Multiple Sclerosis

By Jiang Liu, Diplomate of Oriental Medicine
AR Licensed Acupuncturist and Herbalist
Acupuncture & Chinese Medicine Clinic
2024 Arkansas Valley Dr., Suite 402
Little Rock, AR 72212

 

Multiple sclerosis (MS) is a serious chronic neurological disorder that affects the brain and spinal cord. It results from damaging the myelin sheath, the material that surrounds and protects nerve cells, leading to demyelination and scarring. MS onset usually occurs in young adults and it is more common in females. There are several subtypes of MS: relapsing remitting; secondary progressive; primary progressive; and progressive relapsing. The specific cause of MS is not fully understood and there is no known cure for MS.

Causes and Pathophysiology
The cause of MS remains unknown. MS is currently believed to be an autoimmune disease mediated by a complex interaction of the individual’s genetics and environmental factors and infection. Myelin sheath provides a covering or insulation for nerves, improves the conduction of impulses along the nerves, and maintains the health of the nerves. In MS, inflammation causes the myelin sheath to disappear. Consequently, the electrical impulses that travel along the nerves slow down or stop. Therefore, communication between the brain and other parts of the body is disrupted. In addition, the nerves themselves are damaged. As more and more nerves are affected, a person experiences a progressive interference with functions that are controlled by the nervous system such as vision, speech, walking, writing, and memory.

Signs and Symptoms
Because nerves in any part of the brain or spinal cord may be damaged, patients with MS can have a broad spectrum of signs and symptoms, which may include:

Central nerve symptoms:

  • Fatigue
  • Decreased attention span
  • Difficulty of reasoning and solving problems
  • Memory loss
  • Depression and unstable mood
  • Dizziness
  • Loss of balance
  • Hearing loss

Sensation:

  • Pain
  • Numbness
  • Loss of sensitivity
  • Tingling, pricking, crawling, or burning feeling in the arms and legs
  • Electric-shock sensations that occur with certain head movements

Musculoskeletal symptoms:

  • Weakness in one or more arms or legs
  • Muscle spasms
  • Problems with moving arms or legs
  • Problems with walking
  • Lack of coordination or unsteady gait
  • Tremor in one or more arms or legs

Bladder symptoms:

  • Difficulty of beginning to urinate
  • Frequent need to urinate
  • Strong urge to urinate
  • Urine leakage (incontinence)

Bowel symptoms:

  • Incontinence
  • Diarrhea or
  • Constipation

Eye symptoms:

  • Double vision
  • Blurring of vision
  • Vision loss (usually affects one eye at a time)
  • Uncontrollable rapid eye movements

Sexual symptoms:

  • Problems with erections
  • Problems with vaginal lubrication

Speech and swallowing symptoms:

  • Slurred or difficult-to-understand speech
  • Trouble chewing and swallowing

Conventional treatment
There is no known cure for MS at this time. However, there are the therapies that may slow the disease and relieve the symptoms. Consult with your physicians.
Medications used to slow the progression of MS may include:

  • Interferons, glatiramer acetate, mitoxantrone, and natalizumab
  • Methotrexate, azathioprine, intravenous immunoglobulin (IVIg), and cyclophosphamide
  • Steroids may be used to decrease the severity of attacks

Medications to control symptoms may include:

  • Lioresal, tizanidine, or a benzodiazepine to reduce muscle spasms
  • Cholinergic medications to reduce urinary problems
  • Antidepressants for mood or behavior symptoms
  • Amantadine for fatigue

The following may help MS patients:

  • Physical therapy, speech therapy, occupational therapy, and support groups
  • Assistive devices, such as wheelchairs, bed lifts, shower chairs, walkers, and wall bars
  • A planned exercise program early in the course of the disorder
  • A healthy lifestyle, with good nutrition and enough rest and relaxation
  • Avoiding fatigue, stress, temperature extremes, and illness

Chinese medicine
MS is chronic disease. Currently in China, treatment strategy for MS is a combination of Western and Chinese medicine. Western medicine is mainly used in acute stage while Chinese medicine is taken as adjunct treatment. In chronic stage, Chinese medicine is major regimen since it has fewer side effects for long-term treatment. In recent years, Chinese medicine is becoming very popular in the western world for treating MS. Chinese medicine attenuates clinic symptoms of MS and prevents the relapse of MS, therefore controlling the development and progression of MS. Another advantage is that Chinese medicine is a personalized medicine, in which the treatment plan is made according to individual’s situation.

Acupuncture or herbal medicine can improve local or systemic blood circulation, regulate cellular and humoral immune function, attenuate inflammation and reduce edema, relieve pain or reduce pain level, regulate skin sensitivity, relax tightened and spasmodic muscles, tendons and ligaments, ameliorate bladder symptoms, regulate bowel movement, improve vision, relieve fatigue, stress, anxiety and depression, improve sleeping quality, increase the energy, reduce reliance on inappropriate medication, and enhance the quality of life.

Classifications: MS is often classified as the following:

  1. Phlegm-heat blocking meridians
  2. Damp-heat invading
  3. Stagnation blocking meridians and channels
  4. qi deficiency of lung and spleen
  5. Liver and kidney deficiency
  6. Kidney yang deficiency

Herbal Medicine: treatment principles and herbal formula

  1. Phlegm-heat blocking meridians
  • Treatment principle: Clear heat, eradicate phlegm, open up meridians and activate channels.
  • Herbal formula: Ditantang as a major formula but additional herb(s) can be added or some herb(s) can also be taken out from this formula, according to individual situation.
  1. Damp-heat invading
  • Treatment principle: Clear heat and eradicate damp.
  • Herbal formula: Jiaweiermiaosan as a major formula but additional herb(s) can be added or some herb(s) can also be taken out from this formula, according to individual situation.
  1. Stagnation blocking meridians and channels
  • Treatment principle: Tonify qi, nourish internal organs, activate blood circulation, and open up meridians.
  • Herbal formula: Shengyutang as a major formula but additional herb(s) can be added or some herb(s) can also be taken out from this formula, according to individual situation.
  1. qi deficiency of lung and spleen
  • Treatment principle: Tonify qi and nourish spleen.
  • Herbal formula: Shenglingbaishutang as a major formula but additional herb(s) can be added or some herb(s) can also be taken out from this formula, according to individual situation.
  1. Liver and kidney deficiency
  • Treatment principle: Tonify and nourish liver and kidney, and supply marrow and replenish essence.
  • Herbal formula: Zuguiyin as a major formula but additional herb(s) can be added or some herb(s) can also be taken out from this formula, according to individual situation.
  1. Kidney yang deficiency
  • Treatment principle: Lightly tonify kidney yang, and supply essence and replenish marrow.
  • Herbal formula: Erxiantang and Zuoguiyin as a major formula but additional herb(s) can be added or some herb(s) can also be taken out from this formula, according to individual situation.

Acupuncture treatment
First, according to individual patient’s diagnosis (phlegm-heat blocking meridians, damp-heat invading, stagnation blocking meridians and channels, qi deficiency of lung and spleen, liver and kidney deficiency, and kidney yang deficiency), appropriate accupoints are chosen:

  • For the patient with the diagnosis of Phlegm-heat blocking meridians, choose the accupoints that can clear heat, eradicate phlegm, open up meridians and activate channels.
  • For the patient with the diagnosis of Damp-heat invading, choose the accupoints that can clear heat and eradicate damp.
  • For the patient with the diagnosis of Stagnation blocking meridians and channels, choose the accupoints that can tonify qi, nourish internal organs, activate blood circulation, and open up meridians.
  • For the patient with the diagnosis of qi deficiency of lung and spleen, choose the accupoints that can tonify qi and nourish spleen.
  • For the patient with the diagnosis of Liver and kidney deficiency, choose the accupoints that can tonify and nourish liver and kidney, and supply marrow and replenish essence.
  • For the patient with the diagnosis of Kidney yang deficiency, choose the accupoints that can lightly tonify kidney yang, supply essence, and replenish marrow.

Second, according to patient’s location of affected tissue or organ, as well as characteristics of patient’s signs and symptoms, additional accupoints can be added. For example:

  • Arm paralysis: Jianyu, qiuchi,shousanli, waiguan, and hegu
  • Leg paralysis: Huantiao, piguan, fengshi, zushanli, yangliqiuan, shanyijiao, xuanzhong, and kuenluon
  • Speech problems: Lianqian, hegu, tongli, and yamen
  • Swallowing problems: Tiantu, lianquan, futu, fengshi, and hegu
  • Urine retention: Guanyuan, qihai, zhongji, and shenshu
  • Urine incontinence: Zhongji, guanyuan, and qihai
  • Constipation: Zusanli, yangliqiuan, tianshu, dachanbshu, and zhongwuan
  • Blurring eye: Jinming, taoyang, and guangming
  • Paralysis of mouth and eye: Yifeng, xiaguan, and qihai

Other modalities of Chinese medicine

  • Accupiont injection: Accupiont injection is one of the modality of Chinese medicine and is a technique in which some liquid medicines (western medicine or herbal medicine) are injected into the accupoint(s). This is technique is banned in Arkansas.
  • Moxibustion: Moxibustion is one of the modalities in Chinese medicine. It stimulates the acupoints to adjust or realign stagnated qi, restoring normal flow of qi to the areas where the pain or illness was originating from.
  • Tui Na: Tui Na is another modality, also called Chinese therapeutic message and is now very popular in US as a powerful therapeutic extension of traditional western massage. Tui Na utilizes the theory of Chinese medicine (such as meridians and qi) as its basic therapeutic principle. Tui Na has a variety of different systems that emphasize particular aspects of these therapeutic principles, such as rolling, gliding, kneading, percussion, friction, pulling, rotation, rocking, vibration, and shaking by using fingers, thumb, knuckles, palm, and elbow. Tui Na relaxes tightened tendons and ligaments, opens up the meridians and channels, warms meridians and eradicates coldness, improves blood circulation and eradicates stagnation, eradicates edema and attenuates the pain, strengthens spleen and harmonizes stomach. According to individual patient’s diagnosis, appropriate accupoints are chosen for Tui Na.
  • Cupping: Cupping often follows the pattern of point selection that is used for standard acupuncture therapy. During cupping therapy, the practitioner creates a vacuum in a cup by a fire and applies the cup onto selected point of the body, which then draws the skin and some subcutaneous tissues up into the cup. Cupping warms up qi and promotes the free flow of qi and blood in the meridians, therefore, dispelling coldness and dampness and diminishing swellings and pains. Cupping improves local blood circulation, increases the tissue threshold to pain, relaxes muscle tightness, eradicates spasm, and attenuates the pain and edema. Cupping is also useful to strengthen immune system.
  • GuaSha: GuaSha is one of Chinese medicine modalities, which involves repeated pressured strokes over lubricated skin with a smooth edged wood or ceramic cap. The smooth edge is placed against the pre-oiled skin surface, pressed down firmly, and then moved down the muscles along the pathway of the acupuncture meridians, along the surface of the skin. GuaSha:
    • Improve local blood circulation
    • Reduce fever
    • Attenuate fatigue
    • Relax muscle, tendon, and ligaments
    • Ameliorate headache
    • Improve stiffness, pain, and immobility
    • Treat digestive disorders
    • Treat urinary and gynecological problems

In Chinese medicine practice, making correct diagnosis and choosing correct accupoints or herbal formula are the first two most important steps. Second important thing is that during the period of treatment, adjust accupoints and regulate herbal formula such as adding additional herb(s) to the original herbal formula, taking off existing herb(s) from original formula, or increasing/decreasing the quantity of individual herb(s) in original formula, according to patient’s response to the treatment. Third is to combine different modalities of Chinese medicine according to individual patient’s situation and diagnosis. Appropriate combination of different modalities has synergistic effect, which reaches maximal effects of Chinese medicine. In my practice, I have successfully treated the patients with MS. For each MS patient, I make individual treatment plan according to one’s situation and diagnosis. I often take acupuncture and/or herbal formula as a major regimen and combine it with moxibustion, cupping, Tui Na, GwaSha, or reflexology, according to individual patient’s diagnosis. During the period of the treatment, I adjust the accupoints or herbal formula, according to patient’s response.

Life style and dietary suggestions

  • Positive Attitude: Having a positive outlook cannot cure MS, but it can reduce your stress and help you feel better.
  • Exercise: Exercises (moderately and regularly) such as tai chi, yoga, or walking, which can lower stress, help you to be more relaxed, and increase energy and balance, and flexibility.
  • Diet: It is important for people with MS to follow a healthy, well-balanced diet. These nutritional tips may help reduce symptoms:
    • Eliminate all suspected food allergens, including dairy, wheat (gluten), soy, chocolate, corn, preservatives, and food additives.
    • Eat more antioxidant-rich foods (such as green, leafy vegetables and peppers) and fruits (such as blueberries, tomatoes, and cherries).
    • Avoid refined foods, such as white breads, pastas, and sugar.
    • Eat fewer red meats and more lean meats, cold-water fish, or beans for protein.
    • Use healthy oils in foods, such as olive oil or vegetable oil.
    • Reduce or eliminate trans-fat.

Avoid coffee and other stimulants such as alcohol and tobacco.