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The MS hug is a symptom of multiple sclerosis where you feel as if you have a tight band around your chest or ribs or it can be pressure on just one side of your torso. Some people find that it is painful to breathe.

Any pain in the chest needs checking by a doctor unless you are sure of the cause, for instance if you have already been diagnosed with the MS hug and the symptoms have not changed. The MS hug is not dangerous but any chest pain should be taken seriously just in case it has a cause that needs immediate medical attention like heart or breathing problems. It is best not to assume that what you are experiencing is part of your MS but to get checked out by a health professional straight away. Your MS nurse may be available at short notice or it may be quicker to see your GP. If you are at all worried about pain in your chest or if you have severe chest pain or difficulty breathing, you should go straight to the accident and emergency department of your local hospital.

Some people experience a symptom similar to the MS hug but in their hands or feet, where it feels as though you are constantly wearing gloves or boots. For others, the tight feeling is around the head. The feeling can range from annoying to very painful.

Treatment is not often needed and there are changes you can make which may make a difference to the odd sensations. However, if the MS hug is long lasting or very painful, there are drugs which may help you.

What is the MS hug?

The MS hug, also known as banding or girdling, is a symptom of multiple sclerosis in which someone feels as if they have chest pain, rib pain or a tight uncomfortable band around their chest. It can be felt anywhere between the neck and the waist and may feel so tight around the chest that it’s painful to breathe. For some people, it can be pressure on just one side of their body. Others experience a similar symptom in their arms, hands, legs or feet so it feels as though they are constantly wearing gloves or boots. The feeling can also occur around the head. The feeling is different for everyone and may be described as pressure, an ache, a tickle, a pain or a burning feeling. It may be sharp or dull and can be short or long lasting.

Describing your MS hug

The MS hug feels different to each person. Consequently, you can help your health professionals by describing what you are experiencing as accurately as possible. In this way, they can understand what it feels like for you and any effect it is having on your everyday life. You might like to think about whether the feeling:

  • comes in short or long lasting bursts or is there all the time
  • is sharp or dull
  • feels painful, aching, burning, tight or like a pressure? Or is it some other feeling Can you describe it even if it seems odd?
  • is relieved by changes you have made like tighter or looser clothing or by applying heat or cold
  • started suddenly or increased bit by bit
  • started at the same time as other new symptoms or when previous symptoms came back quite suddenly
  • has happened before When? Does it feel the same?
  • is stopping you doing what you’d like to do. Give some examples such as it’s affecting your sleep, work or ability to move freely. It is good to say exactly what’s happening, for example, it takes you two hours to get to sleep or you can only sit still for 20 minutes at a time.

What causes the MS hug?

The MS hug occurs because messages from nerves are blocked or disrupted by the damage caused by MS. The feeling of tightness around your chest can be due to spasms in the small muscles between your ribs (the intercostal muscles) which help expand your chest when breathing. The odd sensations, including aching, stabbing, crawling or pins and needles, are classed as a kind of nerve pain known as dysaesthesia  (meaning “not normal sensation”). 

How many people get the MS hug?

The MS hug is quite a common symptom of MS but is not well known, especially to people who have just been diagnosed. It may be worth being aware of this possible symptom as it can be surprising or worrying if it suddenly appears from nowhere.

What can I do if I have the MS hug?

Any pain in the chest needs checking by a doctor unless you are sure of the cause, for instance if you have already been diagnosed with the MS hug and the symptoms have not changed. The MS hug is not dangerous but any chest pain should be taken seriously just in case it has a cause that needs immediate medical attention like heart or breathing problems. It is best not to assume that what you are experiencing is part of your MS but to get checked out by a health professional straight away. Your MS nurse may be available at short notice or it may be quicker to see your GP. If you are at all worried about pain in your chest or if you have severe chest pain or difficulty breathing, you should go straight to the accident and emergency department of your local hospital.

If other MS symptoms have come on suddenly at the same time, it may be part of a relapse so it is best to consult your MS nurse or neurologist as soon as possible to see if steroids would help.

Like many MS symptoms, the MS hug may appear or get worse if you are heat sensitive, stressed, have an infection, like a cold, flu or bladder infection, or fatigued. Consequently, it is important to cool down, get treatment for any fever caused by an infection and relax to see if it eases the feelings.

How is the MS hug treated?

Although uncomfortable, the symptom often passes without treatment. However if it persists or is very painful, there are drug treatment options (see below).

How can I manage the MS hug myself?

There is plenty you can try to see if it helps. Everyone is different so you may need to try a range of different options before you find what works for you. You may need to do several at once for the best effect.

  • Tight clothing. Some people find that creating an understandable cause for the feeling of tightness tricks the brain into accepting the feeling more. You could try a close fitting top, scarf or bandage around the chest, a glove on the affected hand or socks or boots if it’s your feet or legs that are affected. Applying pressure with the flat of your hand can also work well.
     
  • Loose clothing. Some people find that loose, lightweight clothing is best.
     
  • Other options. Many of the ways to manage other types of pain can also help with the MS hug.

What drug treatments are there?

If the MS hug is long lasting or very painful, you could ask about drug treatments. These fall into two categories depending on whether the feelings are due to nerve pain or spasms in the small intercostal muscles between your ribs. If the symptoms are part of a relapse, then steroids may be prescribed too.

Nerve pain, also known as neuropathic pain, includes unusual feelings like pressure, tightness, aching or stabbing. These altered sensations are known as dysaesthesia and the MS hug is often treated in the same way as other dysaesthesia symptoms. NICE (National Institute for Health and Care Excellence) has recommended that amitriptyline, duloxetine, gabapentin or pregabalin (Lyrica) are tried first.

If the feeling is due to spasms, the first drugs to try are usually baclofen or gabapentin but there are other options if these are not working well enough.

Often your neurologist and MS nurse will work with you to manage your MS hug symptoms. In some parts of the UK, you may be referred to a pain clinic with its own specialist team of doctors and nurses.

Your health professionals should review your treatment regularly and suggest alternatives if something is not working well. Sometimes a combination of drugs works best. 

References

  • Jawahar R, et al. A systematic review of pharmacological pain management in multiple sclerosis. Drugs. 2013;73(15):1711-22. Full article

Last updated: 17 September 2015
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