Understanding complementary therapies and MS

What is MS?

Multiple sclerosis (MS) is a condition that affects the central nervous system (CNS). The CNS consists of your brain and spinal cord, and as the name suggests it plays a central role in the regulation and management of key bodily functions.

Nerve cells in the CNS are covered by a protective layer of fatty protein called the myelin sheath, which is a bit like the insulation which surrounds an electrical cable. MS is an auto-immune condition where the immune system gets confused and attacks the nerve cells. Instead of attacking an infection or virus, it damages this protective sheath. This process is called demyelination. The effect of demyelination is to disrupt the messages that are transmitted from and to the brain, causing them to slow down, become distorted or not get through at all.

Common MS symptoms

While there are common symptoms experienced by people with MS, the combination of symptoms, their severity and frequency will be different for everyone. Equally, symptoms can come and go, with some being responsive to treatment, whereas others can be more difficult to manage.

Common MS symptoms include fatigue, visual problems, issues with balance and co-ordination, musculoskeletal and neuropathic pain, limb weakness, muscle spasticity and impaired bladder and bowel function.

The individualised nature of MS is such that not everyone affected will experience all of these related symptoms. Furthermore, the progression of disability in people with MS will also differ greatly from person to person.

How is MS managed?

Managing the impact of MS can require a multi-disciplinary approach for both management of the course of the condition itself and also individual symptoms. The National Institute of Health and Care Excellence (NICE) guidelines for MS management underpins this and pinpoints the need for both pharmacological and non-pharmacological interventions which work in tandem for maximum impact.

Disease Modifying Therapies (DMTs) are available for most people who are affected by relapsing forms of MS. These are medications that aim to change the course of MS and are designed to reduce the number of relapses and slow down condition progression. Not everyone with MS will benefit from DMTs in the same way and people will respond differently to treatment. Additionally, DMTs are not suitable for everyone affected by MS, with some also declining to use them for many different reasons. Therefore, it is important to raise awareness of the non-pharmacological ways in which MS and associated symptoms can be managed.

Complementary therapies and MS

The NICE guidelines underpin the importance of taking a whole of lifestyle approach to managing MS and its related symptoms. This includes taking regular exercise, eating well and accessing complementary therapies. The latter is a term used to describe treatments and therapies which sit outside of mainstream medical care. They can be used to ‘complement’ conventional medicine or indeed in isolation.

It is estimated that around 70 per cent of people with MS have used a form of complementary or other therapy to treat their symptoms. Studies have shown that some of the more popular complementary therapies amongst people with MS are reflexology, massage, yoga, relaxation, mindfulness, aromatherapy, and acupuncture. The most common reasons for their use are reported to be pain management and relief from the impact of other symptoms associated with MS, including spasticity and mobility problems.

Below we look at a selection of these therapies and their potential benefit for MS management.

Acupuncture

Originating from China, acupuncture has been practised for thousands of years. It works with the energy or ‘qi’ of the body which flows through channels, known as meridians or conduits. It

is believed that acupuncture stimulates the nervous system and causes the release of neurochemicals to promote physical and emotional wellbeing.

Acupuncture involves the use of very fine sterile needles which pierce the skin to reach an acupuncture point. They are inserted very precisely and connect with the body’s qi. It is not considered painful, involving just a small prick to the skin and maybe a dull ache for a few seconds when the point is reached.

For MS, acupuncture is commonly used to help relieve pain and tension, improve movement, sensation and manage the impact of spasticity. It may also help with managing bladder urgency, and studies have shownthat for some people it can be a useful tool to combat fatigue.

Massage

This is one of the oldest known therapies and has been used for thousands of years to help ease stiffness in muscles and joints, relieve pain, improve blood and lymph circulation and induce a sense of wellbeing. It can be used to stimulate the various systems of the body and can also help with posture, ease stress and release tension.

It has been found that for people with MS, massage lowers anxiety, reduces pain, promotes relaxation and improves patient wellbeing. A 2021 review of previous studies concluded that using massage as a complementary therapy helped to alleviate the impact of MS related fatigue.

Mindfulness

Mindfulness has been practiced for a number of centuries and derives from eastern secular and religious institutions, including Buddhism and Hinduism. In practice, it provides a way of being able to be ‘in the moment’, setting aside anxieties about the past or the future, and being grounded in the present.

There is a growing body of evidence which shows that practicing mindfulness can be beneficial to people affected by MS, particularly with managing anxiety, stress and low mood. For example a study published in 2023 found that people with MS reported improvements in emotional balance and brain processing speed after receiving just four weeks of mindfulness training. Practicing mindfulness meditation has also been shown to help people with MS improve sleep quality, including managing the impact of insomnia.

In their guidelines for MS management NICE recommends that health professionals consider mindfulness as a way of treating fatigue. They also suggest it is used as a preventative practice for people with experience of recurrent depression. For many people with MS poor mental health can be a problem, so mindfulness can provide a helping hand in in the management of this incredibly complex and life-affecting issue.

Yoga

Yoga originates from India and has been practiced for over 5,000 years. Its main components involve physical postures, regulation of breathing, meditation, and relaxation. It is generally safe to practice, however, there are many styles of yoga which differ in terms of their focus and difficulty. Therefore, supervision may be required for beginners, particularly to help find the most appropriate style and starting point.

There is a growing body of evidence which shows that yoga can be useful in supporting people with MS for a variety of reasons. For example, a small-scale study which was published in 2019 found that just a 12 week-long course of yoga could help people with both relapsing and non-relapsing forms of MS to improve their overall quality of life, including their physical and mental health.

Key considerations and accessing complementary therapies

MS-UK would always strongly suggest that people with MS consult with their neurologist or MS nurse team prior to starting any new complementary therapy. It would also be wise to speak with your GP. This will ensure that you receive expert guidance, considering MS and your wider health, meaning you can continue with accessing any particular therapy with confidence.

Additionally, a reputable therapist will be fully insured for any liability and should be aware of any potential contraindications that may affect you. They should also be members of a professional body for their particular area of expertise. MS-UK’s Complementary Therapy Choices booklet provides signposting to these for each discipline.

Specifically for people with MS and other neurological conditions, complementary therapies are available via a network of neuro therapy centres scattered around the UK and a variety of private neuro rehabilitation centres.

MS-UK’s online activities portal offers access to complementary therapies from the comfort of your home, including meditation, mindfulness, seated qi gong and yoga. All classes are devised and run by therapists that are accredited specialists in their field.