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Complementary and Alternative Therapies for Multiple Sclerosis

Medically reviewed by Amit M. Shelat, D.O.
Written by Emily Wagner, M.S.
Posted on April 7, 2021

People living with multiple sclerosis (MS) often try complementary and alternative medicine (CAM) therapies, alongside traditional medical treatments, to manage their symptoms and improve overall quality of life. Up to 80 percent of people living with MS have used CAM therapies, and many report feeling better afterward.

Although these approaches may help temporarily alleviate MS symptoms, they cannot alter the course or progression of the disease. Disease-modifying therapies are the only treatments that are proven to slow disease progression.

Various alternative treatments and complementary therapies are available that you can combine with your current medications and health care regimen. These include vitamins, nutritional supplements, and bodywork techniques. To help avoid potential adverse effects, check with your doctor before you begin any new complementary or alternative therapies. Some dietary supplements may interact with your current medications or worsen some symptoms.

Dietary Supplements

Dietary changes are relatively easy to make and can positively impact MS symptoms. Some common dietary supplements used in CAM treatments include omega-3 fatty acids, lipoic acid, ginkgo biloba, and more.

Omega-3 Fatty Acids

Omega-3 fatty acids are known as “essential” fatty acids because they must come from food and cannot be made by humans. Foods that are rich in omega-3 fatty acids include canola, soy, flaxseed oils, and fish. Many studies have looked at the effects of omega-3 fatty acids on the immune system, but only a handful have done so in people with MS.

A double-blind placebo-controlled study found that omega-3 fatty acids improved disease severity in people with MS when compared to a placebo group taking olive oil. This was a large study (312 participants), but it was poorly designed and the results failed to reach significance. This 1989 study highlighted the need for well-designed clinical trials looking at the effects of omega-3 fatty acids in people with MS.

More than 5,000 research papers have now discussed omega-3 fatty acids and MS. An analysis of all those papers shows that omega-3 and fish oil supplements are beneficial to people living with MS, specifically in reducing the relapse rate and levels of inflammatory markers in the blood.

Lipoic Acid

Lipoic acid is a dietary supplement known for its antioxidant effects. In Germany, it is used to treat diabetic neuropathy, a nerve condition that develops in people with type 2 diabetes. Given this, there is evidence that this compound may help treat other conditions that affect the nerves, such as MS.

One double-blind, placebo-controlled trial looked at the effects of different doses of lipoic acid on inflammation in the body. Although the study was small (37 participants) and lasted only two weeks, the researchers found that inflammatory marker levels fell when participants took lipoic acid by mouth. Some side effects that were noted during the study included:

  • Nausea
  • Headache
  • Gastrointestinal intolerance

However, the most promising trial to date was conducted over two years in people with secondary progressive MS. Results showed a significant decrease in brain shrinkage and an overall tendency to improve walking speed.

Vitamin D

Vitamin D is an essential vitamin in the body that is made when the skin is exposed to ultraviolet rays from the sun. It plays an important role in bone and immune system health. There is also evidence that low levels of vitamin D may increase the risk of developing MS.

Overall, studies have found that many people living with MS have low vitamin D levels. One group found that low levels of vitamin D correlated with increased MS disability. They also found that people with MS have lower vitamin D levels during relapses compared to remission states. With this, further studies have looked at the effects of vitamin D supplements. One small study of 29 people with relapsing-remitting MS found that vitamin D supplementation reduced levels of inflammatory mediators.

Read more about vitamin D and MS here.

Ginkgo Biloba

Ginkgo trees have traditionally been used in Chinese medicine for treating a variety of health conditions. Today, ginkgo leaf extract is used as a dietary supplement for allergies, anxiety, Alzheimer’s disease, and other conditions. Studies have also looked at ginkgo’s effects in people with MS. Results seem to be mixed, with some showing benefits and others showing none.

One double-blind, placebo-controlled study found that taking 240 milligrams of ginkgo per day for four weeks improved a number of functional measures in participants with MS. When compared to the placebo group, the ginkgo group saw modest improvements in symptom severity, functionality, and fatigue.

Another randomized, placebo-controlled study looked at the effects of ginkgo biloba on cognitive function in people with MS. Participants were given either placebo or 240 milligrams of ginkgo for 12 weeks. After treatment, researchers completed four different tests evaluating participants’ cognitive function (word association, verbal learning, and task-based tests). At the end of the study, researchers found there were no statistically significant differences between the placebo and ginkgo groups in any of the tests, showing that ginkgo did not improve cognitive function in people with MS.

Cannabis and Cannabidiol

Cannabis is a commonly used medicinal plant in CAM therapies, and it is recognized for medical use in 29 states. The active compounds found in cannabis are known as cannabinoids; the most popular of these is cannabidiol (CBD). Further studies are needed to determine the effects of CBD in people with MS and how it may enhance mobility. Researchers hypothesize that this compound may decrease inflammation, pain, fatigue, depression, and spasticity in people with MS, potentially leading to improvements in mobility.

The combination of CBD and THC (the psychoactive compound in the cannabis plant) has also been studied for treating spasticity in MS. Overall, this study failed to show a significant impact on spasticity and symptoms of MS. An important point to note in these studies is that THC is still illegal in many states, but a medical form of the compound is available in some.

CBD and THC can be unsafe and can have many serious side effects including:

  • Dizziness
  • Difficulty concentrating
  • Hallucinations
  • Falls
  • Psychotic behavior
  • Depression

These compounds should never be started without first talking to your doctor.

Read more about cannabis and MS here.

Bodywork Techniques

Different types of bodywork can help relieve symptoms of MS. Popular methods include acupuncture, reflexology, and osteopathic manipulative therapy (OMT). These practices focus on stimulating the skin and nerves to provide relaxation and relief.

Acupuncture

Acupuncture is a form of traditional Chinese medicine that uses thin needles to stimulate the skin. This practice is widely used to treat a variety of conditions. One small study of 20 people with MS found that walking speed was improved after participants underwent acupuncture. A report of one person’s experience with scalp acupuncture was also published, which reported improvements in a number of symptoms.

Future large-scale clinical trials are needed to evaluate the effects of acupuncture on symptoms of MS.

Read more about acupuncture and MS here.

Reflexology

Reflexology is a technique that uses pressure on specific points of the hands and feet. This practice is based on the theory that these areas correspond to different organs and systems in the body. When pressure is applied, it can bring healing and relaxation to those areas. This technique can be combined with other therapies and is performed by physical therapists or masseuses with training in reflexology technique.

A few studies have explored the benefits of reflexology in people with MS. One randomized clinical trial compared the effects of reflexology to a sham (e.g., placebo) procedure over the course of one and a half months in 53 participants with MS. The reflexology group received pressure to specific points on the feet and calves, while the sham group received nonspecific pressure to the calves. Overall, the reflexology group saw a significant improvement in urinary symptoms, numbness and tingling in the skin, and spasticity.

Another study evaluated the effects of reflexology on pain in people with MS. A total of 73 participants received either reflexology to specific points or a sham procedure for 10 weeks. Both groups experienced a significant decrease in pain, depression, fatigue, spasms and more, when compared to their baseline scores. This finding shows that reflexology is not superior to the sham procedure, but that massage still offers pain relief for those with MS.

Osteopathic Manipulative Therapy

In OMT, an osteopathic physician “moves a patient’s muscles and joints using techniques that include stretching, gentle pressure, and resistance,” according to the American Osteopathic Association.

Among OMT’s noted benefits, it can help with spasticity and promote blood flow in the body, thereby reducing MS-related fatigue and improving the function of the respiratory and circulatory system. Among OMT techniques is the thoracic inlet myofascial release, designed to stretch tissues and ease joint-related restrictions. Similarly, the sacral wobble technique can be used to treat symptoms related to the large intestine and the genitourinary system.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 165,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you tried complementary and alternative medicine therapies for MS? What has or has not worked? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. A Double-Blind Controlled Trial of Long Chain N-3 Polyunsaturated Fatty Acids in the Treatment of Multiple Sclerosis — Journal of Neurology, Neurosurgery and Psychiatry
  2. Effect of Omega-3 Fatty Acid and Fish Oil Supplementation on Multiple Sclerosis: A Systematic Review — Nutritional Neuroscience
  3. Lipoic Acid in Multiple Sclerosis: A Pilot Study — Multiple Sclerosis Journal
  4. Lipoic Acid and Other Antioxidants as Therapies for Multiple Sclerosis — Current Treatment Options in Neurology
  5. Complementary and Alternative Medicine for the Treatment of Multiple Sclerosis — Expert Review of Clinical Immunology
  6. Serum 25-Hydroxyvitamin D Levels and Risk of Multiple Sclerosis — Journal of the American Medical Association
  7. Vitamin D Status Is Positively Correlated With Regulatory T Cell Function in Patients With Multiple Sclerosis — PLOS One
  8. 25-Hydroxyvitamin D Levels in Serum at the Onset of Multiple Sclerosis — Multiple Sclerosis Journal
  9. The Effect of Ginkgo Biloba on Functional Measures in Multiple Sclerosis — Explore
  10. Ginkgo Biloba Does Not Improve Cognitive Function in MS — Neurology
  11. Cannabidiol To Improve Mobility in People With Multiple Sclerosis — Frontiers in Neurology
  12. Cannabis for MS: Can It Help Treat Symptoms? — Mayo Clinic
  13. Whole Plant Cannabis Extracts in the Treatment of Spasticity in Multiple Sclerosis — BMC Neurology
  14. Acupuncture — Mayo Clinic
  15. Effects of Acupuncture on Gait of Patients With Multiple Sclerosis — Journal of Alternative and Complementary Medicine
  16. Treatment of Multiple Sclerosis With Chinese Scalp Acupuncture — Global Advances in Health and Medicine
  17. What Is Reflexology? Can It Relieve Stress? — Mayo Clinic
  18. Reflexology Treatment Relieves Symptoms of Multiple Sclerosis: A Randomized Controlled Study — Multiple Sclerosis Journal
  19. Reflexology for the Treatment of Pain in People With Multiple Sclerosis: A Double-Blind Randomised Sham-Controlled Clinical Trial — Multiple Sclerosis Journal
  20. What is Osteopathic Manipulative Treatment? — American Osteopathic Association
Posted on April 7, 2021
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Amit M. Shelat, D.O. is a fellow of the American Academy of Neurology and the American College of Physicians. Review provided by VeriMed Healthcare Network. Learn more about him here.
Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.

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