Contributor Ramtin Hakimjavadi
If you are familiar with multiple sclerosis (MS), you have heard the statistics about the prevalence of this disease recited many times. Still, it is important, so here is a quick summary:
In 2016, it was estimated that over 2.2 million people worldwide live with MS.
MS is the most common inflammatory neurological disease affecting young adults. The mean age of diagnosis is 30 years.
MS occurs more frequently in women than in men.
The prevalence of MS increases as you move farther away from the equator – Canada ranks amongst the highest in rates of MS worldwide.
MS is not only a common disease, it is also a progressively debilitating condition affecting people in early to mid-adulthood – a time that would otherwise signify some of the most productive years of a person’s life.
There is no cure for MS. However, over the past several decades, significant advances have been made in the development of disease-modifying therapies. These interventions aim to deter the progression of the disease along with reducing the frequency and severity of relapse
Recently, the focus has been towards complementary medical approaches to manage symptoms for people with MS (pwMS). Specifically, two forms of complementary and alternative medicine (CAM) - mindfulness-based therapy and yoga – have each found success improving certain aspects of the disease. Here is a brief overview of each intervention, and how they could potentially help deal with the complex symptoms and different needs associated with a diagnosis of MS.
MS is commonly associated with an impairment of mental well-being. Anxiety, depression and stress are often consequences of living with the condition. Mindfulness-based therapies (MBTs) serve to help pwMS by addressing their mental health problems.
Mindfulness meditation is a mental training practice that can be helpful for bringing one’s attention to present circumstances without judgement. It brings you and your thoughts into the present, focusing on emotions, thoughts, and sensations that you're experiencing in the moment.
There is substantial evidence supporting mindfulness therapy as an effective treatment for anxiety, stress and depression in the general population. In theory, MBTs could also help pwMS improve their mental well-being – an important step towards improving their overall quality of life.
A recent systematic review published by the Institute of Health and Wellbeing, from the University of Glasgow, examined twelve randomized clinical trials to evaluate the effectiveness of MBT. They found that MBTs were moderately effective for reducing anxiety, stress and depression for pwMS.
Given that comorbid mental health conditions in pwMS could lead to significantly lower quality of life and greater social problems, this review provides a promising intervention for addressing mental well-being. However, the study also cautions that further investigation is needed to determine the optimal delivery method, cost-effectiveness and comparative effectiveness of MBT.
Yoga is a type of mind-body therapy that has been proposed as a safe and effective alternative form of treatment for managing the symptoms of pwMS . MS is associated with a wide range of physical, emotional and psychological symptoms. Yoga is considered a holistic approach to health; therefore, the systematic integration of this practice is a promising candidate for effective symptom management.
The ancient practice of yoga started in India over 5000 years ago. Today, yoga is recognized as a form of CAM by that National Institutes of Health. Therapeutic yoga serves to integrate the physical, mental, and spiritual components of an individual in order to improve health and well-being.
A review published in the Journal of Alternative and Complementary Medicine summarized the literature on exercise and mind-body dualities to treat MS symptoms. They amassed a large body of evidence showing the benefits of practicing yoga for pwMS including reduced depression, decreased pain, reduced fatigue, improved strength and flexibility, lower levels of stress, improved quality of life and muscle relaxation. The study concluded that yoga is a promising candidate for managing the symptoms of pwMS. However, more research is needed to determine the effect of yoga on symptoms that are specific to MS including spasticity, depression, and impaired mobility.
Mindfulness training and yoga are CAMs that are known to be highly beneficial for all individuals. Perhaps, these interventions are reportedly beneficial for pwMS because they improve their overall health and quality of life, without addressing specific MS-related symptoms. Still, any therapeutic practice that pwMS could incorporate into their daily lives without interfering with their standard course of treatment should be a topic for discussion with their doctor.
As with any complementary medicine, the key lies within the complementary nature of the approach. Patient characteristics and clinical severity vary widely, so it is up to patients and their clinicians to work together to decide whether alternative therapies may enhance the patient’s treatment plan and quality of life.