MS and Pain: Alternative Therapies
MS pain can be excruciating, frequent, inconvenient or heavy unending dullness. There are many traditional treatments that help to alleviate those pains. However, they don't always work and there is always someone who can't or just doesn't want to take too much medication. Some MSers are ready to try anything -- just to make the pain stop.
Today, I am talking about alternative treatments that may be used when addressing pain.
Approximately 50% - 75% of MSers use some form of Complementary and Alternative Medication (CAM), non-traditional interventions intended to reduce pain. There are many alternative treatments targeting MS pain, some even promising a cure. Some of them are recognized and recommended by the medical community, effective in stopping or reducing pain. Others are completely useless and a few possibly even harmful.
Alternatives often lack sufficient documentation and research, and some are not taken seriously enough to justify research costs. Therefore, efficacy of most alternative therapies is largely anecdotal. MSers must be aware of risks and benefits before jumping into these treatments. There is no cure for MS, regardless of claims, but alternative therapies may relieve pains accompanied by MS. Even though a doctor's prescription is usually not required, it is highly recommended that we [inform our doctors] to guard against a conflict with pharmaceutical drugs or misreading symptoms because the care is not coordinated. Doctors who practice conventional care are embracing legitimate alternative treatments more than ever before.
When considering a therapy, it is important to consult with your neurologist or your pain management doctor. Here are some alternative treatments that address or claim to address MS pain:
Acupuncture has been tried by 20% of MSers. There is a lot of anecdotal information, but it tells two stories. There are some stories that say acupuncture really helps where pain is concerned. However, there are other accounts of acupuncture actually leading to, and perhaps causing, relapses. The National MS Society [recommends caution].
Applied kineseology is a method of assessing the balance of the body and finding and correcting imbalances. This non-invasive holistic technique involves massage, acupressure, and nutrition, among other techniques.
Chiropractic therapy is based on the concept that the nervous system coordinates all of the body's functions. This sounds perfect for MS. The idea of chiropractic therapy is to realign vertebra to eliminate irritation to nerves. There is anecdotal evidence that this therapy helps the lower back, but not necessarily the head and neck. A few years ago, I personally had a masseuse, trained in a chiropractic office, who came to the house on a regular basis. I was quite satisfied with her work.
Cold laser therapy - Cold laser refers to the use of low-intensity or low levels of laser light. It is intended to stimulate cells so they can actively respond to stress and pain; however, it also inhibits some cell activity. Although there has been some reported success with cold laser therapy in chronic pain, there are still questions about nerve regeneration. The FDA has approved 25 cold laser devices or methods in the US. Research and evaluation of this therapy continues.
This therapy is definitely not for pregnant women. It is also suspect for children because a laser too close to the end of a bone inhibits further growth. The National MS Society suggests you may want to postpone or proceed with caution until the research has been completed.
Exercise/Yoga/Tai Chi/Qigong increases strength, flexibility and balance, helping alleviate stiffness and posture problems. According to the National MS Society, exercise improves "better bladder and bowel function, less fatigue and depression, a more positive attitude, and increased participation in social activities." Exercise can be effective for chronic neck pain and back pain.
Julie Stachowiak, Phd, reviews yoga, telling us even wheelchair users can benefit, sometimes with a caregiver's help. Yoga helps with muscle tone, balance, and spasms. She recommends we give it try long enough for it to begin to work.
Dynamic Meditation is a holistic technique of mind development to allow focusing on the pain. This is thought to help vision problems, stress, and depression in MS. Julie Stachowiak, PhD, one of my favorite sources, also addresses the use of creative visualization for MS Hugs.
Homeopathics looks at the whole person, including personality, temperament, state of mind and lifestyle, then flushes toxins from body. There is anecdotal evidence that some painful symptoms are eased. This method is popular, but it is also controversial. There is a possibility of conflicting with a conventional treatment or interfering with diagnosis.
Hippotherapy takes advantage of a horse's rhythmic gait to improved posture and balance as well as other functions. Hippotherapy is also credited with normalizing muscle tone and reducing spasticity. This one sounds great to me, but there could be some safety issues. Horses used in this therapy are generally mature, gentle, horses specially trained for unconventional mounting. The National MS Society is convinced this one works -- they are willing to [pay 50%] of the cost. However, some insurance companies say there is not yet sufficient scientific data.
[**Massage**] is the most common form of bodywork used to relax muscles and reduce stress. Types of massage range from stroking and kneading to shaking. There is evidence that massage benefits pain, depression, constipation, spasticity and muscle tension.
Extra caution is recommended with edema, unless it is caused by immobility. Also, massage should be gentle when osteoporosis is present to prevent damage to the brittle bones.
Medical Marijuana is perhaps the most controversial alternative therapy. Medical marijuana in one form or another - pills, cannibis, hemp, mouth spray - has been a topic of discussion for years in many medical communities and especially with MS.
I have written about medical marijuana before, talking about the medical, legal, and personal perspectives. Doctors often remind us of the risk due to illegality. Thirteen states have legalized medical marijuana use, but it is still subject to federal law. The last time a bill was presented to the Senate for a vote (2006), the bill was narrowly defeated showing that Senate support is stronger than ever before, and reflecting a growing compassion among the population. Pertinent to MSers are personal anecdotes telling us it is useful for reducing pain, spasticity and tremors.
Research has been inhibited because this drug is illegal. However, there are occasionally small trials intended to prove or disprove the benefit of medical marijuana, including a small 10-year trial funded by the National MS Society for secondary and primary progressive MS. The Society has a statement.
Until medical marijuana is legalized this alternative therapy will remain controversial.
Nutrition works with the body-weight-pain connection, especially to correct posture problems and awkward gaits. Nutrition addresses constipation, swallowing problems, and the relationship between nutrition and energy to fight fatigue. I think the importance of nutrition to an MSer's general health is greatly underestimated and I have written about this before. In my research I found: "Medicare accepts [Medical Nutrition Therapy] for diabetes and renal disease. Even the retail food industry has adopted the idea of a 'heart healthy' diet." What about MS?
Valerian roots are dried roots used as a mild sedative to calm restlessness and anxiety and overcome mild insomnia. These roots generally relax the nervous system. This herbal therapy is considered helpful to calm nerves, treat spasms, and reduce blood pressure. Brain treatment theories These brain therapies are not current alternative treatments, but clinical trials developing treatments of the future. Our brain tells us when we have pain, whether there is a true stimulus or simply a misinterpreted signal from the nervous system. Therefore, it sees logical that the brain can be used as a pain deterrent or it can be taught to react positively. Dynamic meditation is a current alternative therapy that uses creative visualization, similar to the first of two trials I am talking about in this section.
A friend who suffers from migraines once told me she could think her way out of the pain by focusing on the headache. She said it did not work all of the time, but it did work. Is that a tactic that might reduce MS pain? "My Pain, My Brain" is a NYTimes article that says it just might. This technique is actually watching brain activity during a pain episode and consciously reprogramming it to reduce the pain.
Author Melanie Thernstrom tells of a functional MRI (fMRI) being used in a Stanford study hoping to develop a technique that teaches people to control their brain's response to pain. Pain causes the nervous system to re-wire itself, and this study aims for the patient to redirect that wiring. It sounds a bit sci-fi, but in the most positive way. Wouldn't it be great if this neuroimaging study found the answer to help us reduce severe pain? If we can learn to control our reactions to pain, then we can all focus on something besides hurting.
Another current study is sponsored by the National MS Society.The goal of this trial is to develop Cognitive Behavioral Therapy (CBT) to conquer pain. It is targeting neuropathic pain and using a positive attitude and self hypnosis to actually shut it down. I have always advocated the benefits of a positive attitude, but I had not thought of coupling it with self hypnosis. That sounds like a good idea to me.
These are only some of the alternative therapies used to fight pain in MS -- I'm sure there are more. There are other therapies designed to address the entire disease, but here we are focusing on pain.
There are times, especially when we are in the midst of long-term excruciating pain, that we are willing to try almost anything to get it to stop. However, the best idea at times like that is to take a deep breath and investigate the proposed therapy a little further. Is it possible there will be unpleasant side effects or even an outcome more horrible and more long-lasting than the pain itself. It would be nice if the "snake oil days" of the old West were gone, but that is not so.
At the same time, some therapies -- even some that sound fantastical -- are actually helpful, reducing the pain without side effects. We need to do our best to ensure that any time we embark on a new therapy path there is a chance, a good chance, for a positive outcome.
Good luck with all of the therapies you use to manage your pain. There is such a thing as pain-free life, even with MS, and there is also the possibility of a joyful life with MS.
Next I will conclude this series by talking about living with pain.
Notes and Links
WebMD Alternative Therapies
Taking Control of MS