Managing multiple sclerosis can be difficult, especially when it comes to choosing between different treatment options. You want a treatment plan that is going to help minimize your symptoms while being mindful of any side effects. All the while making sure that your mental health is being protected.
Many patients with MS use an integrative or complementary approach to manage their symptoms and reduce relapses. That’s because these approaches don’t just focus on the physical nature of MS, but the mental, emotional, and spiritual effects. The mind-body connection works both ways: although MS primarily affects the central nervous system, patients often experience mental and emotional symptoms such as anxiety and depression. Similarly, studies have shown that having a positive outlook can improve MS recovery and health.
What is integrative medicine?
Integrative medicine includes a full spectrum of physical factors, as well as emotional, mental, social, spiritual, and environmental factors that can influence someone’s health. It emphasizes a holistic, whole person view rather than a segmented one that only focuses on one aspect of managing a health condition. Integrative medicine uses appropriate, evidence-based therapeutic and lifestyle approaches to achieve optimal health and healing. It emphasizes the relationship between the patient and the healthcare provider(s) because this too can affect the healing process. Although integrative therapies have not traditionally been part of Western medicine, more practitioners and patients are realizing their benefits.
What integrative therapies are beneficial for MS?
Integrative therapies combine conventional medicine, like medication, lifestyle changes, and sometimes surgery, and complementary medicine, which are typically not part of traditional Western medicine. That means you may see a wide variety of different healthcare providers to help manage your MS. In addition to your primary care team and specialists, you might also work with massage therapists, acupuncturists, energy healers, or chiropractors. You may also work with a counselor/therapist, nutritionist or dietitian, herbalist, or other naturopathic practitioners.
It is important to keep in mind that integrative therapies are not meant as a replacement for traditional or conventional medicine. The two work in tandem to help you manage your MS, so that means you should keep each of your providers or therapists in the loop about your treatments elsewhere. An open pathway of communication allows each provider to make any necessary adjustments and can help ensure that there are no side effects or contraindications for any of the treatments.
Some of the integrative therapies you might use to manage your MS include:
Food and diet
Although there is no evidence that a specific diet can prevent, treat, or cure multiple sclerosis, there is evidence to support that making certain food choices can prevent MS symptoms from getting worse. Both the American Cancer Society and the American Heart Association recommend that adults with MS eat a high-fiber, low-fat diet that is high in omega-3s and omega-6s. Omega-3 fatty acids contain two compounds, eicosatetraenoic acid (EPA) and docosahexaenoic acid (DHA), that are believed to decrease certain inflammatory responses in the body. Omega-3 fatty acids can be found in:
- Dark, leafy greens like kale, spinach, collard greens, and mustard greens
- Fatty fish like salmon, tuna, mackerel, anchovies, herring, and sardines
- Flaxseeds and flaxseed oil
- Chia seeds
Omega-6 polyunsaturated fats are healthiest in their natural state, but can lose nutrients when they are refined. Too much of these fats can promote inflammation, so it’s important to consume only a moderate amount. These fats can be found in:
- Sunflower oil
- Safflower oil
- Corn oil
- Soybean oil
- Pumpkin seeds
- Sunflower seeds
Other recommendations for dietary changes that can help manage MS symptoms include preparing food at home as often as possible, choosing whole grains, limiting processed foods and added sugars, and eating fresh fruits and vegetables daily.
Another dietary change that can help with managing multiple sclerosis is vitamin B12 supplementation. Research has shown that people with MS are more likely to have a vitamin B12 deficiency than people who are otherwise healthy. Vitamin B12 plays a significant role in synthesizing and maintaining the myelin sheath, the protective layer that forms around nerve fibers. Damage to the myelin sheath disrupts the flow of information from the brain to other parts of the body, causing some of the symptoms of MS. It is important to note that vitamin B12 deficiency can be a separate condition on its own and does not necessarily mean that someone has MS.
Acupuncture and acupressure
Acupuncture is a form of traditional Chinese medicine that is based on the theory that the body has 14 pathways called meridians, that promote the flow of energy, called qi (pronounced “chee”). When there is an imbalance or disruption in someone’s qi, it can cause disease. Acupuncture alters the flow of energy by inserting thin, disposable needles into specific locations on the skin and along the body’s meridians. Acupressure follows a similar thought process, but instead of needles it involves applying pressure to specific parts of the body. Another form of acupuncture is electroacupuncture, which involves the use of electrically stimulated needles.
Acupuncture can provide relief for MS-related symptoms such as pain, numbness and tingling, and depression, although it has not been proven to slow the progression of the disease. One survey of 1,000 people with MS found that about 1 in 5 had tried acupuncture, mostly for anxiety and pain. Half of the participants said they saw an improvement in depression, fatigue, sleep problems, and spasticity (muscle stiffness or tightness).
One study of 100 women with MS who were split into two groups, an experimental group and a placebo group. The study found that the women who received acupressure at acupoints reported significant improvements in their mean fatigue scores. Prior to the intervention, there was no significant difference in fatigue severity between the two groups. However, immediately after the intervention, the women in the experimental group reported a mean score of 44.5 compared to 79.5 for the placebo group. Four weeks after the intervention, the experimental group reported a mean score of 65.6 while the placebo group reported a mean fatigue score of 95.5. The study concluded that acupressure was a simple, cost-effective technique that can be applied in any setting, and that nurses could be trained to provide acupressure to clients to help manage their fatigue.
Massage and bodywork
Massage isn’t just a means of occasional self-care; it can also help reduce pain, improve blood circulation, and relieve muscle spasticity. There are several different types of massage to help MS symptoms.
Swedish massage, for example, uses a few different techniques:
- Effleurage — A long gliding stroke
- Friction — Deep circular movements with the thumb pads or fingertips
- Petrissage — Kneading and compression
- Tapotement — Quick movements using the hands to alternative strike and tap the muscles
Shiatsu massage is a Japanese method based on finger pressure and focuses on prevention by increasing circulation and restoring energy balance in the body (similar to acupressure). Other forms of bodywork include:
- Rolfing — Attempts to correct the body alignment by applying deep pressure to the tissues that cover muscle and internal organs
- Trager approach — Gentle, rhythmic touch combined with exercises to release tension in movement and posture
- Alexander technique—Movement therapy intended to correct habits of bad posture and movement that cause muscle and body strain and tension
Reflexology is a massage technique that helps reduce pain. A reflexologist applies pressure to predefined pressure points on the hands and feet. These pressure points are connected to the nervous system, and applying pressure to those spots helps relieve the source of discomfort. For many people, reflexology is very relaxing, and some people with MS report improved mood and less pain and fatigue after a session.
Massage and bodywork can be effective for many people with MS, but it is important to note that there are certain conditions where massage might be unsafe. These include edema, osteoporosis, or ulcers. It is also important to note that while massage and bodywork can help relieve stress and pain, they do not have an effect on the progression of MS. They can, however, improve mood, relieve anxiety and depression, and increase ambulation (the ability to walk from place to place).
Studies have shown that meditation can be helpful for reducing pain and improving quality of life for patients with MS. There are several different forms of meditation, including mindfulness-based meditation and mantra meditation, like transcendental meditation. For people who have trouble meditating on their own, there are guided meditations that walk you through the full process.
One of the benefits of meditation is that it can help decrease cortisol levels. People with MS typically have elevated levels of cortisol, which is the body’s main stress hormone. When cortisol levels remain too high for too long, it can cause a number of health problems, such as anxiety and depression, headaches, sleeping problems, and more. Meditation can help decrease cortisol levels and improve sleep. Meditation may also help slow the progression of MS by regulating the body’s stress response.
Cannabis and cannabinoids have been proven to be effective ways to reduce pain and improve spasticity and bladder symptoms in people with MS. Cannabis is a flowering plant that when matured is covered with trichomes, which are gland of resinous oil containing cannabinoids and terpenes and provide the physical and psychoactive effects. The two main compounds that have been studied are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the most psychoactive substance while CBD is a non-psychoactive subatance.
The Food and Drug Administration has approved two synthetic cannabinoid products, dronabinol and nabilone, with specific guidelines for prescribing. While other forms of cannabis may be helpful for MS, there are currently no other medical marijuana products approved by the FDA in treating MS.
It’s important to know that psychoactive properties can produce adverse effects, like memory loss, increased risk of depression and decreased IQ. Cannabis is also a highly addictive substance. Because of this, it’s important to work with your doctor to monitor your progress with cannabis and to help you find the right type and amount that works best for you.
Implementing New Therapies
There are many other integrative therapies that may be beneficial for people with MS, including vitamin D supplementation, gingko biloba, Ayurveda, regenerative therapies, and more. Finding the right therapies for you might time, research, and experimenting, so try not to get discouraged if you implement a new therapy and don’t see results right away. Work with your doctor to evaluate your options and track your progress. Remember that these therapies are meant to complement traditional or conventional treatment you are receiving for your MS.
If you want to learn more about what integrative therapies other people with MS have tried, PatientsLikeMe can help. There are nearly 75,000 patients with MS you can connect with who know what you’re going through and can offer support.