A Few Words on Complementary Therapies
Some people living with MS, as well as other conditions, have found that a range of complementary therapies may be, or feel, beneficial for alleviating symptoms and discomfort. It is important to note that in many cases reported benefits are anecdotal with limited or no research to support them. However, whether the effect is a placebo or not, if a treatment has a positive impact on symptoms and there is no harm created from using it, then complementary therapies can be a helpful adjunct, rather than alternative, to conventional medicines.
Complementary and Conventional Therapies
Complementary therapies are focused on a holistic (or whole-istic) view of an individual's experience and improving overall wellbeing, rather than treating a particular individual symptom. They can include treatments such as herbal medicines, aromatherapy, mindfulness, reflexology, yoga, massage, visiting a chiropractor, acupuncture or osteopathy (the last three of which are viewed as mainstream with acupuncture being available in pain clinics due to its proof as an analgesic although it is still classed as a complementary therapy). There is evidence for yoga and pilates in MS and these are referred to in the NICE Guideline for helping MS related fatigue.
Conventional therapies, otherwise known as Western medicines, include treatments for MS such as Disease Modifying Drugs (DMDs) and physiotherapy, among others. The uses of these are backed up through robust clinical trials to prove their efficacy and are administered by medical professionals who have trained for years to qualify in their field and are dedicated to their work. It is important to know the difference between conventional and some complementary therapies and those who dispense them, because of the difference in standards, like regulatory boards and training.
Regarding Herbal Medicines
We advise some caution when approaching the use of herbal medicines, particularly if you are using DMDs or other prescribed medications. This is due to the potential for drug interactions and contraindications. Some herbal treatments can be detrimental to the efficacy of some medicines or even for some conditions. Please seek medical advice before starting a herbal remedy.
You should always declare any herbal treatments to your doctor, who will be able to provide advice on whether they may interfere with any medicines, such as DMDs which you may also be taking. When taking prescribed medications to help your MS for example, to reduce the number of relapses you may have, you do not want to prevent their efficacy because of the impact of a herbal remedy on your internal biochemical balance.
Another important point to note is that we can’t know how much active ingredient will be in a herbal medicine, as the exact amount of the active ingredient is often unknown. Whereas medicines prescribed by an MS professional or GP and delivered by a trained pharmacist are precise and are as a result of exacting studies to prove efficacy and safety. Unfortunately, at this stage, there is simply not enough evidence to prove this in herbal remedies. One reason for this is that complementary therapies do not attract the funding required to provide evidence-based scientific trials.
It should be noted that a lack of evidence does not always mean that something will bring harm or be ineffective. It does mean that the evidence simply isn't there to prove effectiveness and safety or to identify harmful effects.
Physical Complementary Therapies for Wellbeing
It is difficult to apply the gold standard of double-blind trials to physical treatments to gain the same standard of evidence as drug trials, due to the inherent challenges of how a trial would progress. However, there is good evidence for the benefit of physiotherapy and exercise for MS. FACETS, a 6 week course for fatigue in Multiple Sclerosis run through MS Research uses energy effectiveness techniques and a cognitive behavioural approach and was developed through a Randomised Control Trial (RCT) at Bournemouth University. MSRTE were involved in this multi-centre study and offer FACETS courses on a regular basis.
Non-drug-based therapies have been shown to bring benefits. They can provide a sense of well-being and control to those who are engaged in their use. In addition, some physical treatments may have a component of low-impact exercise and relaxation, such as yoga, pilates or exercise in water. Doing exercise in water counters your body weight and reduces the risk from the force of gravity while providing resistance for muscles.
Osteopathy and Chiropractic therapy are considered to be mainstream but can also be considered to be complementary as they are not widely available on the NHS. Most Osteopaths and Chiropractors operate privately. Acupuncture has been found to work as pain relief and is available on the NHS in pain clinics, however, that is the limit of its use in mainstream channels, due to a lack of evidence in clinical trials for its use in other areas.
Placebo or Not?
Individuals may feel an improvement from engaging in complementary therapies, which may be a placebo effect or not. This is not to say that all complementary therapies can only provide a placebo effect, but that it may be possible that improvements may derive from a placebo. Whether the treatment genuinely treats the symptom it purports to or not, a placebo effect can be beneficial.
If something feels like it is helpful, then it can be empowering to feel as if you're doing something good for yourself. Exploring methods in addition to medical treatment and care, recommended and provided by MS professionals, can play a supporting role in the overall course of treatments. Therefore, complementary therapies can bring a sense of optimism and assistance to a person's daily life.
However, we would strongly urge anyone wishing to use complementary therapies to first seek advice from their MS nurse, doctor or GP, and to approach the use of any herbal medicine with caution.
As a medical research charity, the focus of MS Research is to support robust scientific research in a solutions-based strategy for advancing treatments and care in Multiple Sclerosis. Our mission is to help improve quality of life for people living with the condition and hopefully one day, to see the back of MS.
For further information take a look at our pages on treatments and therapies for MS.
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