The MS hug is a type of pain associated with MS that goes by the medical term dysesthesia. Because it feels like something is tightly wrapped around the torso, this unpleasant sensation is also known as banding or girdling. As with other MS symptoms, the MS hug is unpredictable. Not everyone experiences it and those that do experience it differently. It can be a first symptom of MS or occur years after diagnosis. The MS hug often resolves without treatment, however, if it is persistent or painful, there are a number of ways to find relief.
An individual experiencing the MS hug may feel a variety of sensations, such as burning, pain, pressure, tickling, tightness, tingling, or vibration, stretch around their body, or just on one side. This most often occurs between the neck and waist. When these sensations occur around the chest, they may feel so tight that it’s painful to breathe. Some people with MS experience dysesthesia around their feet or hands, making it feel as though they are wearing tight boots or gloves. It may also occur around the head. The MS hug can last a few seconds to a few hours, and in rare cases, a few days.
Dysesthesia also occurs in other inflammatory conditions, for example transverse myelitis or costochondritis. It is caused by demyelination in the brain and spinal cord. The disruption of nerve signals can lead to sensory changes and muscle spasms in the intercostal muscles (the small muscles between the ribs), which help expand the chest when breathing. In general, these sensations are not a sign of damage to the areas where they are felt. Rather, the damage is in the nerves that communicate to the brain what’s happening in another part of the body. However, it’s important to note that anyone experiencing pain or tightness in their chest should have it evaluated immediately to be sure it’s not a heart or breathing problem.
The MS hug often resolves with no intervention. If it persists, there are a number of natural ways to ease it. It’s important to look for and avoid triggers, if possible. These might include fatigue, changes in temperature, eating a large meal, illness, or being stressed. If the cause isn’t obvious, it may help to keep a diary to learn what sets it off. During an episode of dysesthesia, applying pressure to the area with the flat of the hand or wrapping the body with an elastic bandage may bring relief. This helps the nervous system translate the unpleasant feelings of pain or burning into pain-free pressure. The fit of one’s clothing can also make a difference. Some prefer tight clothing, because its grip on the skin distracts the brain in a similar way that an elastic bandage would. In other cases, loose, lightweight garb or, when the situation allows, taking off items of clothing is most helpful. Applying hot or cold compresses can also help with these sensations. Just like tight and loose clothing, the opposites of temperature seem to help different people. Many people with MS find that, when the hug happens, it also helps to move, stretch, or try a different position.
Relaxation techniques like deep breathing, mindfulness, meditation or having a massage can sometimes ease the discomfort caused by the MS hug. Researchers in Scotland found that acupuncture is effective at reducing pain in people with MS and may be a way to help manage dysesthesia. There is also evidence that hypnosis is helpful in this regard. Transcutaneous electrical nerve stimulation (TENS) may be another option. A TENS unit
is a battery-operated device that delivers small electrical impulses through electrodes that are attached to a person’s skin. The electrical impulses flood the nervous system, reducing its ability to transmit pain signals to the spinal cord and brain, and also stimulate the body to produce natural pain relievers called endorphins. Certain vitamins and minerals, such as vitamin D and magnesium, are also known to reduce muscle spasms and may help ease MS hug symptoms.
If natural remedies are not effective, a number of drug treatments are available to treat dysesthesia. If it is a symptom of an MS relapse, steroids might help speed up recovery. Muscle relaxants (diazepam, baclofen), anticonvulsants (gabapentin, pregabalin) and antidepressants (amitriptyline, duloxetine hydrochloride) are also used. Many of these medications were originally approved for other conditions and are used off-label for MS, the exact way they work against MS hug symptoms isn’t clear. It may be a process of trial and error to determine which one, or if a combination, of these treatments is most effective.
The MS hug is often unpredictable, tiring and stressful. There are a number of non-drug approaches to treat this uncomfortable MS symptom. If they are not effective, a variety of medications can help. The MS hug is not dangerous in and of itself, however anyone experiencing it should have it evaluated immediately. The symptoms can mimic other health conditions that require immediate medical attention, like heart or breathing problems. If other MS symptoms come on suddenly at the same time, the MS hug may be part of a relapse. In this case, it is best to consult a neurologist as soon as possible to see if steroids would help.
