BASIC DATA, from the American Multiple Sclerosis Association (national MS society. org ) For Information: 1 800 FIGHT MS (1 800 344 4867)
Acupuncture is a technique of Traditional Chinese Medicine that is widely used around the world. In the United States, acupuncture was relatively rare until the early 1970s. Since then, its popularity has grown rapidly, and today, about a million Americans do acupuncture each year. Acupuncture application in people suffering from Multiple Sclerosis (MS) in the United States and Canada is not known, but based on two extensive statistical surveys, it may likely be higher than in the general population.
There are great conceptual differences between Western Medicine and Traditional Chinese Medicine. For example, Chinese medical theory does not include the concept of the nervous system. In Western science and medicine, the nervous system is considered a critical given in understanding and treating many diseases. Moreover, while “causality” (meaning that the “A” process leads to the “B” process) is fundamental to many Western concepts, Chinese thinking assumes that the world is an online series of many interrelated processes, which cannot be viewed individually or in comparison to each other.
Acupuncture and Traditional Chinese Medicine in general, are based on a complex theory about body function that involves the flow of energy, or “ch’i ”, through 14 main pathways or meridians in the body. There’s also the balance of opposites known as “yin” and “yang”. According to Traditional Chinese Medicine, diseases are believed to be a consequence of disturbed energy flow, and the disturbed balance within the body.
Attempts have been made in the past by scientists, to explain some of the comforting effects of acupuncture, in Western terms. It has been assumed that acupuncture may function by altering the levels of chemical transmitters in the body. Specifically, acupuncture can release opioids that reduce pain. Other assumptions suggest that acupuncture reduces stress or acts as a placebo, meaning thatthe improvement occurs because the patient believes the treatment is beneficial.
In a study using a special type of Magnetic Resonance Imaging (MRI), acupuncture in certain parts of the body caused changes in brain activity. These changes, some of which occurred in pain-related areas of the brain, existed there, during the period in which the relief effects were present.
In the end, it can be found that many processes are involved in the effects of acupuncture to relieve pain – or, that today’s Western Biology concepts are not sufficient to explain the processes.
Acupuncture refers to a group of procedures that stimulate specific spots on the skin. Most often, this involves the insertion of thin, metal needles into specific areas of the body, the so-called meridians. It is believed, that this, alters the flow of energy, therefore leads to improved health. There are about 400 points in the human body that acupuncture can be applied to, but usually only four to twelve points are used in one session.
Other methods for skin stimulation are also used. Acupuncture points can be stimulated by:
• finger-pressure which is known as acupressure or, in Japan, shiatsu
• Small heated glasses (suction cups)
• Electroacupuncture which uses electrically stimulated needles
• Moxibustion in which flame-retardant fibers of an herb (Asian mug wort or moxa) are placed at acupuncture points, or used to heat the needles after they are introduced into the skin.
Multiple Sclerosis Studies
Few clinical studies have been conducted to evaluate the effectiveness of acupuncture in people with ΜS. A preliminary study conducted in Canada evaluated whether acupuncture can improve bladder function in people with Multiple Sclerosis, or not. This well-designed but limited study (involving 41 people), showed that bladder incontinence could be improved through acupuncture. However, the result was different, depending on the acupuncturist performing the procedure.
Several other acupuncture studies for Multiple Sclerosis involved a very small number of individuals, and were not well designed, making it difficult to draw conclusions based on them.
There are two major acupuncture surveys, involved people with MS – one in the United States and one in Canada. Although the results of the researches are not as convincing as those of clinical trials, they are however an important method of generating awareness for further research. The preliminary findings of both studies are similar. In each one of them, 20% – 25% of respondents who suffered from Multiple Sclerosis had tried acupuncture, and 10% – 15% of those who tried it, indicated that they planned to continue. Both studies reported a decrease in pain, convulsions, numbness and tingling. Other symptoms often reported to decrease with acupuncture, included fatigue, depression, anxiety and the dysfunction of bowel or bladder.
Studies in individuals without Multiple Sclerosis
A large number of studies have evaluated acupuncture for other medical conditions. To evaluate these studies objectively, in 1997 the National Institutes of Health (NIH) created a group of 12 members. Based on research data and clinical experience, the team concluded that acupuncture is a treatment option for repairing strokes, headaches and pains (including pain in the face, back and neck). Other studies showed that with acupuncture, there was a decrease in: anxiety, depression, dizziness and difficulty urinating.
However, the people participated in the above studies, did not have Multiple Sclerosis, therefore it cannot be assumed that people suffering from Multiple Plaque Sclerosis would have the same results.
Effects on the Immune System
In case, acupuncture affects the Immune System, it is something very important for those suffering from MS, because inflammation and its attacks are related to certain specific hyperactive immune functions. However, this is an issue that needs further investigation. Studies focusing on the effects of acupuncture on the Immune System have been performed in people with various forms of cancer, and rheumatoid arthritis. Acupuncture has given mixed results on the stimulation or the suppression of the Immune System, while there are also indications of zero effect. Due to these mixed results, further studies are required.
Risks and Side Effects
In general, acupuncture is a very well tolerated process by the body, especially when performed by a well-trained acupuncturist. The NIH committee who evaluated acupuncture stated, “The occurrence of undesirable side effects has been documented to be extremely low”. They concluded that acupuncture was ‘extremely safe with fewer side effects than many standard treatments’.
Over 20 years, only 216 serious acupuncture complications have been reported worldwide. Serious complications such as lung –perforation, were associated with acupuncturists who were not well trained.
Further rare risks and contraindications to acupuncture, are:
- People with damaged or prosthetic heart valves should not be treated with acupuncture, to avoid the risk of infection.
- People taking blood thinners (Warfarin or Coumadin) may occasionally experience bruising or, less commonly, bleeding complications.
- Electro-acupuncture can cause heart rhythm abnormalities in people with a pacemaker, and fumes from moxibustion can worsen difficulty in breathing, in people with asthma.
- Sterile disposable needles should be used, to avoid hepatitis or AIDS contamination.
Acupuncture usually takes place once or twice a week. Sessions usually cost $45-$100. The length of time required for a course of treatments, varies. If a beneficial response occurs, it is usually noted after six to ten sessions. The duration of a complete treatment depends on the symptoms and the underlying disease. For Multiple Plaque Sclerosis and other chronic diseases, a longer course of treatment may be needed.
In the United States, there are about 30,000 licensed acupuncturists. There are 3,000 acupuncturists who have M.D. or D.O. training. The organizations that can help obtain information about acupuncture and locate a trained acupuncturist, are:
• The American Academy of Medical Acupuncture www.medicalacupuncture.org 310-364-0193
• The American Academy of Acupuncture and Eastern Medicine www.aaaom.edu 651-631-0204
• The National Certification Committee for Acupuncture and Eastern Medicine www.nccaom.org 904-598-1005
Acupuncture in combination with other Asian Treatments
Traditional Chinese Medicine includes: Chinese Herbal Medicine, Chi Ching, Lifestyle Recommendations, T’ai Chi and Exercise, as well as Acupuncture.
There are many important considerations regarding Chinese Herbal Medicine, or any kind of herbal therapy. Chinese Herbal Medicine includes treatment with complex mixtures of many different herbs. There may be a considerable variety in the quality and composition of these preparations. Some chemical compounds in herbs may be toxic, or may interact with prescription drugs. The safety of these herbal preparations in people with Plaque Sclerosis has not been studied.
It is known that some of the herbs used in herbal medicine, stimulate the immune system, which in theory, can be harmful to people with Multiple Plaque Sclerosis. Some of these potentially harmful, immunostimulant herbs include: Asian ginseng (Panax ginseng), dong quai (Angelica sinensis), astragalus (Astragalus membranaceus), coix, Epimedium sagittatum, reishi mushroom (Ganoderma lucidum), shiitake mushroom (Lentinus ededes), Acanthopanax obovatus, Artemisia myriantha, Artemisia annua, Salvia Miltiorrhiza, Sophora flavescens, green tea and licorice.
Asian patent medicine is a form of herbal medicine that usually includes herbs along with minerals and animal parts. Several studies show that Asian patent medicine may contain toxic ingredients. In one of those studies was found that about a third of these preparations contained Western prescription drugs (including diazepam [Valium], steroids and prescribed asthma drugs). Hazardous metals such as arsenic, mercury, lead and cadmium, were also found among the ingredients.
While acupuncture has a very low risk when properly performed, there are many uncertainties and some clear risks associated with Chinese Herbal Medicine. Asian Proprietary Medicine should be avoided, due to the possible presence of toxic substances.
From a scientific point of view, it’s difficult to assess whether Acupuncture is a good choice for people with Multiple Sclerosis, or not. Acupuncture may be useful for alleviating certain symptoms of MS such as pain, spasticity, numbness and tingling, certain urination disorders, or depression. However, these symptoms and especially depression should never be treated with acupuncture alone.
In patients with Multiple Sclerosis, when acupuncture is used, it should only be used in conjunction with conventional medicine, and in consultation with your attending physician, or other licensed Health Professional.
While acupuncture may be a sensible choice – in combination with conventional medicine – for the management of certain symptoms in Multiple Sclerosis, there is no evidence to suggest that acupuncture can delay progression in this disease, or affect the development of disability.
Source: American & National Multiple Sclerosis Society.