Lhermitte sign is a sudden, uncomfortable sensation that travels down the neck to the spine when flexing the neck. It can be a symptom of conditions affecting the spinal cord, like multiple sclerosis.

Experts classify Lhermitte sign, also called Lhermitte phenomenon or the barber chair phenomenon, as one of the paroxysmal pain symptoms of MS.

Paroxysmal pain refers to short bursts of pain, usually nerve pain.

People often describe Lhermitte sign as an electrical shock or buzzing sensation.

Lhermitte sign is a type of nerve pain that occurs when the neck is bent down. It can feel like an electric shock that travels from the head down the spine.

In people with multiple sclerosis (MS), Lhermitte sign develops due to damage to the protective coating surrounding the nerves, called myelin. In MS, the immune system attacks and destroys myelin in the brain and spinal cord, slowing down the signal that travels between nerves.

Due to a lack of myelin, your nerves can’t effectively relay messages, which causes various physical symptoms, including pain. It can also result in nerve damage over time.

Lhermitte sign mainly causes an electric or wave sensation that travels down your neck and back. You may also feel it in your arms, legs, fingers, and toes. The shock-like feeling is often short and intermittent. However, it can feel quite powerful while it lasts.

The pain is usually the most prominentTrusted Source when you:

  • move your neck, such as bending your head to your chest
  • are stressed
  • experience fatigue
  • are overheated

While painful, Lhermitte sign isn’t dangerous and won’t cause further damage to your spinal cord or worsen your MS.

You can experience Lhermitte sign when your nerves are no longer coated with adequate myelin. This causes abnormal signals across the damaged area when pulling or extending the spinal cord, like when your neck is flexed.

Lhermitte sign is common in MS, but it’s not exclusive to the condition. People with spinal cord injuries or inflammation might also feel symptoms. Other common causes can include:

Talk with your doctor if you believe that these conditions may be causing you to feel the distinct pain of Lhermitte sign.

Some possible treatments that may help minimize Lhermitte sign’s symptoms include:

A doctor may prescribe antiseizure medications to help manage your pain. These medications help control your body’s electrical impulses. Some possible types that may helpTrusted Source include:

  • gabapentin (Neurontin)
  • carbamazepine (Tegretol)
  • oxcarbazepine (Trileptal)

A doctor might also recommend steroids if you are experiencing Lhermitte sign as part of an MS relapse. They may also recommend:

Though more research is still needed, pulsed electromagnetic field (PEMF) therapy may also help. Some people use theseTrusted Source devices to reduce inflammation and manage pain.

Some lifestyle changes may make your symptoms more manageable. These can include:

  • wearing a neck brace, which can keep you from bending your neck too much and worsening pain
  • working with a physical therapist on improving your posture, which can help prevent an episode
  • practicing deep breathing and stretching exercises to help lessen your pain
  • practicing mindfulness, meditation, yoga, or other ways to help manage stress

MS symptoms like Lhermitte sign, especially in the relapsing-remitting form of MS, often worsen in times of physical or emotional stress.

Try to get plenty of sleep and monitor your stress levels to help manage your symptoms. It might even be helpful to talk with others about what you’re going through.

If you’d like to connect with others with MS and get support, try our free Bezzy MS Healthline app on your iPhone or Android.

Before making major changes to address your symptoms, consider talking with a doctor.

Studies on the prevalence of Lhermitte sign are scarceTrusted Source.

However, one 2015 study suggests 16% of people with MS experienced this symptom.

Lhermitte sign can feel jarring, especially if you’re unfamiliar with it. If you begin to feel sensations like electric shocks in your body when you bend or flex your neck muscles, it’s best to talk with a doctor.

Lhermitte sign is a common symptom of MS. If you’ve been diagnosed with MS, you should seek regular treatment for the condition. You can also manage Lhermitte sign if you’re aware of the movements that trigger it and can avoid them.

Lhermitte sign may resolve on its own, especially if it appears during an MS flare.

Once you have a diagnosis of MS, the best way to prevent Lhermitte sign is to start an effective disease-modifying therapy (DMT). If you’re already on one and it doesn’t seem to be effectively managing your MS, you can discuss switching to a different DMT with your doctor.

What does a positive Lhermitte’s sign indicate?

Though it can indicate other potential underlying issues, Lhermitte sign often occursTrusted Source with MS. It can also be an early sign, which means you should contact a doctor if you develop the sensation before having a formal diagnosis of MS.

It can also occur if you have a spinal cord injury or another health condition that affects the spinal cord.

Can you have Lhermitte’s sign without MS?

The short, intense pain or electric shock feeling often occurs with MS. However, you can also experience the sensation without MS. Other underlying conditions can cause it, such as transverse myelitis or trauma to the neck.

What triggers Lhermitte’s sign?

The main trigger of Lhermitte sign involves bending or flexing the neck forward, such as when putting your chin to your chest.

Lhermitte sign causes a painful, electric shock sensation. Though it can occur for other reasons, it is considered one cause of pain associated with MS and may be an early indicator of the condition in some people.

Management may include medical and nonmedical interventions. In some cases, reducing the motion that triggers it can help improve your quality of life. This may include managing stress and wearing braces.

The condition does not mean MS is worsening, and it usually resolves on its own.