Complementary and alternative therapies
People mean different things by the term 'complementary and alternative medicines' (CAMs), but broadly, they can be defined as health-related therapies and disciplines which are not considered to be part of mainstream medical care.
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Within the term there’s a lot of variation – they might refer to something relatively standard and inexpensive, like pilates, or something more unusual and unproven, such as bee sting therapy.
Other terms used to describe complementary and alternative medicines include 'holistic' or 'natural' medicine. The term 'natural' can be misleading, as many complementary and alternative medicines are processed and are as 'unnatural' as any other drugs. About 25 per cent of medicines produced by the pharmaceutical industry are derived in some way from natural products such as herbs.
CAMs might include:
- Acupuncture and acupressure
- Alexander Technique
- Cannabis and cannabis extracts
- Herbal medicine
- Honey bee venom
- Hyperbaric oxygen therapy
- Multi-modal therapy
- Replacement of mercury amalgam fillings
- Relaxation and meditation
- T’ai chi
CAMs is an area that’s poorly researched, often because these therapies are rarely suited to traditional research techniques. There isn’t much evidence to show how effective or safe medicines are.
Many studies only include a few people, or aren’t conclusive. However, many people who use CAMs say that they make them feel better, so it’s often a case of weighing up things like:
- cost – bearing in mind how you’ll feel if the therapy is very expensive and doesn’t make a difference
- how effective the treatment is it (efficacy)?
- is it likely to make you feel better?
- safety – could it make your MS worse or interact with other medications?
The NICE guideline also has some information on CAMs.
Watch out for products that make big promises, cost a lot, say they are scientifically proven or can 'cure MS'. Paying for these treatments or therapies can be a waste of money and leave you disappointed, or perhaps even make things worse.
Because there probably won’t be clear cut evidence available about the treatment, there may be other things to consider. It might be that, for you, a treatment makes you feel more in control of your MS, makes the effects of MS seem less or make you feel better overall – add to your sense of wellbeing, reduce stress and help you relax. These things are important, particularly if other treatments aren’t available or don’t seem to be working.
Think about the source of information - just because someone says something is effective doesn't mean it is. Loads of information is easily accessible on the internet, but it’s often of questionable quality. Anyone can publish a website, without needing to supply names, qualifications or sources, let alone whether the information is based on scientific research.
Anecdotal evidence (what other people say) is obviously solely based on their own individual experience. If you only know them online, it’s hard to be sure they’re reliable or impartial. Find out more about why scientific evidence is important.
Your doctor can advise you of any risks. Do your research on how that particular therapy is regulated - most complementary therapy practitioners are not regulated, with the exception of osteopathy and chiropractic, both of which have strong regulatory bodies that have been established by law. But many therapies have professional bodies that practitioners can join. It’s worth checking these so you can establish a practitioner’s qualifications.
It’s ultimately up to an individual to manage their MS in the way they want to, but of course it’s worth bearing safety, cost and efficacy in mind at all times.
The NICE guideline says that there is some evidence that the following may be helpful for people with MS in terms of their general sense of well-being. However, it goes on to say there isn’t enough evidence to give firm recommendations:
- t'ai chi
- magnetic field therapy
- neural therapy
- fish oils
- combination of some forms of complementary therapy (known as ‘multi-modal therapy')
For more information on all of these types of therapy, download our booklet Complementary and alternative medicine.
A practitioner is the person who provides the complementary or alternative medicine - for example, an acupuncturist, chiropractor, homeopath, massage therapist or osteopath.
Some people find a practitioner via their doctor, MS nurse, MS therapy centre or another member of their health care team. Others look for a practitioner independently. In either case, it is important to do your research before making a commitment.
Check that they are properly trained, have qualifications, and whether they are a member of a regulatory or professional organisation.
Before any treatment begins, make sure the practitioner is aware of your MS, any other medical conditions you have, and any medications you take. At the appointment, the practitioner should take a full history of your condition and explain what the process will involve. They should welcome any questions you have and keep you well informed throughout the treatment period.
The practitioner should tell you to see your doctor if they realise you might have something serious that your doctor does not know about, or if they identify any further health conditions that you or your doctor are not aware of. They should also tell you if they cannot help, and if possible suggest you see someone else.
Take care if a practitioner pushes you to book many sessions and pay for them in advance, or to 'bulk buy' any products. Also if a therapy seems to be excessively expensive, it’s a good idea to check what the typical costs are for that treatment with one of the regulatory bodies.
Almost half of GP practices in England now provide access to some sorts of complementary and alternative medicines for NHS patients. When provided on the NHS, it might be at no extra cost or you might be asked to pay something towards it. On the NHS choices website, you can search by your postcode to find out which complementary therapies are available near you.
Complementary and alternative medicines are also often provided by hospices, palliative care services, and in some hospitals and pain clinics. Alternatively, some local Healthy Living Centres and MS therapy centres may be able to offer complementary and alternative medicine at subsidised prices to those who cannot afford them otherwise.
Accessing therapies privately
Charges for individual appointments and for full courses of treatment can vary significantly, so check cost before making a commitment.
Private health insurance
Some private health insurance schemes and medical cash plans will cover the costs of selected complementary and alternative medicines.
There are various reasons why you may not be happy with CAMs. You might not like the treatment or the way it makes you feel, or you might think it’s not helping you.
As with conventional medicine, a good professional relationship with your practitioner will help you get the best out of a treatment. It’s worth trying to explain to your practitioner what the problem is - if there is an issue with the treatment, it may be possible to adapt it to suit you better. Alternatively, it may be that this particular treatment is not the one for you.
If you feel you are unable to sort out the problem by talking to your practitioner, or are not satisfied with a treatment, you may wish to complain.
There are different approaches depending on whether your practitioner was accessed via the NHS or privately.
For information on how to complain if the treatment was received via the NHS, or found independently, see our booklet Complementary and Alternative medicine.