Complementary and Alternative Medicine for Multiple Sclerosis

Only a few have proven benefits, though others have potential

As many as 80 percent of people living with multiple sclerosis (MS) turn to alternative treatments to help alleviate pain, spasticity, fatigue, and other symptoms, according to the American Academy of Neurology (AAN). Often referred to collectively as complementary and alternative medicine (CAM), these are non-conventional, non-pharmaceutical approaches to dealing with MS that range from massage to magnetic therapy.

One thing most have in common is that there's little-to-no research proving effectiveness. Some types of CAM purported to be beneficial for multiple sclerosis haven't even been studied. Others have proven to be useless and, in some cases, potentially harmful.

While it's true that no CAM option has proven to be overwhelmingly effective for treating MS symptoms, the AAN highlights some that may be particularly worth considering.

The organization did thorough evaluation of more than 30 modes of complementary and alternative therapies that have undergone at least rudimentary research as treatments for MS. Of those, only 10 had been studied enough for the AAN to determine if they should or should not be recommended for treating MS. Of those, the AAN found only six could be recommended for the purpose of treating MS symptoms:

CAM Therapy What the AAN Says
Oral cannabis extract (OCH) Effective for reducing symptoms of spasticity and pain
Tetrahydrocannabinol (THC) Probably effective for reducing symptoms of spasticity and pain
Sativex (CBD plus THC) mouth spray Probably effective for improving symptoms of spasticity, pain, and urinary frequency
Ginkgo biloba Possibly effective for reducing fatigue
Reflexology Possibly effective for reducing parasthesias
Magnetic therapy Probably effective for reducing fatigue

This is by no means all of the complementary and alternative treatments that have been studied for treating MS, nor does this list include several that are likely to be beneficial. In addition, while there may be no hard numbers as of yet to show that generally safe and healthy practices like yoga and following a low-fat diet alleviate specific MS symptoms, there's no question that they can boost quality of life.

Whatever complementary and alternative options you may be considering, be sure to discuss them with your doctor. Here's what you need to know about the AAN's six picks, as well as others that are often considered for MS patients.

Cannabinoids

Two compounds that occur naturally in the marijuana plant, Cannabis sativa, are being used in medicine today. One is tetrahydrocannabinol (THC), which causes changes in brain function, perception, and mood (the "high" associated with the drug). The other is cannabidiol (CBD), which does not have psychoactive effects.

Researchers have studied cannabis as a treatment for a range of diseases and conditions, as well as in a variety of forms. THC and CBD have also been tested individually and together, and synthetic forms of THC have been developed and tested as well.

In June 2018, the U.S. Food and Drug Administration (FDA) approved a drug called Epidiolox (cannabidiol), which comes as a liquid solution that's taken by mouth, to treat two severe seizure disorders; it has not been researched for MS, however.

Benefits for MS

The AAN established that oral cannabis extract (OCE) is effective for reducing symptoms of spasticity and easing pain. British researchers looking at Sativex (nabiximol), a drug that combines THC and CBD in the form of a mouth spray that's available only in the United Kingdom, found that subjects who received nabiximol had significantly more improvement in spasticity, spasm frequency, and sleep disruptions.

Side Effects and Safety

In studies, most side effects were mild and short-lived, including:

  • Dizziness
  • Fatigue
  • Dry mouth or dry eyes
  • Muscle weakness
  • Muscle spasms
  • Urinary tract infection
  • Mental confusion
  • Cognitive impairment
  • Anxiety and/or paranoia
  • Nausea, vomiting
  • Dry mouth
  • Dry eyes
  • Increased appetite
  • Headache
  • Impaired balance and coordination
  • Elevated heart rate
  • Sedation

Ginkgo Biloba

The leaves of the Ginkgo biloba tree contain two compounds thought to be beneficial for MS: flavonoids, powerful antioxidants, and terpenoids, which help improve circulation by dilating blood vessels and making blood platelets less sticky. Gingko is available as a tablet or capsule that you can swallow, an extract, or a tea.

Benefits for MS

Several studies have looked at the plant's possible benefits for multiple sclerosis, largely because it's believed to alter the levels of a brain chemical called glutamate, thereby improving cognition, memory, and concentration.

According to four studies cited by the AAN, although ginkgo does not appear to improve cognitive function in people with MS, it may help to reduce fatigue in MS.

Side Effects and Safety

Ginkgo biloba was well tolerated in MS studies. It did not, for example, cause hemorrhaging, a concern because of its vessel-widening effects. Even so, ginkgo is regarded as unsafe for people who take blood-thinners or have bleeding disorders. It's also known to interact with a number of medications, including certain disease-modifying therapies for MS.

Remember that “natural” does not necessarily mean “safe.” For example, some dietary supplements may have side effects or interact with drugs and other supplements.

Reflexology

This traditional Chinese medicine therapy involves applying pressure to specific areas of the feet believed to correspond to certain organs, glands, and systems. It's based on a belief that stimulating these points can increase circulation of blood and energy to improve the function of the body.

Benefits for MS

Reflexology may help reduce MS-associated paresthesia (numbness or a "pins-and-needles" sensation). Other potential benefits include relieving pain, lessening muscle spasms, improving walking, and helping treat MS-related bladder and bowel problems.

Side Effects and Safety

Certain manipulations of the feet may cause contractions in pregnant women. Reflexology isn't advisable for people with foot problems, gout, arthritis, or varicose veins.

Magnetic Therapy

Magnetic therapy involves exposing the body to low-frequency pulses of magnetic energy. It's administered in different ways—by having a person lie on a metal mat, for example, or through a magnetic pulsing device worn on the wrist.

Benefits for MS

There's a small amount of evidence to suggest that magnetic therapy might have modest benefits when it comes to spasticity and may help lessen fatigue in people with relapsing-remitting MS.

Side Effects and Safety

Magnetic therapy is considered safe for most people, with the exception of those with pacemakers, insulin pumps, and other medical devices, as the magnets may interfere with how well they function.

Massage

Generally speaking, massage is hands-on bodywork in which a trained therapist strokes, kneads, and applies pressure to muscles. Variants of massage commonly used in the United States include Swedish massage, Shiatsu, and acupressure. None specifically target MS, however.

Benefits for MS

According to the National MS Society (NMSS), massage can help reduce spasticity and increase range of motion, relieve pain, enhance blood flow, and help prevent pressure sores.

Side Effects and Safety

Massage may not be safe for people who have:

  • Edema (swelling)
  • Osteoporosis
  • Ulcers
  • Enlarged liver or spleen

Those who've recently been injured or diagnosed with cancer, arthritis, or heart disease should check with a doctor before having a massage. The same is true for women who are pregnant for whom certain types of massage may be harmful.

Omega-3 Supplements

Fish oil capsules, cod liver oil, and other omega-3 fatty acid supplements—often used in conjunction with an otherwise low-fat diet—have been proposed as potentially beneficial for MS.

Benefits for MS

Although research so far is inconclusive regarding taking supplements, there's no question that making foods rich in omega-3 fats, such as certain fatty fish, walnuts, and flaxseed, part of a regular diet has overall health benefits.

Side Effects and Safety

Omega-3 supplements do not cause adverse side effects, although some people might experience mild gastrointestinal symptoms. According to the NMSS, three grams a day is usually considered safe

People who are allergic to fish or shellfish should be careful about taking supplements derived from fish oil. In addition, according to the National Center for Complementary and Integrative Health (NCCIH), people who take non-steroidal anti-inflammatory drugs, such as aspirin, or anticoagulants should "use caution when taking omega-3 supplements because they may extend bleeding time."

Acupuncture

This is a type of Chinese medicine in which very slim needles are inserted into specific areas of the body in order to allow for the free flow of energy. Blockages of energy, or "chi," are believed to cause or contribute to a multitude of diseases and conditions.

Benefits for MS

Studies have found acupuncture potentially helpful for anxiety, depression, dizziness, and urinary problems, but not specifically in people with MS.

The NMSS states that acupuncture "may provide relief for some MS-related symptoms, including pain, spasticity, numbness and tingling, bladder problems, and depression. There is no evidence, however, that acupuncture can reduce the frequency of MS exacerbations or slow the progression of disability."

Side Effects and Safety

When performed by a licensed therapist, acupuncture is generally regarded as safe.

Yoga

This ancient practice combines moving through specific postures with a focus on breathing and, often, a component of meditation.

Benefits for MS

Although scientific results have been inconsistent, some research has found certain types of yoga may lessen fatigue and possibly ease spasticity in people with MS. The practice also has been associated with improvement in mood.

In fact, a review of 94 studies published in a 2017 issue of the Journal of Clinical Neuroscience concluded that "yoga might be considered as an effective adjuvant" for people with various neurological disorders, including multiple sclerosis.

Even people who are severely disabled can benefit from yoga by using blocks, blankets, or other assistive devices to get into and hold poses. Those who are wheelchair-bound can work with an instructor trained in teaching seated poses.

Side Effects and Safety

Not all forms of yoga are appropriate for people with MS. For example, because hot yoga is done in a warm environment, it can worsen MS symptoms—a phenomenon called the Uhthoff's phenomenon.

Guided Imagery

Guided imagery includes techniques for conjuring up and focusing on positive and peaceful images in order to reduce stress and bring about physical benefits. In variations that target specific conditions (such as multiple sclerosis), guided imagery may involve imagining disease-fighting activity taking place inside the body.

Benefits for MS

Guided imagery may help strengthen the body’s self-healing abilities, reduce pain and stiffness; increase energy; relieve stress and anxiety, and boost mood. It may also help alleviate fear and nervousness before difficult or painful treatments.

Side Effects and Safety

There are no known risks posed by practicing guided imagery.

Tai Chi

This gentle Chinese martial art, which is rooted Buddhism, involves deep breathing and slow, elegant movements. Tai chi is designed to relieve stress, heighten focus, improve muscle tone, and help fine-tune the balance between mind and body.

Benefits for MS

Although sparse and largely inconclusive, research looking at the effects of tai chi on MS symptoms suggests that the practice may help to improve balance and quality of life, as well as flexibility, leg strength, gait, and pain, according to a 2017 review of studies published in Plos One.

Side Effects and Safety

There have been no reported side effects or safety issues linked to tai chi when practiced by people with MS.

CAM Options to Avoid

Certain alternative treatments marketed to people with multiple sclerosis have either been proven totally useless or are downright unsafe. These are just a few examples:

  • Bee sting therapy: The theory behind this practice, also known as apitherapy, for MS is that because bee stings produce inflammation, the body mounts an anti-inflammatory response that may, in turn, reduce inflammation of myelin in the brain and spinal cord. In studies, bee sting therapy hasn't worked to relieve MS symptoms. And, not surprisingly, it has many potential side effects, from temporary pain, redness, and swelling at the site of stings to a severe and potentially fatal allergic reaction (anaphylaxis).
  • Hyperbaric oxygen therapy: This well-established treatment for decompression sickness caused by scuba diving, certain infections, and other conditions involves breathing pure oxygen in a pressurized room or tube. Although consider safe, no research looking for benefits of hyperbaric oxygen therapy for multiple sclerosis have been found, according to the NCCIH.

The National Multiple Sclerosis Society (NMSS) publishes a downloadable brochure for understanding alternative therapies on its website, along with overviews of specific options.

A Word From Verywell

If you're interested in enhancing your present conventional MS treatment with CAM, it's important to choose carefully and have realistic expectations. Because there literally are dozens of options that are alleged to be helpful for people with MS, the best way to start your search is by talking to your neurologist. Some MS doctors even prescribe or provide certain alternative therapies (a good thing to keep in mind when you're looking for a long-term caregiver).

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