Alternative Treatment (CAM) for MS

Yoga for an alternative therapy

• Fatigue and muscle spasticity are the symptoms of MS that are best addressed by complementary or alternative treatment or medicine (CAM).
• Complementary or alternative treatments or therapies that have been shown to be helpful in helping reduce fatigue include:
  • Yoga,
  • exercise, (including swimming and walking),
  • magnet therapy, and
  • gingko biloba supplements.
• Massage therapy and acupuncture have been reported by some to provide relief for spasticity.
• Ongoing studies are being conducted to look at the potential benefits of medical marijuana on MS symptoms; including chronic pain and spasticity. Marinol and Sativex, two FDA-approved forms of medical marijuana (medical cannabis) may be beneficial in improving spasticity or bladder frequency.
• People who desire CAM therapies generally feel that conventional treatments are not effective in controlling their symptoms or that the side effects are not acceptable.
• Most CAM therapies are not covered by insurance.
• It is important to discuss the use of CAM therapies with your healthcare professional, since some CAM therapies may interact adversely with medications.
• CAM has not been shown to have significant effects on the progression of MS over time.

CAM (complementary and alternative medicine) is care provided in addition (integrative medicine) to or instead of traditional or standard medical practices. This group of therapies is wide-ranging and includes:

• acupuncture,
• herbal supplements,
• dietary modifications,
• magnets,
• reflexology, and
• much more.

Some people who seek out alternative medicine feel that conventional therapy has not successfully controlled their symptoms, or that the potential side effects associated with traditional therapy aren't acceptable. Others find that adding complementary medicine to their program allows improved control of symptoms. When complementary medicine is added to traditional routes, it is referred to as integrative medicine.

Recent studies through the US Centers for Disease Control and Prevention (CDC), specifically the National Health Interview Survey, suggest that as many as 38% of residents within the United States seek out CAM.

Many therapies that are considered within the group of complementary and alternative medicines haven't been studied extensively or investigated in comparison to conventional treatment options.

Multiple sclerosis (MS) is a disease that causes demyelination of the brain and spinal cord or a loss of the covering around axons. When this occurs, the axons (the parts of the nerve cells that transmit impulses to other cells) don't work well. As more areas of the central nervous system are affected by the loss of myelin, different symptoms develop.

The specific symptom seen in MS is related to the area of injury in the brain or spinal cord. Examples of symptoms of MS include:

• a numbness, burning or tingling feeling, or weakness in certain areas of the body; the weakness might be mild or severe enough to cause paralysis of one side of the body;
• bladder and bowel symptoms such as incontinence, difficulty in starting to urinate, a strong and/or frequent urge to urinate, and even loss of control of the bladder or an inability to empty the bladder;
• eye problems such as eye discomfort, double vision, uncontrollable eye movements, optic neuritis, and vision loss;
• difficulty moving the arms or legs, difficulty walking, or problems with coordination and fine motor skills;
• sexual problems in men and vaginal dryness (decrease in vaginal lubrication in women);
• Nerve and brain problems such as dizziness, depression, memory loss, balance problems, poor judgment, and memory loss; and
• as MS progresses, some patients are left with muscle spasticity, which is an involuntary painful contraction of some muscles.

Fatigue and spasticity

Fatigue and spasticity seem to respond best to CAM.

Therapies that have been shown to be of some benefit for fatigue have included:

• exercise, for example, yoga, swimming, walking, and other types of regular exercise;
• magnet therapy; and
• gingko biloba supplements.

Spasticity has reportedly been reduced with the use of acupuncture and massage therapy. A sense of tingling (paresthesias) has been reportedly improved with reflexology.

Alternative treatments for other MS symptoms

Symptoms including depression, memory loss, urinary incontinence, and progression of MS itself (including relapses, disease extent as measured on MRI), and disability have had limited improvement when treated with CAM.

Therapies tested in an effort to improve these symptoms have included:

• a low-fat diet,
• bee venom,
• hypnosis,
• multiple different amino acids,
• alpha lipoic acid, and
• hyperbaric oxygen therapy.

None of these treatments led to any significant benefit in the studied symptoms.

There have been a number of studies looking at the potential benefits of medical marijuana (cannabis) on MS symptoms, including spasticity and chronic pain. There is some suggestion that FDA-approved forms of medical cannabis (Marinol or Sativex) may be beneficial in improving spasticity or bladder frequency. However, there are no reports that ingested or inhaled medical marijuana is beneficial for conditions associated with MS.

The National Multiple Sclerosis Society has more information about medical marijuana for MS symptoms (http://www.nationalmssociety.org/Treating-MS/Complementary-Alternative-Medicines/Marijuana)

Anyone can participate in CAM therapy. However, it is important to recognize that most of these therapies are not covered by insurance, and may be an "out of pocket" cost for patients with MS.

Patients who decide to pursue CAM need to share this information with their physicians, as some supplements may interact with conventional medication and lead to side effects.

The costs of CAM can vary widely; regular exercise and yoga can be low or no-cost options, while massage therapy, acupuncture, and some supplements can be quite expensive.

Every patient must have a good relationship with treating healthcare professionals of traditional and non-traditional therapies to best understand potential costs.

Side effects of CAM vary depending on the treatment.

• Patients who have selected various supplements or dietary measures may experience:
  • hot flashes (flushing), or
  • gastric disturbances, such as nausea or constipation.
• Some supplements can increase the risk of bleeding (ginkgo Biloba) or interact with traditional medications.
• Infections may occur when the skin is punctured, such as with acupuncture.
• Some patients expect CAM to be able to outperform conventional treatments, despite a lack of scientific evidence. If this doesn't occur, patients may feel discouraged.

It is important to discuss any potential or ongoing use of CAM with your healthcare professional, who may need to adjust your current therapies to prevent any adverse effects caused by interactions between the two types of therapies.

Different types of complementary and alternative medicines that were studied in the National Health Interview Survey from 2002 through 2012 include:

• Acupuncture
• Ayurveda
• Biofeedback
• Chelation therapy
• Chiropractic care
• Energy healing therapy/Reiki
• Special diets: Vegetarian, Vegan, Macrobiotic, and others
• Folk medicine
• Guided imagery
• Homeopathic treatment
• Hypnosis
• Massage
• Meditation
• Movement therapies: Alexander technique, Feldenkrais, Pilates
• Naturopathy
• Nonvitamin and nonmineral dietary supplements
• Osteopathic manipulation
• Progressive relaxation
• Qi gong
• Tai chi
• Traditional healers: Botanica, Curandero, Espiritista, Yerbera, Medicine man, Shaman, and others
• Yoga