Treating the Multiple Sclerosis Hug

Combining drug and home treatments to alleviate pain

Stomach problem
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The MS hug is an annoying and often painful symptom of multiple sclerosis (MS) caused by spasms in the intercostal muscles located between the ribs. MS hug gets its name because of the squeezing or girdle-like pain that it causes around the torso.

While debilitating, there are a number of ways to manage the symptoms of the MS hug. Some involve medications to reduce or prevent muscle spasms, while others focus on lifestyle changes to better cope with rigors of chronic or intermittent pain.

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

If you are suffering the stress and discomfort of the MS hug, know that you are not alone. Pain affects more than 50 percent of people with MS and can often lead to feelings of extreme depression of anxiety.

While you may not be able to erase the pain, you shouldn't suffer it needlessly. If the pain is interfering with your quality of life, speak with your doctor about ways to improve your physical and emotional well-being.

There may be treatments for both.


Drulovic, J.;  Basic Kes, V.; Grgic, S. et al. "The prevalence of pain in adults with multiple sclerosis: A multicenter cross-sectional survey." Pain Med. 2015;16(8):1597-602.

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