Breaking it Down: What Does the MS Hug Feel Like?

Podcast: Breaking it Down – A Multiple Sclerosis Podcast
Episode: "What does the MS hug feel like? Banding tightness, rib cramps, stitch sensations, girdling pains, and how to deal with it"
Host: Helena (MS Trust) with Stephen
Guest Expert: Dr. Kate Petheram, Neurologist
Released: September 22, 2025

Overview of the Episode

This episode is dedicated entirely to exploring the symptom known as the MS Hug. Hosts Helena and Stephen—both living with MS—discuss what the MS Hug feels like, the confusion surrounding it, how it may be managed, and how common it is. Neurologist Dr. Kate Petheram delves into the science behind the symptom, and community members share personal stories and coping strategies.

Main Purpose:
To demystify the MS Hug, provide medical insights, validate the spectrum of patient experiences, and share practical tips for managing this often-misunderstood MS symptom.

1. Introducing the MS Hug (00:00–04:23)

• Definition and Description

  • The MS Hug is a neurological symptom resulting from MS, commonly experienced as a tight, pressure-like band around the chest or torso.
  • Descriptions include "tight band", "squeezing pain", "girdling pain", or "rib cage cramps" ([00:49], Stephen).
  • Quote:

    "It's often described as feeling like a tight band around your chest, from your chest to the ribs, as if something is compressing you with pressure or cramping on one side of the torso."
    — Stephen [00:49]

• Confusion and Search Terms

  • Many people use search terms like "tight band around chest", "squeezing pain around rib cage", and "rib cage cramps".
  • The term "hug" seems misleading, as it sounds pleasant but the symptom is anything but ([01:10], Helena).

• Hosts’ Personal Experiences

  • Stephen experienced intense stabbing pains ("like a hot knife in the ribs") years before diagnosis, which retrospectively were identified as the MS Hug ([02:32]).
  • Helena had it for about a month post-diagnosis, feeling it on just one side ([03:22]).

2. The Medical Perspective: Dr. Kate Petheram Explains (04:25–24:19)

What Is the MS Hug? (05:35–06:42)

• Definition:

  • A neurological symptom in MS characterized by tightness, pressure, burning, tingling, or sharp pain around the chest, torso, or abdomen.
  • Can last from seconds to hours or longer and may occur on one side or all the way around.

  Quote:

  "It describes a neurological symptom that occurs in people with MS…this tight band of pressure around the chest, the torso or the abdomen…a squeezing or burning or a tingling sensation or even quite a sharp, unpleasant pain. It can range from being uncomfortable…to something that's really quite painful and disabling."
  — Kate Petheram [05:35]

Why Does It Happen? (06:42–07:37)

• Cause:
  • Usually due to a lesion in the spinal cord. The MS lesion disrupts nerve signals from the skin and muscles to the brain, causing "dysaesthesia" (abnormal nerve sensation).
  • The disrupted signals generate this abnormal and often painful sensation.

Differential Diagnosis: Not Always an MS Symptom (07:37–09:05)

• Symptom Overlap:

  • Frequently misattributed to heart or lung problems, digestive issues, or anxiety attacks.
  • Important to rule out serious causes (e.g., heart attack) especially if the symptom is new.

  Quote:

  "If people are worried and it's a symptom they've never had before, it's entirely appropriate to have that investigated to make sure that it isn't your heart…But once [those causes] have been excluded, you may be less likely to need to go and have it ruled out every time."
  — Kate Petheram [08:00]

How Common Is the MS Hug? (10:44–11:06)

• Occurs in approximately 25–40% of people with MS at some point ([10:44]).
• Can appear in places other than the chest, such as hands, feet, head, or neck, depending on lesion location ([11:14]).

Triggers and When to Worry (11:56–13:23)

• Common Triggers: Heat, emotional/physical stress, infections, or sudden changes in posture.
• Relapse Indicator: If it’s the first time experiencing MS Hug and it persists beyond 24 hours, it could indicate a relapse and may warrant imaging ([12:36]).

Living With and Managing the MS Hug (15:06–19:22)

• First Steps: Rule out other causes (heart/lung). Contact MS nurse or neurologist for new symptoms.

• At-home techniques:

  • Gentle stretching, deep breathing, and relaxation.
  • Experiment with hot/cold packs—preferences vary among individuals.
  • Mindfulness, distraction, tight/loose clothing as personally beneficial ([16:19]).
  • Identifying and avoiding triggers, such as overheating ([18:39]).

• Helena’s tip: Tying a bathrobe cord around her ribs helped mentally "explain" the pressure ([33:50]).

Medical Treatments (19:22–21:50)

• Medications: For frequent/severe cases, neuropathic pain meds may help: pregabalin, amitriptyline, carbamazepine (for short, sharp pain), baclofen (if muscle spasm predominates).

• Medication caution: Taper meds as directed to avoid withdrawal ([21:08]; Helena’s gabapentin experience).

  Quote:

  "Those medications aren't going to cure the hug. They're just going to reduce the severity...You want to use the lowest possible dose and probably not be on it forever."
  — Kate Petheram [21:28]

3. Real Stories: Experiences from the MS Community (27:09–31:59)

Community Voices

• Person 1 (Inga):

  • Experiences MS Hug almost constantly; sometimes like "bottom rib has been snapped" with sharp, digging, burning pain. Has had to adapt breathing, which affects speaking for work ([27:09]).

    Quote:

    "It sometimes is as sudden and painful as if my bottom rib on each side…has been snapped off or broken. It's a really sharp, digging, burning pain and other times it's more corset-like…it moves too…"
    — Inga [27:09]

• Person 2 (Caroline):

  • Feels like a bra several sizes too small; tight chest band ([28:40]).
  • Also gets tight bands around upper arms like a strong elastic band, but not often ([28:57]).

• Person 3 (Mohammed):

  • Gets MS Hug as headache, pounding heart, and chest tightness, usually at night ([29:19]).

• Person 4 (Justin):

  • At first believed he was having a heart attack due to intense chest tightness; only past reading about MS Hug prevented A&E visit.
  • Describes ongoing tightness—"like someone...just getting tighter and tighter"; muscle relaxers and heat didn’t help, symptom passes after a few hours ([30:13], [31:59]).

4. Tips & Coping Techniques from the Community (31:59–34:44)

• General Advice

  • Always check new symptoms with healthcare professionals.
  • Popular coping methods:
    • Mindfulness, breathing through the pain.
    • Heat packs (wheat bags), hot baths, distraction (e.g., music, focusing visually), comfortable clothing.
    • Compression garments (Spanx) help some; others prefer going braless or loose clothing ([32:43]-[33:50]).
    • Standing, stretching, or gently moving can help, according to some ([33:50]).

  Quote Compilation:

  • "Breathe through it. I find it gets worse if I'm stressed, so I…give myself a little bit of time to breathe." — Jenny [31:59]
  • "I have a focus point that I concentrate on and sometimes put headphones on and listen to music." — Leslie [32:34]
  • "Try Spanx…compression helps." — Lanya [33:31]
  • "Definitely go braless for the ladies…it felt like I was already wearing one." — Lexi [33:43]

5. Key Takeaways and Memorable Moments

• Expect variability: Each person’s MS Hug is different—painful or mild, constant or episodic, one-sided or all-encompassing.
  Quote:

  “If I know if I’ve learned anything about MS…how variable and individual it is in terms of symptoms.”
  — Kate Petheram [24:11]

• Misattribution is common: The MS Hug is often mistaken for more serious or unrelated symptoms, such as heart or digestive problems. When new or different, always rule out other causes.

• Psychological impact: The symptom can be deeply distressing and provoke anxiety or panic. Validation and reassurance are important.

• Management is multilayered: Treatments (medications, self-care, lifestyle, and psychological approaches) may need to be tailored; sometimes, just waiting it out is the best course.

  Memorable Quotes:

  • "It's easy for us to forget as physicians how unpleasant that sensation can be...we might say, 'Oh, it's just sensory,' but can be really disabling and horrible." — Kate Petheram [14:26]
  • “Pain shared is pain halved and all that.” — Stephen [38:35]

6. Important Timestamps

• 00:49 — Early definitions and host experiences
• 05:35 — Dr. Kate Petheram: Medical breakdown of the MS Hug
• 10:44 — Prevalence and variability of the symptom
• 15:06 — First steps for new symptoms and when to seek help
• 16:19 — At-home management techniques
• 19:28 — Medical treatments and their risks/benefits
• 27:09–31:59 — Real-life voices: community experiences
• 31:59–34:44 — Tips from listeners: practical, lived strategies

7. Overall Tone and Final Thoughts

The episode strikes a warm, accessible, and empathetic tone, combining professional expertise and deeply personal testimony. It normalizes unpredictable symptoms, advocates for self-kindness, and urges listeners to reach out to professionals or the MS Trust for guidance and reassurance.

Call to Action:
If you’re ever in doubt whether a new symptom is the MS Hug or something more serious, always consult your healthcare provider—it’s “better to ask than to sit in silence and suffer” ([38:05], Helena).

For more information:
Visit mstrust.org.uk → A-Z of MS → M for MS Hug
Contact the MS Trust helpline: 0800-323-839 (Mon–Fri, 10am–4pm)
Follow the MS Trust on Facebook, YouTube, X, TikTok, and Instagram

“Be kind to yourself, acknowledge the symptoms…they’re not causing you harm, but whilst they are very unpleasant there are ways of managing them.”
— Dr. Kate Petheram [22:08]