Acupuncture for Multiple Sclerosis (MS)

Multiple Sclerosis (MS) is a degenerated central (brain and spinal cord) nervous system disorder. It is a condition which the immune system attacks nerve cells (the insulating covers in the brain and spine called myelin) causing nerve cells damage. The damage disrupts the communication of the nervous system. This results in loss of function of the nervous system causing various symptoms depending on which nerves are affected most. It is a lifelong condition. There are 2.3 milions people worldwide suffer MS. It's estimated that there are more than 100,000 people diagnosed with MS in the UK. It's most commonly diagnosed in people in their 20s and 30s, although it can develop at any age. It's about two to three times more common in women than men. The main symptoms include fatigue, difficulty walking, muscle stiffness and spasms problems with balance and coordination vision problems, problems controlling bladder, problems with bowl, vision problems problems with thinking and learning. Medical management limits the frequency and intensity of disease activity, but only for persons with relapsing-remitting MS. The most common type of MS is relapsing-remitting (RR) MS. In this type, a series of attacks followed by complete or partial disappearance of the symptoms until another attack occurs. It may be weeks to years between the attacks. The symptoms can be from mild to severe. Vision disturbances could be the first sign of MS. Limb weakness with or without difficulty of coordination and balance could be early symptom. Other common symptoms include muscle spasm, fatigue, numbness and pricking pain. Loss of sensation, speech impediment, tremors or dizziness can exist. Mental changes include lack of concentration and attention, memory loss, impaired judgment and performing sequential tasks, depression etc. Sexual dysfunction and reduced bowl and bladder control can develop as the disease worsens. Early treatments are recommended for patients with MS. Apart from medications, patients with MS are seeking complementary and alternative medicine (CAM) as an additional treatment option.

Acupuncture has been used in the management of neurologic conditions such as stroke, spinal cord injury, and Parkinson's disease. Acupuncture is also used in treating MS. There are also some studies on the effect of acupuncture on MS. This study is involved in a few aspects such as MS quality of life, MS fatigue, MS spasticity and MS pain.

For example, there is a case report of a sixty-five-year-old male with a twenty-year history of MS. The patient was received with Chinese scalp acupuncture once a week for ten weeks, then once a month for six more sessions. There was significant improvement in well-being, gait, balance, spasms, and incontinence. Another study has shown that after electroacupuncture of 10 weeks on nine MS patients with bladder dysfunction, mean urge frequency decreased significantly and mean number of daytime leaking episodes decreased. A study by McGuire examined the effect of acupuncture on the fatigue of a fifty-year-old female with MS who received twenty minutes of acupuncture once a week for seven weeks. There were reports of improvement on fatigue. Another study on twenty MS patients received twelve sessions of acupuncture over two months following an unsuccessful trial of the antifatigue medication Amantadine. Five of the twenty patients recorded improved scores on the FSS. Also there was a report that acupuncture improved coordination and fewer slips and trips with effects lasting for eight months in MS patient.

A study evaluated the efficacy of acupuncture in treating forty-nine MS patients with chronic pain using a case series pretest/posttest design. Patients received biweekly acupuncture treatments for six months and noticed significant improvements in the Oswestry Disability Index (ODI).

From these studies we can see acupuncture is a potential treatment option for MS patients, though much of the research needed for the efficacy of acupuncture.

There was a report by Kerr Grieve et al from Tayside MS research unit, Ninewells hospital and medical school, Dundee, Scotland. They had positive data to support that acupuncture is an effective treatment for pain and other MS symptoms. There were 20 patients with MS involved in the research. 85% were female aged 20 to 60 years. Duration of diagnosis was 1-29 years. All of the patients had been attending the clinic for between 3 and 24 months. The majority were receiving acupuncture on six weekly bases. 18 patients had some reduction in pain. 9 patients scored the level of pain relief as 8/10 or better. 18 patients had pain relief for four or more weeks. Improvement of sleep pattern, mood, energy levels and mobility was also subjectively improved, though not as much as pain relief. 9 patients had a temporary increase in pain. 55% of patientsreduced their use of pain killers and 3 stopped additional pain killers completely. The authors were confident that acupuncture could be a treatment for apin and other MS related symptoms for patients with MS.

Recently a survey conducted by Stoll SS et al from Neurology department in Drexel University College of Medicine Phyladelphia USA about using CAM treatment for patients with MS. 111 patients with MS completed the survey properly. All patients used non disease-modifying agents (non-DMA agents). 65 patients (58.6%) exercised on a weekly basis. 64 patients (57.7%) used CAM therapies such as acupuncture and massage, or osteopathic manipulative treatment and psychotherapy.

Quispe-Cabanillas JG et al investigated the effect of acupuncture in 31 patients with relapsing-remitting type of MS under treatment of immunomodulators. The patient’s quality of life was assessed to evaluate the effectiveness of acupuncture. They found that acupuncture improved various aspect of quality of life for those patients including reduction in pain and depression. Foroughipour M et al also observed the effectiveness of acupuncture in 20 patients with MS. They found that 12 sessions of acupuncture improved the fatigue symptom in patients with MS who were resistant to the medication amantadine.

A recent research found that three months of acupuncture treatment reduce MS symptoms and disability score in 3-month and 6-month follow-up were reduced as compared with those before treatment and annual recurrent rates were also reduced with acupuncture treatment.

References

Stoll SS et al J Am Osteopath Assoc (2012) 112:22-8

Quispe-Cabanillas JG et al BMC Complement Altern Med (2012) 12:209

Foroughipour M et al Acupunct Med (2012)

Kerr Grieve et al J Neurol Neurosurg Psychiatry (2013) 84:e2.

Karpakin HI et al Evid Based Completment Alternat Med (2014) 2014:972935

Wang C et al Zhongguo Zhen Jiu (2017) Jun 12;37(6):576-580. doi: 10.13703/j.0255-2930.2017.06.002.