Acupuncture in MS
Acupuncture is one form of traditional Chinese medicine that is widely used throughout the world. In the United States, acupuncture was relatively rare until the early 1970s. Since then, it has grown quickly in popularity, and today, possibly a million Americans use acupuncture yearly. The frequency of acupuncture use among people with MS in the United States and Canada is not known, but based on two large surveys, it may be higher than in the general population.
Acupuncture, and traditional Chinese medicine generally, is based on a complex theory of body functioning that involves a flow of energy, or “qi”, through 14 main pathways, or “meridians”, in the body. There is also a balance of opposites known as “yin” and “yang”. According to traditional Chinese medicine, disease states are thought to be a consequence of disrupted energy flow and/or imbalances.
Attempts have been made by scientists to explain some of the pain-relieving effects of acupuncture in Western terms. It has been hypothesized that acupuncture may work by altering the levels of chemical messengers in the body. Specifically, acupuncture may release “opioids” that decrease pain. Other hypotheses propose that acupuncture decreases stress or acts as a placebo. (Improvement occurs because the patient strongly believes the treatment is beneficial.)
In one study using a special type of magnetic resonance imaging (MRI), acupuncture at certain sites produced changes in brain activity. These changes, some of which occurred in pain-relevant brain regions, were present during the time in which the pain-relieving effects were present.
In the end, it may be found that multiple processes are involved in acupuncture’s pain-relieving effects—or that current Western biological concepts are insufficient to explain the processes.
Other methods for stimulating the skin are also used. The acupuncture points can be stimulated by:
Studies in MS
Several other reported trials of acupuncture in MS involved very small numbers of people and were not well designed. It is difficult to draw any conclusions based on those studies.
Two large surveys—one in the United States and one in Canada—have been conducted involving people with MS and acupuncture. Although the results of surveys are not as convincing as those from clinical trials, they are an important method for generating ideas for further research. The preliminary findings of both studies are similar. In each, 2025% of the respondents who said they have MS had tried acupuncture, and 1015% of those who tried it indicated that they planned to continue using it. In both surveys, pain, spasticity, and numbness or tingling were among the symptoms most frequently reported to be improved. Other symptoms that were frequently reported to be improved by acupuncture included fatigue, depression, anxiety, and bowel or bladder function.
Studies in people without MS
It is important to remember that people in these studies did not have MS. It cannot be assumed that these same effects would be experienced by people who do have MS.
Effects on the immune system
Risks and side effects
Over a 20-year time period, only 216 serious acupuncture complications have been reported worldwide. Serious complications, such as puncturing a lung, were associated with acupuncturists who were poorly trained.
There are other rare risks. To avoid hepatitis or AIDS, sterile disposable needles should be used. People with heart valves that are damaged or prosthetic should probably not be treated with acupuncture to avoid the risk of infection. People who take blood-thinning medication (warfarin or Coumadin ®) may occasionally experience bruising or, more rarely, bleeding complications. Electroacupuncture may produce heart rhythm abnormalities in people with pacemakers, and the fumes from moxibustion may worsen breathing in people with asthma.
In the United States, there are approximately 10,000 licensed acupuncturists. There are 3,000 acupuncturists who have M.D. or D.O. training. Organizations that can be helpful in obtaining information about acupuncture and locating a trained acupuncturist include:
Acupuncture combined with other Asian therapies
There are several important considerations regarding Chinese herbal medicine or, indeed, any type of herbal therapy. Chinese herbal medicine involves treatment with complex mixtures of many different herbs. There may be significant variability in the quality and composition of these preparations. Some chemical compounds in the herbs may be toxic or may interact with prescription medications. The safety of these herbal preparations in people with MS has never been extensively studied.
It is known that some of the herbs used in herbal medicine stimulate the immune system, which, theoretically, may be harmful to people with MS. Some of these potentially harmful, immune-stimulating herbs include: Asian ginseng (Panax ginseng), dong quai (Angelica sinensis), astragalus (Astragalus membranaceus), coix, Epimedium sagittatum, reishi mushroom (Ganoderma lucidum), shiitake mushroom (Lentinus edodes), Acanthopanax obovatus, Artemisia myriantha, Artemisia annua, Salvia Miltiorrhiza, Sophora flavescens, green tea, and licorice.
Asian patent medicine is a form of herbal medicine that typically includes herbs along with minerals and animal parts. Several studies indicate that Asian patent medicine may contain toxic ingredients. One study found that approximately one-third of these preparations contained Western prescription drugs (including diazepam [Valium ®], steroids, and prescription asthma medications). Dangerous metals, including arsenic, mercury, lead, and cadmium, have also been found.
While acupuncture is very low risk when properly performed, there are many uncertainties and some clear risks associated with Chinese herbal medicine. Asian patent medicine, should be avoided due to the possible presence of toxic contaminants.
If acupuncture is used, it should only be used in addition to conventional medicine, in consultation with your physician or other licensed health-care professional.
While acupuncture may be a reasonable option to manage some MS symptoms, in conjunction with conventional medicine, there is no evidence to suggest that acupuncture can decrease the frequency of MS exacerbations or the progression of disability.
Thomas Stewart, J.D., M.S., PA-C
Copyright © National Multiple Sclerosis Society, 2004