What Is the MS Hug?

In this article, we explain what an MS hug feels like, what you can do to manage or prevent it, and when to see a doctor.

An MS hug is a symptom of MS. In fact, it’s often the first sign of the condition, or it may be a sign of an MS flare-up, or relapse. It can also occur as part of a pseudoexacerbation, in which new symptoms occur or recurring symptoms worsen for less than 24 hours, often in response to overheating.

What Does the MS Hug Feel Like?

Typically, an MS hug feels like a rubber band is being wrapped very tightly around your torso. However, different people can have different sensations, and the levels of severity can also vary greatly.

• A tickling or tingling sensation
• Pins and needles
• Numbness
• Dull pain
• Crushing sensation or pain
• Crawling sensation under the skin

Justin Abbatemarco, MD, a neurologist with Cleveland Clinic’s Mellen Center in Ohio, says: “Patients will often describe it as a tightness, a belt, a tight squeeze around their body. But some patients will only notice a difference in sensation above and below the affected area. For example, if they're in the shower and the hot water is running across their body, they'll only feel a difference on the top part versus the bottom half of their bodies.”

Other times, the squeezing pressure is so intense that it makes it difficult to take a deep breath.

An MS hug can also be accompanied by other symptoms, Dr. Abbatemarco says. “You may have weakness in the arms and legs, and trouble with your bowel and bladder. You may also feel numbness and tingling in your extremities.”

How Long Does an MS Hug Usually Last?

What Happens in Your Body During an MS Hug?

In MS, the immune system mistakenly attacks the myelin sheath — a protective layer surrounding the nerve cell fibers in the brain and spinal cord. This causes inflammation and associated symptoms. An MS hug “usually represents some inflammation of the spinal cord,” says Abbatemarco.

But there are also other factors involved. The brain signals that normally travel throughout the body and spinal cord are blocked, interrupted, or altered due to the myelin sheath being damaged. This can cause all sorts of sensations in the body, including muscle spasms and the tightening sensation that is the MS hug.

• Exercise
• Eating a very large meal
• Overheating the body or changes in temperature
• Infection
• Another illness
• Fatigue
• Stress

Stress in the broadest sense of the term can trigger an MS hug, explains Abbatemarco. “Heat, infections, but also mental anguish is absolutely something that can cause the body to not work as well. When you’re putting the nervous system under this kind of tremendous pressure, those wires and nerves don't work as well in these conditions, because they’re already frayed,” he says.

Abbatemarco stresses the importance of a holistic approach to treatment when it comes to MS and preventing flare-ups.

“Disease-modifying therapies are super important,” he says, “but they have to be paired with taking care of the whole person, making sure we're mindful of any other medical conditions, eating a healthy diet and exercise, taking care of the mind-body connection. All of these different elements help keep these attacks at bay and help the body be in a state of repair.”

Tips for Managing an MS Hug

There are things you can do to manage an MS hug when it happens. For example, many people find that the following help:

• Wearing loose clothes or removing tight clothes
• Alternatively, wearing tight clothes that can help mask the MS hug sensation
• Warm compresses, baths, or towels
• Cold compresses, or applying ice to the affected area
• Stretching, lying down, or changing position
• Gentle movement like yoga, walking, or swimming
• Acupuncture
• Practicing mindfulness meditation
• Cognitive-behavioral therapy
• Medications such as muscle relaxants, antidepressants, or topical pain relief drugs

Neuropathic pain medications are also an option, especially if other prevention or management strategies fail, says Abbatemarco. “Gabapentin, Cymbalta, and Effexor are some of the brand names for medications that can sometimes quiet the nerves and take away some of the painful sensations associated with them.”

“If you’re living with MS, taking disease-modifying therapies is the most important thing you can do to prevent MS hugs,” Abbatemarco says.

These medications don’t address specific symptoms, but they reduce the development of new lesions in the central nervous system (the brain, spinal cord, and optic nerve), reduce the frequency and severity of relapses, and slow the progression of disability associated with MS.

• Keeping a diary to figure out what your triggers are
• Avoiding triggers as much as possible
• Trying relaxation techniques like mindfulness or breath work
• Wearing a cooling vest or using a spray bottle to cool your skin when exercising to keep your core temperature down
• Avoiding infections by washing your hands and taking the right vaccinations

“No, the MS hug is not dangerous per se,” says Abbatemarco. “It can interfere with day-to-day activities. It can be painful, it can be distracting, but the sensation in itself is not dangerous,” he says.

The MS hug is also not necessarily a sign that MS is worsening.

If a patient sees a doctor about an MS hug for the first time, however, without having an MS diagnosis already, it can cause a delay in diagnosis, says Abbatemarco.

“If a patient presents with MS hug as their initial symptom, it can sometimes confuse physicians who don't often treat MS patients, because if the discomfort is located around the chest or belly, they think of those areas and start doing a cardiac workup or a GI workup, instead of looking toward the brain as the originating cause. So it can cause a little bit of a diagnostic delay,” he says.

“What I usually counsel patients,” says Abbatemarco, “is if you're having new neurological symptoms that you've never had before, that's the time to reach out to your doctor.”

An MS hug can feel like a few other potential conditions, so it’s best to get it checked out if you’re experiencing it for the first time, whether or not you’ve been diagnosed with MS.

• The MS hug is a symptom of multiple sclerosis that feels like a tight band squeezing around your torso.
• Techniques like stretching, engaging in gentle exercise, and applying hot or cold compresses, as well as taking certain medications, can help to relieve the discomfort.
• If the MS hug is a new symptom for you, let your doctor know about it.