The MS Hug: The Embrace No One Wants

The MS hug feels like a tight squeeze around the chest, and it can last for minutes, hours, or days. Medications and other strategies can provide relief.

Multiple sclerosis (MS) can cause an uncomfortable or painful sensation of squeezing or tightening around the chest. When this happens, you’re experiencing what’s known as an MS hug.

The MS hug is one of the more common symptoms of MS. And for some, an MS hug can even be the first symptom of MS. However, people may easily mistake the MS hug for symptoms of more serious conditions, so it’s important that you work with a doctor to help determine the underlying cause of the squeezing sensation.

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What is the MS hug?

The MS hug, sometimes called the “anaconda sign,” is just one of many different symptoms you may — or may not — experience when living with MS.

While there’s no established medical definition for it, the term “MS hug” typically refers to a constricting or tightening sensation around the torso, which may also cause:

• difficulty breathing
• numbness or tingling in your arms
• pain or discomfort

Not everyone who has MS experiences the MS hug. And some people who do get it only experience it on one side of their body.

When the MS hug occurs, however, it can be a frightening experience, especially because it can mimic other concerning conditions, such as angina or a heart attack. The opposite can occur, too: You or a doctor may mistake signs of a heart attack for an MS hug, which can be very dangerous.

Several other health conditions other than a heart attack or MS can also cause similar sensations in the chest. Some examples include:

• gastroesophageal reflux disease (GERD)
• gallbladder problems
• shingles
• lung disease
• anxiety
• inflammatory conditions that affect the cartilage in the chest or spine

If you haven’t experienced an MS hug before, your doctor will want to rule out other possible causes of your discomfort and make sure heart-related problems or other issues are not causing the sensation.

What does the MS hug feel like?

An MS hug typically feels like a tight squeezing sensation around your chest that can make it difficult to breathe.

People in the Bezzy MS forum have described it in the following ways:

• “It’s a tight feeling that goes around my ribs.” — Kremz
• “The tightening around my torso and the disabling spasticity makes me feel like I’m having heart palpitations and difficulty breathing.” — Vilar
• “My MS hug is more like a[n] MS kick in the ribs. I get a sharp pain on my right side that usually lasts about 2 weeks.” — Mike M.

Others have described the feeling as:

• a crushing sensation
• a dull, sharp, or stabbing pain
• a feeling of burning hot or cold
• tingling, tickling, or pins and needles
• numbness
• vibration
• crawling sensations under the skin

You may experience it for a few seconds to a few hours. Less commonly, it may last for days or weeks.

The exact sensations you feel, as well as how long it lasts, and how bad it feels can all vary greatly between you and others who experience this MS symptom.

If you’re not sure of the cause of the constriction, pain, or numbness, or if the pain is particularly severe or long lasting, you should call 911 or seek emergency medical care immediately.

What causes the MS hug?

An MS hug is a type of dysesthesia, or abnormal sensation. It occurs as the result of the loss of myelin, affecting nerves in the spinal cord. The specific level of the spinal cord that’s affected can determine where you feel it, as well as the type of sensation you feel, such as pain, numbness, or tingling.

Another aspect of an MS hug involves the intercostal muscles in the chest. These muscles help hold the ribs together and help to move your chest when taking a breath.

When you experience an MS hug, the intercostal muscles may spasm or contract (also due to the demyelination in the spinal cord), causing a tightening or squeezing sensation in your ribs or chest.

Like most other symptoms of MS, the MS hug can be brought on by triggers like:

• stress
• overheating
• feeling overly fatigued
• having an illness or infection

Your triggers may be different. Figuring out your triggers can play an important part in your overall care and well-being when living with MS.

When it occurs with new or worsening symptoms, it could be a sign of relapse. If that’s the case, you may want to talk with a doctor about the changes in your symptoms.

Medications for the MS hug

Experts say there are still no established therapies that directly target the MS hug, but that doesn’t mean there’s nothing you can do about the symptom.

For nerve-related pain in MS, a doctor may prescribe medications from the following classes of drugs:

• over-the-counter pain relievers
• antidepressant medications
• antispasticity medications
• anticonvulsant medications

In one case study, a woman who experienced the MS hug for 2 months underwent a procedure called a thoracic paravertebral nerve block (TPVB), which involves injecting anesthesia into the nerves surrounding the spinal cord. While it hasn’t been established as a conventional treatment for the MS hug, it may be an option for more severe cases.

Tips for managing the MS hug

Medications can help with pain or discomfort from an MS hug, but they are not the only approach to managing this symptom.

In the BezzyMS forums, people have shared the following strategies for easing their discomfort from the MS hug:

• “I use baclofen and another muscle relaxer my neurologist prescribed. Also, having someone push on my back seems to help. Sounds crazy but … it works.” — Shelia
• “I have recently started to slow down and take a rest if I even feel an inkling that a hug is beginning, and that seems to help more than anything else.” — Anonymous
• “[When] I used … [cannabis] oil, it was gone in seconds, and more importantly the episodes have lessened.” — Vilar
• “I have to stand up to really stretch out my torso. Depending on the severity, sometimes I’ll use Theraworx [a muscle cramp cream] or CBD cream or maybe just ice, self-massage, and a heating pad.” — MSpalsMary

Some other common tips to help ease the discomfort of an MS hug include:

• Wear looser or tighter clothing. This is a matter of preference as some people find tighter clothes can feel better against their body while others may not want any extra pressure from their clothing.
• Take a warm bath, or use a heating pad or blanket wrapped around your chest (however, some people may find the additional heat makes things worse).
• Try yoga, or meditation, or deep breathing exercises to help relax.

These tips may not stop or relieve your pain altogether, but you may find they help. Since a lot of management comes down to personal preference, you may find that taking the time to figure out what works for you is the best next step.

The takeaway

The MS hug can feel like a squeezing or crushing sensation. It may be painful and feel like a heart attack, which can be scary. You may experience an MS hug as a first symptom of MS or as a new symptom. If you feel this sensation for the first time, talking with a doctor is a good idea so you can rule out an emergency and figure out steps to take to help manage this symptom.

FAQ

The following are some commonly asked questions about the MS hug.

Are there any long-term effects from experiencing the MS hug?

As uncomfortable as an MS hug can be, it does not cause any long-term complications.

Is the MS hug a sign that my MS is getting worse?

Not necessarily. Some people experience it as one of several MS symptoms, while others experience it during a period of relapse.

Is there anything I can do to prevent the MS hug?

Since the MS hug may be brought on by the same kinds of factors as other MS symptoms, it’s a good idea to:

• avoid your MS triggers
• stay cool
• drink plenty of water
• avoid infections and treat them promptly when they occur