Can Acupuncture Help MS Patients Walk Better?
Multiple sclerosis (MS) is a neurological disease associated with several symptoms that can lead to disability. For years, one of the more obvious outward symbols of MS disability was a wheelchair. Gait, or walking, is a complex process that involves the coordination of multiple systems of the body. Several common MS symptoms, including weakness, spasticity, loss of coordination or proprioception, pain, and visual and cognitive dysfunctions, can contribute to difficulty walking.
In a study of 1011 people with MS, 41 percent reported difficulty walking, including 13 percent with inability to walk at least twice a week. Of those with difficulty walking, 70 percent said it was the most challenging aspect of having MS. Only 34 percent of people with MS with difficulty walking were employed.
Researchers have investigated various pharmacologic and non-pharmacologic interventions to help improve walking in people with MS. Many of these interventions focus on medication and/or physical activity. Now, recent study findings suggest that acupuncture, a complementary treatment, may be effective.
What is acupuncture?
Acupuncture is a practice used in Traditional Chinese Medicine (TCM) to stimulate specific points on the body using a variety of techniques. The most familiar technique of acupuncture involves penetrating the skin with needles that are manipulated by hand or electrical stimulation. The needles used in acupuncture are metal, solid, and very thin— only a fraction of a millimeter in diameter. In TCM, the stimulation of points along any of the 12 meridians, or channels that transport energy called qi throughout the body, can encourage healing and relieve symptoms.
Does acupuncture improve walking?
Results from a recent study, published in the Journal of Alternative and Complementary Medicine, demonstrate that acupuncture may improve walking in people with MS. The study included 20 people (60 percent female) diagnosed with relapsing-remitting MS who experience trouble walking.
Gait impairment was evaluated by the 25-foot walk test (T25-FW). Participants were randomized into two groups. Group A received “true” acupuncture while group B received “sham” acupuncture. Immediately before and after treatment, gait was measured. At least one month later, groups received the other acupuncture treatment and gait was measured again.
When using true acupuncture, 85 percent of cases showed an improvement in T25-FW test (with two cases showing no change and one case showing increased time to walk 25 feet following treatment), compared with 40 percent when sham acupuncture was done. The average improvement in the true treatment group was 13.9 percent, with greater effect in females than males, 17.5 percent and 8.6 percent improvement, respectively.
Can acupuncture help other MS symptoms?
A 2014 review of studies examining the effects of acupuncture on MS found that scientifically rigorous research is lacking. Authors identified fifteen articles that met their review 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.
Study results were mixed. Problems with these studies include the number of case reports, small sample sizes, no randomization, little use of controls, and lack of reported statistical analysis. Future studies need to address these methodological flaws before evidence-based treatment decisions can be made regarding the use of acupuncture in MS.
How can I find studies on acupuncture in which to participate?
When searching for clinical trials in which to participate as a person living with MS, there are several resources, including the National MS Society (NMSS), ClinicalTrials.gov, ResearchMatch.org, and the Center for Information & Study on Clinical Research Participation.
I found no acupuncture-related studies on the NMSS website. However, when searching ClinicalTrials.gov, I found two trials listed that use acupuncture to address MS symptoms. One of these trials is already completed and the other trial, “A Study to Analyze the Effect of Acupuncture on Mobility And Quality of Life in Multiple Sclerosis” (NCT03174379), is not yet recruiting participants. This trial was registered by the New York University School of Medicine, but no contact information is listed in the details of this study.
See more helpful articles:
Criado MB, Santos MJ, Machado J, et al. Effects of Acupuncture on Gait of Patients with Multiple Sclerosis. J Altern Complement Med. 2017 Apr 14. doi: 10.1089/acm.2016.0355. [Epub ahead of print]
Karpatkin Hi, Napolione D, Siminovich-Blok B. Acupuncture and multiple sclerosis: a review of the evidence. Evid Based Complement Alternat Med. 2014;2014:972935. doi: 10.1155/2014/972935. Epub 2014 Jun 18.
LaRocca NG. Impact of walking impairment in multiple sclerosis: perspectives of patients and care partners. Patient. 2011;4(3):189-201. doi: 10.2165/11591150-000000000-00000.
Yadav V, Bever C Jr, Bowen J, et al. Summary of evidence-based guideline: complementary and alternative medicine in multiple sclerosis: report of the guideline development subcommittee of the American Academy of Neurology. Neurology. 2014;82(12):1083-92. doi: 10.1212/WNL.0000000000000250.