The derivation of the term will become clear upon reading various descriptions of this manifestation by MS patients, below.

Firstly, a physiological explanation:-

• There are tiny muscles between each rib, called intercostal muscles which basically hold the ribs together, but also give the ribcage some flexibility; it's when these muscles go into spasm that we get the MS hug, a friendly description of an extremely uncomfortable and often painful symptom.

Secondly, these are personal descriptions by MS patients of how it feels:-

• To start with it's more of a burning pain than a crushing one which begins in the back. Some are lucky and catch it in time so there it stays. However it can sometimes move around to the front, and if it travels all the way around then it does indeed feel like being hugged by a boa constrictor! Some rarely get it as high as the chest and usually stays confined to the midriff area. At its worst, it can last for several days.
• It feels as if I’m wearing a very tight rubber band which stretches from under my arms to below the waistline; the band gets tighter and tighter until it becomes difficult to breath. It feels very constricting and although not all that painful, is very uncomfortable. I don’t feel hungry because of the perceived pressure on my stomach.
• I find myself holding my arm folded across my abdomen in order to ease the discomfort and find I can't breathe deeply enough to get my breath. I tried taking my asthma inhalers thinking these would help but because it's a skeleto-muscular thing, they gave no relief.
• I have excruciating chest pains which take my breath away, however heart tests have shown that my heart is healthy but because of the recurrent nature of this, I was told it was the MS Hug or ‘Girdle’.

Thirdly, how do we deal with or treat these symptoms? Because of the varying severity of the Hug, there are many ways and these are some recommended, again by MS patients  :-

• My Neurologist sanctioned my GP to prescribe a 5mg diazepam pill along with Ibuprofen and I have to admit it only lasts a few hours by taking that combination.
• I’ve never had any "proper" treatment for it, but I incorporated it into my self-hypnosis sessions. I would visualise that I had my torso was wrapped tightly in clingfilm, then would visualise the clingfilm being ripped off – this is an over-simplified description of what I did. With time the hug diminished down to a patch the size of a fist in my solar plexus - interestingly, where I’m told we "hold" our fear. After that it disappeared completely.
• I find that warmth is something which helps. I use a warm blanket or hot water bottle and find that the more I relax the more the tightness goes away. The best thing for me though is to lay down and be cosy. Being outstretched helps the feeling of restriction on the diaphragm and being warm helps to relax enough for the pain to dissipate.
• Two things I depend on are:- Analgesic cream, liberally applied on my back, to calm things down before they get out of hand and Lorazepam. I'm very sensitive to the sedative effects, so just take quarter to half a tablet, which I let dissolve either under my tongue or between my lip and gum, thus it reaches the bloodstream much quicker than if it has to go via the stomach I've discovered that the secret is to treat the hug at the very first sign, rather than trying to ignore it in the hope that it'll go away - I believe that, as with a lot of other things MS (vertigo springs to mind), once the brain gets into a groove, it's very difficult to persuade it to stop.

© Multiple Sclerosis Resource Centre