Acupuncture for Multiple Sclerosis (MS)

Multiple Sclerosis (MS) is a degenerated central (brain and spinal cord) nervous system disorder. The insulating nerve cover in the brain and spine is targeted and damaged by the immune system. This results in loss of function of the nervous system causing various symptoms depending which nerves are affected most. There are 2.3 milion people worldwide suffer MS. 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, s 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.

A study evaluated the efficacy of acupuncture in treating forty-nine MS patients with chronic pain. 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 patients reduced their use of pain killers and 3 stopped additional pain killers completely. The authors were confident that acupuncture could be a treatment for pain 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
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.

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