Surgery

People with multiple sclerosis (MS) who have severe tremor (shakiness) affecting movement may be helped by surgery. People with severe spasticity (muscle stiffness) may be helped by insertion of a spinal pump to deliver medicines when oral medicines fail.

Surgery choices

Surgery options include:

• Deep brain stimulation for tremor. This treatment is only considered after other options have failed. Severe and disabling tremor that occurs with the slightest movement of the limbs may be helped by an implanted device that stimulates an area of the brain. A neurological surgeon does the surgery to implant the device.
• Implantation of a drug catheter or pump, for spasticity. This treatment is only considered after other options have failed. People who have severe pain or spasticity may benefit from having a catheter or pump placed in the lower spinal area to deliver a constant flow of medicine, such as baclofen (Lioresal).

Other Treatment

The unpredictability and variety of symptoms caused by multiple sclerosis (MS) make it a disease that people have tried to treat in many different ways.

Complementary therapies

Many complementary therapies have been proposed as treatments for MS. None of these treatments have been shown to modify the course of the disease. Some of those most commonly used are:

• Acupuncture.
• Biofeedback.
• Diets and vitamin, mineral, herbal, or dietary supplements.
• Massage therapy (often used by physical therapists).
• Meditation.
• Yoga.

Although clinical research has not shown any of these complementary therapies to be effective, a person with MS may benefit from safe nontraditional therapies along with conventional medical treatment. Some complementary therapies may help relieve stress, depression, fatigue, and muscle tension. And some may improve your overall well-being and quality of life. Talk to your doctor if you are interested in trying any of these complementary therapies or alternative medical approaches to MS treatment.

Clinical research also has been unable to show that treatments such as bee venom therapy, Prokarin (a caffeine and histamine combination), removal of mercury fillings (dental amalgams), and hyperbaric oxygen therapy have any benefits for people who have MS. Some of these therapies may be harmful as well as expensive and are not recommended by most experts.

Experimental medical treatments

Experimental treatments for MS involve reducing the activity of the immune system. This may be done with medicines and biological chemicals or through methods such as total lymphoid irradiation, in which the entire lymph node system is exposed to radiation. While these methods have been used with success in the treatment of certain other medical conditions, they have failed to produce significant benefits when tested in controlled clinical trials. They remain experimental treatments for MS.

Stem cell transplant, which uses immature cells from the bone marrow, has been studied. Early results suggest that stem cell transplant may delay disability, especially in people with relapsing-remitting MS.⁴ Stem cell transplant may be an option for people who have very aggressive or malignant forms of MS.⁵ It remains unproved and isn't recommended for treating relapsing-remitting MS.

What to think about

There is no cure for MS. So far, the only treatments proved to affect the course of the disease are approved disease-modifying therapies. Other types of treatment should not replace these medicines if you are a candidate for treatment with them.

Some people who have MS report that complementary therapies have worked for them. This may be in part due to the placebo effect. And even if some complementary therapies don't treat the disease itself, they may affect a person's sense of well-being and help the person feel better and healthier.

If you are thinking about trying a complementary treatment, get the facts first. Discuss these questions with your doctor:

• Is it safe? Talk with your doctor about the safety and potential side effects of the treatment. This is especially important if you are on drug therapy for MS. Some complementary treatments in combination with drug therapy can be quite dangerous. A treatment that could be harmful to you and may or may not improve your symptoms isn't worth the risk.
• Does it work? Because MS symptoms can come and go, you may find it hard to judge whether a particular treatment is really working. Keep in mind that if you get better after using a certain treatment, the treatment isn't always the reason for the improvement. MS may often improve on its own (spontaneous remission).
• How much does it cost? An expensive, unproven treatment that may or may not help you may not be worth its cost. Beware of therapy providers or products that require a large financial investment at the beginning of a series of treatments.
• Will it improve my general health? Even if they aren't effective in treating MS, some complementary practices (such as acupuncture, massage, or yoga) may be safe. And they may lead to healthy habits that improve your overall well-being. These might be worth trying.

With a hard-to-treat disease like MS, it can be tempting to jump at the promise of an effective treatment. Be cautious about trying unproven treatments.