What’s an MS Hug and
What can you do about it

If you feel the slightest twinge of an MS hug coming on, what you should do is to try cooling off and resting and you may be able to prevent it from getting worse.

Multiple sclerosis pain can be felt in strange places. One of the weirdest pain-related symptoms is tis Multiple Sclerosis "hug" or girdle-band sensation.

This particular symptom comes and goes over the course of several weeks and ranged from an annoying pressure to horrible pain. Sometimes it can go as high as your chest or as low as your waistline.

The pain can sometimes be very localized on one side and other times you can feel it all the way around your torso. It is truly one of the most annoying and painful MS symptoms that I have ever experienced.

CAN THE MS HUG MIMIC OTHER CONDITIONS?

Sometimes the symptoms can confuse and lead doctors to think that the pain is caused by:

• Intestinal infection
• Scoliosis
• Mitral valve prolapse (MVP) - Is when the valve between your heart's left upper chamber (left atrium) and the left lower chamber (left ventricle) doesn't close properly.
• Stress

HOW COMMON IS MS HUG AMONGST MSERS ?

It is difficult to say how common this painful MS symptom occurs in MSers. Statistically, up to 75% of MSers will experience pain as a symptom, but statistics on the MS hug are difficult to find so a lot of the information I have gather and present here is from other MSers like you and me.

WHAT CAUSES THE MS HUG?

A lesion on the spinal cord is often the cause and it is technically classified as a “paresthesia,” which is the name given to any abnormal sensation provoked by a neuropathic pain.

The sensation itself is the result of muscle spasms in the tiny muscles between each rib (intercostal muscles). These muscles hold your ribs together, keep them flexible and aid in movements such as forced expiration.

WHAT DOES IT FEEL LIKE?

The MS Hug, like many MS symptoms, feels different for different people – it also feels different in the same people on different days or at different times of day.

Some common complaints describe the pain from an MS hug:

• To appear as low as the waist or as high as the chest. Very rarely the MS hug can be felt as high as the shoulders and neck
• Focused in one small area (usually on one side or in the back) or go all the way around the torso
• It gets worse when you’re fatigued or stressed
• Shows up in “waves” lasting seconds, minutes or hours or can be steady for longer periods of time
• Has been described as sharp pain, dull pain, burning pain, tickling, tingling, a crushing or constricting sensation or intense pressure

HOW SEVERE CAN IT BE?

The pain and the sensations experienced with the MS hug can be so severe that it is often perceived as a heart attack or panic attack.

WHAT TEST SHOULD YOU HAVE DONE?

Your doctor or neurologist may want to run an MRI to rule out the possibility of you having an exacerbation. Often, tests are also done to rule out other things, such as:

• Heart problems
• Gallbladder problems
• Lung disease
Gastrointestinal problems or
• An Inflammation of the cartilage between the ribs.

USEFUL MS HUG TIPS

You can learn to cope and manage this annoying and often painful MS symptom. If the symptom is severe enough to cause discomfort breathing, your neurologist may define this as a true relapse, run an MRI and give a course of solumedrol.

There are also several medications which you should ask your doctor to prescribe that can provide varying degrees of relief.

Different MSers have provided the following list of suggestions and tips – different things may work for you at different times:

• Deep Breathing Exercises: Breathe in as deeply as you can (really engaging the diaphragm) through your nose and blow out through your mouth.
• Apply Pressure: Place the flat of your hand on the area and press fairly hard. Some folks have wrapped themselves in Ace bandages for the same effect, I haven’t try it but…..
• Creative Visualizations: Close your eyes and picture different images that represent the sensation, then visualize doing something to get relief. Try different images to find what may work for you. Some MSers have said that picturing a bunch of thick rubber bands around their bodies, which they are cutting off one by one, help them during the worse of the attack.
• Increase Fluid Intake: Try lukewarm herbal tea for relaxation and plenty of water.
• Wear Loose Clothes: Some MSers have said that the sensation occasionally feels like an unpleasant tickle when touched by fabric, or feels like a waistband that is too tight. In that case, loose-fitting clothes may help.
• Massage: Some MSers report amazing relief from massage, especially from manual Lymph drainage massages.
• Warmth: Heat helps some people and makes it worse for others so be careful when using this strategy. Try a warm bath or better yet a heating pad to see if this provides some relief.
• Analgesic Creams: This is helpful for some MSers sometimes. Try it on a small spot first to make sure the sensation doesn’t become unpleasant (especially with some of the menthol-based products) before smearing it all over your body.
• Ibuprofen: Advil or Motrin has worked for some people. Be sure to take it only on a full stomach and for a limited amount of time (less than two weeks) to avoid gastrointestinal bleeding or gastritis.

WHAT MEDS ARE AVAILABLE TO YOU?

Before starting to show you what medications are out there that might help you deal with the MS hug symptom I would like to explain that many of the medications used to treat the “MS hug” are very addictive and should be used with caution and careful monitoring by your doctor.

These include:

1. Antispasticity Medications: These include Lioresal (baclofen), Valium (diazapam), lorazepam and Zanaflex (tizanidine).
2. Neuropathic Pain Relief Medications: These include Lyrica (pregabalin) and Neurontin

In addition, some doctors are trying Botox, which gets injected directly into the affected muscles to reduce spasticity by selectively paralyzing nerves. It has been shown to be effective in the short term, and works better if the pain is fairly localized (in one small spot, rather than encircling your entire torso).

ADDITIONAL TIPS

While Very specific muscles (the intercostals) are what hold the ribs together yet offer us flexibility in through the torso. When those muscles spasm (for any reason not just MS), tightness ensues. Many report that early intervention with prescription drugs and Complementary and Alternative Medicine (CAM) can be very helpful.

Source:

MS Society. Clinical Updates: The Uses of Botulism Toxin in Multiple Sclerosis. August 2005.

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