Acupuncture is a popular treatment for MS patients to relieve symptoms and improve their quality of life, but few studies have evaluated its effectiveness. This review of multiple sclerosis acupuncture studies explored acupuncture’s beneficial effects. A literature search identified twelve peer-reviewed articles examining acupuncture’s impact on quality of life, fatigue, spasticity, and pain.
Multiple Sclerosis and Acupuncture
More than 300,000 Americans are diagnosed with MS, 2.3 million worldwide. MS is an autoimmune disease where the body’s immune system attacks the central nervous system (CNS) myelin, resulting in progressive loss of function. Any CNS structure can be a potential target of MS. Therefore, many symptoms are possible.
Western medical management had successfully reduced the frequency and intensity of disease activity, but only for persons with relapsing-remitting MS. Disease activity in patients with primary progressive or secondary progressive MS has not been shown to improve from medical intervention. Furthermore, many people with MS are dissatisfied with medical management due to adverse effects. This fact has led many MS patients to investigate alternative therapies.
Acupuncture is a popular non-medication therapy for managing the disease, utilized by 7 to 21% of the MS population. However, few studies have investigated its effectiveness as a means of controlling disease activity and managing symptoms. While many studies have found that acupuncture benefits neurologic conditions (stroke, spinal cord injury, and Parkinson’s disease), there is little research describing the use of acupuncture for treating MS.
Acupuncture’s Effectiveness
Since 1974, the literature on Chinese medicine has described MS as a “modern disease.” However, classical accounts of traditional Chinese medicine (TCM) refer to treating MS-associated patterns. Pattern diagnosis is based on the presentation of symptoms and is used to diagnose all diseases. In addition, the definitions and pathology classifications used for MS in acupuncture have a distinct language and logic separate from Western understandings of disease. Therefore, creating a research methodology that satisfies Western and Eastern medicine is more challenging.
How Acupuncture Works
Acupuncture practitioners analyze imbalances of distinct elements in the human body that result in pathology. MS, for example, results from a pathological accumulation of dampness and phlegm. Dampness produces numbness and heaviness, while phlegm produces double vision and poor memory. TCM recognizes that MS has five stages, characterized as:
- Dampness/phlegm
- Stomach and spleen deficiency (weakness)
- Liver and kidney deficiency (dizziness, vertigo)
- Liver and kidney yin deficiency with liver wind invasion (tremor)
- Blood stasis (rigidity)
Acupuncture treatments must be (A) tailored to the correct disease stage and (B) individualized to the patient’s underlying constitution. Therefore, practitioners must identify standard protocols for these five stages, complementing them with specific components designed to benefit each patient.
Creating appropriate research protocols can be challenging given the individualized nature of acupuncture treatments and the multifactorial nature of MS. There is a compelling need to prove the benefits of acupuncture in this population.
Materials and Methods
Investigators used the following search terms to find relevant multiple sclerosis acupuncture studies:
- Multiple sclerosis
- Acupuncture
- Traditional Chinese Medicine
- Demyelinating Disease
They included all studies that used acupuncture to treat MS symptoms or evaluate disease activity. In addition, they only accepted articles from peer-reviewed journals and excluded articles that did not differentiate acupuncture from TCM. Using these criteria, the investigators comprehensively searched the following databases with no language restrictions:
- Ovid MEDLINE (1966 to June 2013)
- Cumulative Index to Nursing and Allied Health Literature (CINAHL, 1982 to June 2013)
- Ovid Allied and Complementary Medicine (AMED, 1985 to June 2013).
- Acupuncture textbooks
Results of Multiple Sclerosis Acupuncture Studies
Fifteen multiple sclerosis acupuncture studies met their criteria. Of those articles, five examined the effect of acupuncture on quality of life, three looked at the effects of acupuncture on MS fatigue, two examined the effects of acupuncture on MS spasticity, two examined the effect of acupuncture on MS pain, and three were animal studies.
Acupuncture and Quality of Life
Hao et al. presented a case report of a sixty-five-year-old man with a twenty-year history of MS. The patient was treated with acupuncture once a week for ten weeks, then once a month for six more sessions. The patient reported significant improvement in well-being, gait, balance, spasms, and incontinence. The authors concluded that acupuncture successfully treated his MS and other CNS damage.
Likewise, Tjon Eng Soe et al. examined the effects of electroacupuncture (EA) on nine MS patients with bladder dysfunction. Patients received thirty minutes of EA once a week for ten weeks. In addition, patients registered a voiding diary and completed a quality of life questionnaire before and after treatment. Once again, bladder function improved in all patients. Urge frequency decreased significantly by −2.21 from 3.89 to 1.68 times a day, and the average number of daytime leaking episodes decreased by −0.78 from 1.18 to 0.40.
Quispe-Cabanillas et al. evaluated the effect of using EA on the quality of life of patients with relapsing MS undergoing treatment with immunomodulators. Thirty-one patients received thirty minutes of acupuncture weekly for six months in the randomized controlled study. EA improved quality of life, including pain reduction and depression.
Acupuncture and MS Fatigue
Fatigue is a common MS symptom. Acupuncture treats blocked energy meridians in the body to boost energy. Three multiple sclerosis acupuncture studies evaluated MS fatigue.
First, 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. She reported improvement on three fatigue measures (Fatigue Severity Scale, Fatigue Impact Scale, and Fatigue Descriptive Scale).
Foroughipour et al. used a case series to evaluate the benefits of acupuncture in treating fatigue in MS patients whose fatigue was resistant to medication. Twenty MS patients received twelve acupuncture sessions over two months following an unsuccessful trial of the antifatigue drug Amantadine. Seventy-five percent of the patients recorded improved scores on the FSS.
Foell hypothesized that EA could decrease fatigue and lack of coordination in a twenty-five-year-old male with a nine-year history of MS. Treatments lasted thirty minutes and were conducted weekly for four weeks. The patient reported an immediate change of sensation in his right leg accompanied by decreased feelings of heaviness. The patient also reported improved coordination and fewer slips and trips with effects lasting for eight months.
Acupuncture and Spasticity
Spasticity is a common symptom in MS patients. Patients often find the medications have unwanted side effects, especially sedation. Acupuncture may therefore be a good alternative to medical management. However, while acupuncture is known to reduce spasticity in stroke patients, only one study addressed spasticity due to MS.
Miller examined acupuncture’s effects on spasticity in four women with MS. Investigators measured spasticity using the Modified Ashworth Scale and the Barthel Index. One of the four women reported less spasticity. These inconclusive results indicate the need for more extensive studies with a more significant number of participants.
Acupuncture and Pain
Pain is a relatively common finding in MS, with 55% of patients reporting experiencing pain at some time throughout their disease. As is the case for spasticity, doctors primarily treat pain with Western pain medications, often resulting in fatigue. Furthermore, MS pain is multifactorial, occurring for both primary and secondary causes. Therefore, acupuncture may provide a nonpharmacologic option for MS patients who experience pain.
Two multiple sclerosis acupuncture studies investigated acupuncture as a modality for treating the pain associated with Tajik et al. evaluated the benefits of acupuncture in treating forty-nine MS patients with chronic pain. Subjects received biweekly acupuncture treatments for six months and noticed significant improvements in the Oswestry Disability Index (ODI).
Conclusion
While there needs to be more research, these multiple sclerosis acupuncture studies indicate that acupuncture benefits MS patients in several significant ways, improving quality of life, and reducing fatigue, spasticity, and pain associated with MS.
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Additional References
Multiple Sclerosis Case Study.
First Multiple Sclerosis Research Study.
Reference
Karpatkin, H. I., Napolione, D., & Siminovich-Blok, B. (2014). Acupuncture and multiple sclerosis: a review of the evidence. Evidence-based complementary and alternative medicine : eCAM, 2014, 972935. https://doi.org/10.1155/2014/972935
Focus Keyphrase: multiple sclerosis acupuncture studies
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