The MS hug is a painful symptom of multiple sclerosis (MS) that feels like a tight band squeezing the chest or rib cage. Involuntary spasms in the small intercostal muscles between the ribs cause pain that feels like a girdle around the torso.

The MS hug is one of many pain symptoms affecting more than 55 percent of people with MS, according to the National Multiple Sclerosis Society. About 1 in 4 people with MS report experiencing this odd — and sometimes frightening — type of nerve pain, medically known as dysesthesia.

Because chest pressure and pain from an MS hug can arise suddenly, it can be mistaken for other conditions — such as gallbladder problems, heart or lung disease, or costochondritis (inflammation of the cartilage between the ribs). One MyMSTeam member discovered, after a year of hospital visits, that they had a gallbladder problem: “It was the same type of pain, so it was tricky.”

Abdominal or chest pain can be a sign of a serious condition. It’s important to describe your symptoms to your doctor so that they can rule out other medical issues.

1. What Does the MS Hug Feel Like?

Each person experiences the MS hug differently, and MyMSTeam members often share their MS hug stories. The symptom can cause tightness anywhere between the neck and waist. It may be felt on one or both sides of the body, and it can range from an annoying tickle to a viselike grip that makes breathing difficult.

Here’s how MyMSTeam members describe the MS hug:

• “It feels like a boa constrictor tightening around me.”
• “It feels like an elephant on my chest.”
• “A tightening pressure in my abdomen that’s sometimes so intense it takes my breath away.”
• “A HORRIFIC squeeze, like late labor contractions.”
• “Mine are on the mellow side but very annoying!”
• “Feels like my bra is on too tight, then I realize I’m not wearing one!”
• “MS is giving you a hug to show who has power over your body.”

2. How Long Does MS Hug Last?

The length of time people experience an MS hug varies. According to the MS Society, it generally lasts for a few seconds or minutes. However, for some people, the MS hug can sometimes last for a few hours or longer.

3. Can MS Hug Feel Like a Heart Attack?

Many MyMSTeam members have shared the experience of worrying that symptoms of an MS hug were actually those of a heart attack. This isn’t an unreasonable fear: One study found that people with MS have a 60 percent higher risk of heart attack compared with those who don’t have MS. “Guys, does anyone else have the MS hug where it’s so bad it feels like a heart attack?” asked one member.

Heat, stress, and exertion are common triggers of MS symptoms, including the MS hug.

“The MS hug shocked me; I thought I was having a heart attack,” another member said.

Since an MS hug can feel like a heart attack, it’s best to take the following symptoms seriously and seek medical care right away:

• Chest pain or tightness
• Pain radiating through the upper body, including the upper back and upper abdomen
• Shortness of breath
• Sudden cold sweats
• Heart skipping beats or fast heart rate
• Nausea and vomiting
• Dizziness or feeling lightheaded

4. Is It MS Hug or Anxiety?

Things can go from bad to worse when a person’s concern about a possible heart attack leads to panic. “We have to be careful not to overthink it, because then our anxiety kicks in and it becomes a cycle,” advised a MyMSTeam member.

Like the MS hug, both panic attacks and heart attacks can cause chest pain, tightness, and rapid heart rate. Anxiety can affect heart function, and a heart attack can cause anxiety as a symptom. “I’m not sure if I’m having a panic attack at work or an MS hug,” shared one member.

“Yesterday I had the worst anxiety attack I have ever experienced. The pain in my chest felt like I was having a heart attack. I was so scared,” another member said.

There are some key differences between heart attacks and panic attacks. Heart attacks are more likely to cause pain that feels like pressure in your chest and gets worse over time, whereas panic attacks tend to cause sudden pain or discomfort that resolves after 20 to 30 minutes. With heart attacks, pain tends to radiate into the neck, jaw, arm, back, or belly, which doesn’t usually happen in anxiety attacks. Remembering these differences may help you stay calm and better evaluate what’s happening.

5. Can MS Hug Cause Nausea?

People with MS can develop nausea for different reasons, such as with constipation or bowel problems, from dizziness and vertigo, or as a side effect of MS medications. An MS hug across the stomach or torso may cause nausea in some people, as this MyMSTeam member described: “About 15 minutes after dinner, I feel very nauseated. It’s like I’m wearing a belt that’s too tight, but it’s across my stomach and not my waist.”

Speak to your doctor if you begin to experience nausea. They can find the root cause and help you find a way to get relief.

6. What Causes MS Hug?

In multiple sclerosis, the body’s immune system attacks the central nervous system, which consists of the brain and spinal cord. MS symptoms are caused by damage to the myelin, a substance that protects nerves. When myelin is destroyed, it interferes with messages sent from nerves to the brain and body, causing a wide range of symptoms.

With the MS hug, pain symptoms are neuropathic (related to nerves), nonneuropathic, or both. Nerve damage produces the abnormal sensations, and muscle spasms create pressure, tightness, and aching.

Heat, stress, and exertion are common triggers of multiple sclerosis symptoms, including the MS hug. A flare (worsening symptoms), a relapse (returning symptoms), or even wearing tight clothing could also lead to the MS hug. As with many MS pain symptoms, neurologists recommend resting, cooling down, and reducing stress.

Your neurologist may recommend one or a combination of medications to treat the MS hug.

Members of MyMSTeam report that stress brings on or exacerbates their MS hugs. “As soon as I get stressed, the hug symptoms get worse,” explained one member.

Speak with your doctor about any factors you think may be triggering your MS hug symptoms. Getting prompt medical advice may improve your quality of life.

7. How Is MS Hug Treated?

Although the MS hug is not life-threatening and generally passes with time, the spasms and banding sensation may be uncomfortable and interfere with your daily life. The hug is different for everyone, so treatment varies. Your neurologist may recommend one medication or a combination to treat the MS hug.

Anticonvulsant Medications

Gabapentin (sold under brand names such as Neurontin) is one of the first medications neurologists prescribe off-label (not for its approved use) to treat MS neuropathic pain. Pregabalin (Lyrica), an anticonvulsant and analgesic, is approved by the U.S. Food and Drug Administration (FDA) and prescribed for neuropathic pain. The drugs are believed to work by reducing pain signals sent by damaged nerves. “Taking gabapentin twice a day calms down my nerve and spasming pain,” said a MyMSTeam member. Another reported, “Lyrica helped relieve the tingling sensations.”

Antidepressant Medications

Doctors sometimes prescribe antidepressants to treat long-lasting pain associated with MS. If your doctor recommends an antidepressant, it doesn’t necessarily mean they think you are depressed. Instead, they may be using the medication to ease your MS hug symptoms, like painfully sensitive skin. Antidepressants are believed to help with neuropathic pain by changing the balance of neurotransmitters (your body’s chemical messengers) in the brain.

Antispasticity Medications

Baclofen, a muscle relaxant and the preferred drug for treating spasticity in MS, may relieve cramping, muscle tightness, and spasms. “I’ve taken baclofen for years. It works about 50 percent of the time,” said one member of MyMSTeam. Another added, “I’ve been on it for years and went from multiple daily spasms to just a few a month.”

Other medications, such as cyclobenzaprine, have also been known to reduce spasms.

Over-the-Counter Pain Relievers

Some members of MyMSTeam have found temporary muscular relief with aspirin, ibuprofen, or acetaminophen. Members also apply topical pain relief creams or ointments to their skin to help loosen tight muscles.

Botox

Botulinum toxin (Botox) injections have typically been used in MS to treat bladder dysfunction, but some neurologists prescribe them as a muscle relaxant for MS hug spasticity. “Today I really noticed the tension releasing; ‘frozen solid’ muscles beginning to ‘thaw,’” said one member who received Botox.

Medical Marijuana

Several studies have shown evidence of cannabinoids’ potential in treating MS spasticity. Nabiximol (Sativex), a cannabis-based mouth spray found to help muscle spasms, is approved for use in the United Kingdom.

8. Can MS Hug Be Managed at Home?

Because the MS hug may last for a few seconds or hours, many members of MyMSTeam often do nothing and wait for symptoms to pass. When MS hug pain or discomfort becomes unbearable, members report some success with many of the same remedies and complementary and alternative medicine therapies that help with general MS pain.

Ice or Heat

Some MyMSTeam members have found that ice or heat applied to the affected area can help relieve symptoms. One member places a towel-wrapped ice pack on their ribs: “It feels really good and helps tremendously.”

Pressure

Applying pressure to painful areas with the palm of your hand — or wrapping your body with an elastic bandage — may help relieve tension that gets worse with the MS hug. Some people find that lightweight, loose clothing works best when their skin feels tingly or prickly.

Magnesium

Older studies suggest that magnesium, along with calcium and vitamin D, can reduce spasticity in MS. “The best relief I get is from magnesium. About 99 percent of the time it really works,” shared one member.

Always talk with your doctor before starting any new supplements, as some can interfere with prescription medications.

Acupuncture

A 2022 literature review found that acupuncture may have the potential to relieve MS pain and discomfort, but more research is needed. Anecdotally, some members of MyMSTeam have had good results with the therapy. “I’m in my fifth month using Chinese medicine for MS and have more or less stopped all other meds. Feeling OK and a lot less MS hug,” shared one member.

Meditation and Relaxation

Techniques such as deep breathing and meditation have been found to ease MS pain. A 2019 study reported that a meditation program reduced participants’ pain and depression. “I find that breathing techniques, rest, and some yoga poses actually help,” one member said.

“I just try to relax even when it’s hard to breathe. The hug pain eventually lets go,” another member shared.

Yoga and Stretching

Yoga, stretching, and other light exercise have been shown to be beneficial for reducing MS pain and stress. Yoga postures can be adapted to any ability or performed while seated. “Yoga and stretching have been very helpful in keeping me mobile,” said a member who experiences muscle spasms and tension.

Pain Diary

By tracking your symptoms in a pain diary, you can give your doctor valuable information to help them understand your triggers and the severity of your pain. These details can make it easier for them to tailor your treatment plan. However, always talk to your neurologist or primary care doctor before making any changes to your MS care routine. They’ll make sure you’re following the best approaches to manage the MS hug and other symptoms of your condition.

Find Your Team

By joining MyMSTeam, members gain a community of more than 217,000 people living with MS who understand its challenges, including the MS hug. Members support each other and share ways they have found to manage MS symptoms.

Have you experienced the MS hug? How do you manage the discomfort? Share your experiences in the comments below, or post on your Activities page.