealth.com/multiple-sclerosis-hug-2440802 [accessed July 2020].
8. MS Society. MS Hug. https://www.mssociety.org.uk/about-ms/signs-and-symptoms/pain/ms-hug [accessed July 2020].
9. MS Society. Pain and Unpleasant Pain sensations in MS. https://www.mssociety.org.uk/care-and-support/resources-and-publications/publications-search/pain-and-sensory-symptoms [accessed July 2020].
10. Ju ZY, et al. Cochrane Database Syst Rev. 2017(12): CD012057.
11. Miller L, et al. Mult Scler J. 2007;13: 527–33.
12. Zagon IS, McLaughlin PJ. Multiple Sclerosis. Perspectives in Treatment and Pathogenesis. Brisbane: Codon Publications; 2017.