Until recently, if you were diagnosed with multiple sclerosis (MS), treatment options were extremely limited. Doctors prescribed powerful drugs to reduce the number of new harmful brain lesions that characterize MS…to help control relapses…and to perhaps even slow progression of the disease.
Unfortunately, these medications, available only by injection, were often inconvenient to use and not always effective. Newer medications (such as Gilenya, Aubagio and Tecfidera) are now available in pill form. But is that enough?
New thinking: Even though medication is still believed to be important for most people with MS and should begin soon after diagnosis (when it is likely to be most effective), researchers are now identifying nondrug therapies that can also help.
With MS, the immune system mistakenly attacks the myelin sheaths that insulate the nerves, resulting in weakness, tingling, spasticity (marked by stiff or rigid muscles), balance problems and dizziness.
The nondrug therapies below have been shown to help people with MS have the best possible outcomes. Try as many as possible.
• Walking. Inactivity is dangerous for a person with MS—it can lead to muscle weakness, shallow breathing and other problems that can be exacerbated by the illness.
In studies of people with MS, walking (a great exercise because it can be adapted to various fitness levels) has been shown to reduce symptoms of fatigue, depression and pain…and improve sleep quality. Walking also may improve cognitive functioning, which can decline with MS, and improve balance, reducing one’s risk of falling. My advice: Walk for at least 15 to 30 minutes three to five times per week. Use a cane or walker if MS symptoms include leg weakness or numbness, spasticity and/or balance problems.
• Strength training. Research shows that muscle-strengthening exercises increase bone health and improve bladder and bowel control—all of which can be compromised with MS.
My advice: Twice a week, use weights that target the major muscle groups (such as quads, hamstrings, calves, biceps, triceps, shoulders and core). Do 15 of these exercises for each muscle group per session, and slowly add more repetitions and/or heavier weights. Important: Speak with your physician before starting an exercise regimen. If you have problems with balance, consider working out with a physical therapist, friend or personal trainer for extra support.
• Cooling strategies. Increased activity and warmer temperatures can raise the core body temperature in people with MS. Even a slight increase may temporarily worsen their symptoms. With regular exercise, however, the body becomes more efficient in regulating its temperature, and heat sensitivity decreases.
My advice: While your body is becoming conditioned to respond efficiently to heat during your exercise program, take steps to prevent overheating. For example, exercise in an air-conditioned environment…use fans…wear loose-fitting clothing…and stay well hydrated. Cooling products such as vests, headbands, shirts and hats can help keep your core temperature stable.
Good cooling products include: Vests from GlacierTek (GlacierTek.com) or Coolture (Coolture.net), which range in price from $100 to $400. The cost may be covered by insurance. Cooling vests and neck, ankle and wrist wraps are also available from the Multiple Sclerosis Association of America (MyMSAA.org)—free to those who meet income limits.
• Salsa dancing. In a pilot study, people with MS who did salsa dancing for 40 minutes twice a week for four weeks improved their balance and gait and increased their activity levels. The front-to-back and side-to-side movements used in salsa dancing are believed to be especially helpful for those with MS.
My advice: If salsa dancing sounds appealing, ask your doctor whether he/she thinks lessons and regular practice sessions would be appropriate for you. Ballroom dancing and the video game Dance Dance Revolution have also been shown to help MS patients.
• Acupuncture. Acupuncture has been found to help with MS symptoms such as bladder problems, sleep disorders and tingling.
My advice: If you want to try acupuncture, look for a licensed acupuncturist. To find one near you, consult the National Certification Commission for Acupuncture and Oriental Medicine, NCCAOM.org.
• Massage. In a recent study, MS patients who received a 45-minute massage twice a week for five weeks improved their physical and social functioning and suffered less depression. By relaxing the muscles and increasing blood flow, massage may also alleviate spasticity, cramping and pain.
My advice: Consider trying Swedish massage, which uses long strokes and a light touch. Avoid using a table warmer or hot packs during the session, since people with MS tend to get overheated.
Caution: Some people with MS take corticosteroids, which may increase their risk for osteoporosis. If you have osteoporosis, massage may not be advisable unless your physician recommends it.
Tai chi, which includes deep breathing and gentle movements, can help MS sufferers relieve stress, increase muscle strength and improve balance. Yoga, which helps with stretching and balance, may also reduce stress and release tension.
My advice: If you’re interested in trying tai chi and/or yoga, be sure to find a teacher who has experience working with people with MS. Some MS patients have found Iyengar yoga, with its focus on breathing and body alignment, to be helpful. Bikram yoga, which is performed in a very warm studio, is not recommended for people with MS.
