What Is a Multiple Sclerosis Hug?

MS Pain at the Waist and Ribs

Man having pain on his side
Jan-Otto/iStockphoto

Multiple sclerosis pain can be felt in strange places. Perhaps, one of the oddest pain-related symptoms is the MS "hug" or girdle-band sensation.

The “MS hug” is a type of pain that can come and go over the course of several weeks, and ranges from an annoying pressure to abject pain. It sometimes can travel as high as the chest or as low as the waistline. In addition, its location may vary, sometimes felt only on one side, and at other times it can wrap around all the entire torso.

All in all, it tends to be one of the most annoying and painful symptoms that MS patients experience.

Diagnosing the MS Hug

If you haven't been diagnosed with MS yet, going to the doctor with symptoms similar to the MS Hug, requires a thorough workup, as a number of other health conditions can mimic it.

For example, the MS hug can be similar to chest pain, so before it can be deemed simply "MS-related," a doctor would want to rule out serious causes like a heart attack.

Other health conditions that need to be ruled out include:

  • Gallbladder disease
  • Stomach or intestinal infection
  • Lung disease
  • Inflammation of the cartilage between the ribs (called costochondritis)
  • Panic attack

If other causes have been ruled out, your neurologist may want to order an MRI to see if you are having an MS relapse, as you may need steroids if your symptoms are severe or debilitating.

Symptoms of the MS Hug

Like many MS symptoms, the “MS hug” feels different for different people.

It also feels different in the same people on different days or at different times of the day.

For instance, the pain can be as low as the waist or as high as the chest. Rarely, it can be felt as high as the shoulders and neck. In addition, the pain can be focused in one small area (usually on one side or in the back) or go all the way around the torso.

It can occur in "waves" lasting seconds, minutes, or hours or can be steady for longer periods of time.

The pain of an MS Hug has been described in many unique ways as well, including:

  • Sharp
  • Dull
  • Burning
  • Tickling
  • Tingling
  • Crushing or constricting
  • Pressure

Finally, the pain (like other symptoms of MS) can intensify or be triggered by fatigue or stress. It can also be associated with other symptoms like difficulty breathing or painful breathing, which is why it may be perceived as a heart attack or panic attack.

Causes of an MS Hug

The MS Hug is caused by a lesion or an area of active inflammation within the spinal cord. This means that the myelin sheath (the coating that insulates nerve fibers) has been damaged. The type of pain caused by the MS Hug is technically classified as a neuropathic type of pain, also called a “dysesthesia,” which refers to any painful sensation.

The sensation itself is the result of tiny muscles between each rib (called intercostal muscles) going into spasm. These muscles have the job of holding our ribs together, as well as keeping them flexible and aiding in movement, like forced expiration. But like everything related to MS, the root cause of the MS Hug has to do with damage to the myelin sheath.

How to Find Relief From the MS Hug

First of all, any chest pain has to be taken seriously. Be sure to seek immediate medical attention if you experience chest pain or other signs of a heart attack.

If your doctor determines that you are indeed experiencing MS-related pain, there are some MS Hug tips that can help ease your discomfort.

Medications Options

The exact cause of pain in multiple sclerosis is not entirely clear. As such, drug therapies can target any number of pain sources, the medications of which include:

  • Muscle relaxants like Lioresal (baclofen) and Zanaflex (tizanidine)
  • Antispastic drugs like Valium (diazepam) and Ativan (lorazepam)
  • Anticonvulsive drugs like Lyrica (pregabalin) and Neurontin (gabapentin)
  • Antidepressants like Cymbalta (duloxetine) or Elavil (amitriptyline)

In addition, some doctors have used Botox (botulinum toxin) injections to selectively reduce muscle spasticity. Botox blocks a neurotransmitting chemical called acetylcholine which allows the muscle to relax. Treatment is typically indicated for those with severe pain and can last up to six months with relatively few side effects (mainly injection site pain or redness).

Botox is also commonly used to treat severe MS-associated bladder dysfunction.

If the symptoms are severe enough to cause breathing problems, your doctor may diagnose this as a true MS relapse and prescribe a course of a high-dose corticosteroid known as Solu-Medrol.

Lifestyle Adjustments and Home Treatments

Pain is a common feature of multiple sclerosis. It can vary by severity and be persistent in some and intermittent in others.

While it would be nice to think you could erase the pain with a simple pill, that's usually not the case. Instead, many people will aim to manage the pain by making a few, simple lifestyle adjustings or embracing tried-and-true home remedies use by others in the same position. These may include:

  • Applying direct pressure to the pain with the flat of your hand
  • Wrapping the affected area tightly with an elastic Ace bandage
  • Practicing deep breathing to expand the chest and minimise spasms
  • Wearing lightweight, loose clothing
  • Applying an ice pack wrapped in a thin towel directly to the pain (unless the pain was triggered by cold)
  • Taking a warm bath or applying an electrical or microwaveable heating pad (unless the pain was triggered by humidity or heat)
  • Using topical analgesics such as IcyHot or lidocaine creams
  • Taking a nonsteroidal anti-inflammatory drug (NSAID) like Advil (ibuprofen)

A Word From Verywell

It's interesting to note that years ago, people thought MS was a painless disease, even doctors. Now we know that this is not true. In fact, research shows that about half of people with MS experience pain at some point in their disease course. Besides the MS hug, other types of pain include trigeminal neuralgia, abnormal sensations in the legs and feet, and Lhermitte's sign.

Sources:

Drulovic J et al. The prevalence of pain in adults with multiple sclerosis: A multicenter cross-sectional survey. Pain Med. 2015 Aug;16(8):1597-602.

National MS Society. Pain: Overview.

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