What is an MS Hug?

Not all hugs are created equal. Some are warm and cuddly – the ones we look forward to and enjoy – while others can be downright uncomfortable or even painful. The MS Hug definitely falls into the latter group. For those of you who experience this MS symptom, you’re familiar with the pressured squeezing, crushing, banding sensation, and/or hot and cold sensation that can occur around your waist, torso, or even up to your neck. For those of you who haven’t had this experience, it’s good to learn about it so you’re not caught off guard or frightened if you’re suddenly embraced by the MS Hug.

What Does an MS Hug Feel Like?

This MS symptom obviously gets its name from the tight sensation it causes around the middle of the body. The hug can be so tight that it hurts. It may even make breathing feel more difficult. The uncomfortable sensation can last just a few seconds, or it can hang in there for hours at a time. In the worst-case scenario, the MS Hug may last for months. Like every other MS symptom, it is unpredictable and varies from one person to another.

Like other MS symptoms, the MS Hug can be triggered by fatigue, stress, or an elevation in body temperature caused by exertion, a fever, or ambient heat and humidity. If you experience dysesthesias – which are unusual sensations such as burning, pins-and-needles, tingling, or prickling – the MS Hug may be related to those.

What Actually Happens During the MS Hug?

The tight sensation is caused by spasms in the (intercostal) muscles around the ribs. Although muscle spasms cause the hugging, the pain and other sensations you might feel are neurological. In other words, the MS Hug falls into the category of neuropathic pain, which also includes the burning, stabbing, prickling sensations that MS can cause in a person’s face, torso, and limbs. This type of pain is distinct from the musculoskeletal pain that can result from muscle strain, altered gait, improper use of a mobility aid, inactivity, or overexertion.

Is There a Treatment?

The treatments for the MS Hug are the same as those used for other types of neuropathic pain in MS, including anti-spasticity medications like diazepam, anticonvulsant medications like gabapentin, and antidepressant medications like amitriptyline. All these medications were originally approved to treat other conditions but are now used off-label to treat MS neuropathic pain. Although these medications can be very effective in treating the MS Hug, they also come with side effects, including sleepiness (diazepam, gabapentin, amitriptyline) and weight gain and gastrointestinal issues (amitriptyline).

For those of who are reluctant to take another medication or deal with these side effects, there are several behavioral strategies that may help. But be sure to report your MS Hug to your MS care provider and discuss treatment options before making your decision. Occasionally the MS Hug is the first sign of a relapse. Here are some strategies you can consider:

• Stretching and light exercise
• Applying pressure in the area of the MS Hug or wearing an elastic band or tight clothing around your middle to cause some counter-pressure
• Practicing relaxation or meditation strategies
• Wearing loose-fitting, non-constricting clothing
• Applying a warm compress to your torso, or taking a warm bath if you can do so without triggering other MS symptoms
• Applying a cold ice pack or compress to the area
• Eating a healthy, well-balanced diet
• Keeping track of the factors that seem to trigger your MS Hug and doing your best to avoid them

Who on My Healthcare Team Can Help?

Keep in mind that a strategy that works sometimes may not work at other times – and what works for someone else might not work for you. You’ll need to do some trial-and-error detective work to see what works best for you – but remember to consult with your MS care provider in the process.  Also, keep in mind that the rehab team – physical and occupational therapists – have tips and strategies for managing your MS Hug. And if stress and worry seem to be triggers for your MS Hug (or any other of your symptoms), a mental health provider can teach you stress management techniques and coping strategies.