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Tips for Managing the "MS Hug"

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Updated September 12, 2011

How Can the "MS Hug" be Managed?

The "MS Hug" is an 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 Solu-Medrol. There are also several medications which can be prescribed that can provide varying degrees of relief (see below).

The following suggestions have been taken from different patient accounts of what helps them – 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. I have even heard of people wrapping themselves in Ace bandages for the same effect.
  • 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. I have heard some people picture several thick rubber bands around their bodies, which they are cutting off one by one. Another version is plastic wrap around their torso, which is getting unrolled, releasing their bodies and allowing them to relax.
  • Increase Fluid Intake: Try lukewarm herbal tea for relaxation and plenty of water.
  • Wear Loose Clothes: For some people, the sensation occasionally feels like an unpleasant tickle when touched by fabric, or feels like a waistband that is too tight. Loose-fitting garments may help.
  • Massage: Some report amazing relief from massage, especially manual lymph drainage massages. I can report that Thai massages helped me relax while I was having this symptom, and made it feel much better during the massage and several hours afterwards. Start with your favorite type of massage to see what that does.
  • Warmth: Heat helps some people and makes it worse for others. Try a warm bath or heating pad to see if this provides some relief.
  • Analgesic Creams: This didn’t help me, but for some it is the answer. 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 Medications are Available?

Many of the medications used to treat the “MS hug” are very addictive and should be used only with caution and careful monitoring by your doctor. These include:
  • Antispasticity Medications: These include Lioresal (baclofen), Valium (diazapam), lorazepam and Xanaflex (tizanidine).
  • Neuropathic Pain Relief Medications: These include Lyrica (pregabalin) and Neurontin (gabapentin).

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 the “MS hug” can be a sign of an exacerbation, it can also be a sign of a pseudoexacerbation, which means a temporary worsening of symptoms caused by an external factor, such as heat or fatigue. If you feel the slightest twinge of an MS hug coming on, try cooling off and resting and you may be able to prevent it from getting worse. It might not help, but it certainly can’t hurt.

Source:

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

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