Acupuncture and Multiple Sclerosis: A Review of the Evidence

This systematic review examined the available literature on the use of acupuncture in the treatment of multiple sclerosis (MS), a neurological disease that affects approximately 300,000 people in the United States and 2.3 million worldwide. MS is characterized by autoimmune destruction of myelin in the central nervous system, resulting in progressive loss of neurological function. The investigators conducted a comprehensive search of medical databases including MEDLINE, CINAHL, and AMED, using terms such as 'multiple sclerosis,' 'acupuncture,' and 'traditional Chinese medicine.' The analysis yielded twelve peer-reviewed articles that investigated the use of acupuncture to treat MS-related symptoms, including quality of life, fatigue, spasticity, and pain. The studies were categorized by target symptom: four examined quality of life, three focused on fatigue, two investigated spasticity, two studied pain, and three were animal-model studies.

Most studies had serious methodological limitations, including absence of control groups, lack of randomization, absence of blinding, inadequate descriptions of participants and interventions, and limited or absent statistical analysis. Of the studies that assessed quality of life, only two used randomized controlled designs. The study by Donnellan and Sharley compared traditional Chinese acupuncture with minimal acupuncture in 14 patients with secondary progressive MS, paradoxically finding better results in the minimal acupuncture group. Other studies reported subjective improvements but without adequate statistical analysis.

The fatigue studies included primarily case reports and small case series, with mixed results and limited analysis. McGuire reported improvements on multiple fatigue scales in a single patient, while Foroughipour et al. found that only 25% of patients demonstrated significant improvement in fatigue after acupuncture treatment. For spasticity, only one small study was identified, showing limited benefits.

The pain studies were equally limited, with one study combining acupuncture with other treatments, making it difficult to isolate the specific effects of acupuncture. Interestingly, animal-model studies of experimental autoimmune encephalomyelitis showed more promising results, suggesting possible anti-inflammatory mechanisms of electroacupuncture through modulation of T cells and β-endorphin production. The clinical implications of this review are important for patients and healthcare professionals. Although 7-21% of people with MS report using acupuncture, the current scientific evidence does not provide robust support for its efficacy.

This does not mean acupuncture is ineffective, but rather that higher-quality studies are needed. Limitations include very small sample sizes, lack of standardization of acupuncture protocols, absence of objective measures of neurological function, and inadequate follow-up periods. Notably, although loss of mobility affects 91% of people with MS, no study specifically examined mobility measures such as gait or balance. Future research should focus on randomized controlled trials with larger samples, standardized protocols, objective outcome measures, and longer treatment and follow-up periods before definitive recommendations can be made about the efficacy of acupuncture in multiple sclerosis.