By LeeWEpstein

July 16, 2020


Despite the existence of conventional drugs to manage symptoms of multiple sclerosis (MS), a majority of patients also use alternative therapies, including vitamins, exercise, and cannabis, according to a new survey.

Multiple Sclerosis Study: Complementary and Alternative Therapies

For the study, researchers at Oregon Health and Science University in Portland asked MS patients if they used “complementary and alternative therapies”, drugs and practices outside of standard medical care.

A majority of just over 1,000 respondents said they used some alternative therapy, including cannabis, vitamins, herbs, and minerals, as well as mind-body therapies such as exercise, mindfulness, massage, and various diets. An earlier survey, conducted in 2001, found that some people used these therapies regularly – and many find them helpful – but only 7% talked to their doctors about them.

It was a bit of a wake-up call for physicians that they needed to be better informed about complementary or alternative therapies, and then consider these therapies as part of the overall treatment plan for their patients,” said lead author Dr. Elizabeth. Silbermann, a neurology fellow.

What is multiple sclerosis?

MS is a potentially disabling disease that results when the immune system attacks the nervous system and damages nerves. Symptoms vary though some patients eventually lose the ability to walk, others may experience only mild symptoms. MS has no known cure, but treatments can slow the progression of the disease and help patients manage symptoms. “We have many more treatment options for our patients, and we are treating our patients earlier than ever before,” said Silbermann.

Approximately 70% reported using conventional medications to manage their MS symptoms. The percentage using mind-body therapies (such as mindfulness and massage) nearly tripled – 39% of current patients, compared with 14% in the previous survey. More than eight in ten were exercising, up from 67% in 2001.

Sport: one of the best alternative therapies

Exercise is one of the only alternative therapies in the survey that has strong evidence of success in reducing MS symptoms. “MS is a disease that causes physical disability and weakness, so it is very natural to refer patients to physiotherapy and encourage them to be physically active,” Silbermann explained.

There is good evidence that things like stretching can be helpful for MS-related muscle sealing, and that staying physically active and doing aerobic exercise can be very helpful for our patients.

Cannabis to relieve multiple sclerosis

In the current survey, about 30% of participants reported using cannabis in various forms. Cannabis is legal in Oregon and Washington, D.C., where the study conducted, potentially limiting the generalizability of the results. There is evidence that marijuana can help patients suffering from “spasticity” or muscle tightness.

When you ask patients to report how tense their muscles feel, they consistently report that their muscles are less tense when they use cannabis, which is great,” Silbermann said.

Advantages and disadvantages of cannabis

Sean Hennessy, an epidemiologist at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, said:

One of the few uses of cannabis products for which there is reasonable evidence of efficacy is muscle spasticity associated with multiple sclerosis.

Hennessy participated in a 2017 report by the National Academies of Science, Engineering, and Medicine that synthesized available information on cannabis products and their use in medicine.

But cannabis can potentially exacerbate existing MS symptoms, including thought and memory impairment. Silbermann said that “this will show us that everything has a side effect that we need to consider as part of a comprehensive strategy and treatment plan.”

One of the most important findings of the new survey is that more than half of the respondents said they had spoken to their doctors about their use of alternative medicines, compared to a dismal 7% in 2001.

Silbermann said she hoped this was because patients feel that doctors are more accepting and knowledgeable about other treatment options. However, not enough is known about alternative therapies for doctors to decide which ones are safe and effective, she said. Doctors need to know what supplements or medications you are taking for many reasons, but mostly to ensure that the drugs they prescribe do not have potential interactions. But alternative medicines such as supplements and cannabis are not well regulated or well studied, limiting the ability to assess their safety and effectiveness.

It’s hard to know what you’re getting. So there is always a concern about the purity of everything you take, and this is especially true in cannabis,” Silbermann said.

According to Hennessy, there are not enough referenced resources that doctors can rely on to find out which drugs interact badly with cannabis.

So, yes, it’s a good idea to tell your doctor if you use cannabis, but he doesn’t have a place to look to see if cannabis interacts with other drugs you take,” Hennessy said.

Silbermann stressed that more research is needed to support any recommendations on alternative therapies.

This is a whole other area of medicine, and I think we are learning how important it is for our patients,” she said.

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