Acupuncture and Multiple Sclerosis

Around 100,000 people in the UK have multiple sclerosis (MS) (MS Society 2012), an autoimmune disorder of the central nervous system (Compston 2006). Most patients with MS present with a relapsing-remitting disease that, over years, typically leads to a progressive phase of permanent and increasing disability (secondary progressive disease) (Hawkins 2000). (https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/2817-multiple-sclerosis.html)

About 10–15% of patients have progressive symptoms from the outset, with no relapses and remissions (primary progressive disease). Some patients have a relatively benign form of the disease with no significant disability for many years (Hawkins 2000). The underlying pathogenic mechanisms in MS appear to be heterogeneous and involve inflammation and axon degeneration (Compston 2002).

Physical symptoms of MS commonly include vision problems, balance problems and dizziness, fatigue, bladder problems and stiffness and/or spasms (MS Society 2012). It can also affect bowel function, speech and swallowing, and cognitive function. Conventional treatment includes disease-modifying drugs such as interferon beta (-1b and -1a), fingolimod, glatiramer, and natalizumab, physiotherapy and dietary modification.

References

Compston A et al (Eds). McAlpine’s multiple sclerosis. Fourth edition. Philadelphia: Elsevier Inc, 2006.

Compston A et al. Multiple sclerosis. Lancet 2002; 359: 1221-31.

Hawkins C. Pathogenesis and clinical subtypes of multiple sclerosis. In: Hawkins CP, Wolinsky JS (Eds). Principles of treatments in multiple sclerosis. Oxford: Butterworth Heinemann, 2000.

MS Society. Signs and symptoms [online]. Available: http://www.mssociety.org.uk/what-is-ms/signs-and-symptoms?gclid=CPi8nuTBzLICFYYNfAodMnEAjQ

How acupuncture can help

This Factsheet focuses on the evidence for acupuncture in MS.

There has been very little research published. One systematic review, which summarised and evaluated the available evidence of acupuncture for neurological diseases concluded that more rigorous trials are warranted to establish acupuncture’s role in MS. (Lee 2007) A randomised controlled trial that compared the effects of 2 types of acupuncture in 14 patients with secondary progressive MS found that minimal acupuncture resulted in greater improvement than Chinese medical acupuncture for psychological health: all other aspects were similar (Donnellan 2008). An uncontrolled open study, which looked at whether electroacupuncture diminishes voiding symptoms and improves quality of life in patients with MS and overactive bladder and urge incontinence, found that it may have a useful role in patients with MS and mild bladder dysfunction who do not wish to take medication or are unable to because of side effects (Tjon Eng Soe 2009). Both of these studies were tiny, so the results can be seen only as very preliminary.

In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic mechanisms, thus promoting physical and emotional well-being.

Research has shown that acupuncture treatment may specifically help to relieve symptoms of multiple sclerosis by:

  • reducing numbers of inflammatory and CD4 T cells. This accompanied improved paralytic symptoms in a rat model of MS (Kim 2012);
  • promoting NT-3 (a protein growth factor that supports neuronal survival) expression, increasing the cell number and differentiation of endogenous oligodendrocyte precursor cells, and causing remyelination and functional improvement of the demyelinated spinal cord (Huang 2011);
  • acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry (Hui 2010; Hui 2009);
  • increasing the release of adenosine, which has antinociceptive properties (Goldman 2010;
  • improving muscle stiffness and joint mobility by increasing local microcirculation (Komori 2009), which aids dispersal of swelling;
  • reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kavoussi 2007).

Additional Info

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