Acupuncture might be a helpful treatment for MS symptoms.
by Kenneth Bandler
As I arrived early for a breakfast meeting at a major New York City hotel, I tripped and fell in the middle of the lobby. I got up before anyone noticed what happened, saw nothing in the carpet that caused me to stumble, and went to the restroom to check in the mirror that my suit, dress shirt and tie were OK, and attended the business meeting as planned.
It was not the first time I had fallen. It had happened on a walk to work. My briefcase and eyeglasses flew in different directions as my hands struck the concrete sidewalk. Thankfully, my hands were only scraped a bit. A few people came over to ask if I needed help. I stood up quickly, gathered my things, thanked them for their concern and went on my way. I told the caring bystanders that I was fine. But was I?
I was first diagnosed with multiple sclerosis in April 1990. My symptoms were primarily numbness in my hands and feet. Later, when I began to trip and fall, I was concerned that it might be related to my MS. Searching for an explanation, I learned about the symptom called foot drop. My right foot apparently was getting stuck, triggering the tripping and causing me to lurch forward, lose my balance and come crashing down.
I reported the tripping incidents to my healthcare professionals on one of my quarterly visits to Mount Sinai Corinne Goldsmith Center for Multiple Sclerosis in New York.
I tried to be more conscious of how I walked and made subtle adjustments. It was a lifestyle change. As a native New Yorker, I had grown accustomed to walking quickly on the city’s streets, often passing slow walkers to get to my destination faster. Now, I slowed my pace, letting others pass by. I even gave up the New Yorker habit of jaywalking after seeing an approaching yellow taxi as I lay face down in the middle of a street. This was enough to persuade me to wait for the green lights.
And I became more adept at figuring out quickly, in the midst of a fall, how to land gracefully and avoid damage to my body as well as to my clothes.
But these adjustments weren’t enough. I knew I could seriously hurt myself one day. So, in 2015, I visited an acupuncturist for the first time in search of some relief.
Martha, my wife, had been encouraging me to make an appointment with an acupuncturist she was seeing regularly. I had long been skeptical about the efficacy of acupuncture, even though my late mother, a stroke survivor, had frequented acupuncturists in New York City for years, and my wife was doing the same in Westchester County, where we lived.
I also was reluctant because I was already sticking needles into my body thrice weekly to self-administer a prescribed disease-modifying therapy (DMT) to manage my MS. The idea of someone else inserting more needles into my body was not appealing. But with no other remedy apparent, I decided to give acupuncture a try.
A successful first session
On my first visit to Jennifer Mohr-Boscaino, a licensed acupuncturist in Pleasantville, New York, we spent the first 30 minutes just chatting. She wanted to understand who I was, what I did and what health issues had led me to her office. She had some familiarity with MS, having studied treatments for people living with MS and treating others living with the chronic disease. I described my symptoms to her and explained that the series of tripping and falling incidents was the main reason I sought her out. She went on to explain what would happen during the acupuncture session.
As I lay face down on a massage table, Mohr-Boscaino inserted 18 needles into various points of my body from head to feet. It was a restful hour. On each subsequent biweekly visit over the next couple of months, sensations in my right foot improved, and eventually, both my feet felt the same.
Most important, I stopped tripping. Whatever the needles were causing inside my body, the treatments were working. Just as I didn’t know specifically why the DMT my neurologist prescribed might be keeping my MS condition stable, I kept taking it because I trusted my MS medical team. In the same way, I had become a believer in acupuncture thanks to the newest member of my healthcare team.
When I told my neurologist and nurse practitioner that acupuncture had cured my tripping problem, they exchanged skeptical looks. “Cured” might have been the wrong word to use in scientific terms. But they also didn’t try to dissuade me from continuing with the acupuncture sessions.
“I am an empiricist; I look for empirical evidence that something works before I am inclined to recommend it, and that kind of evidence is lacking for acupuncture,” says Aaron Miller, MD, medical director at the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai Hospital. “When people are seeking treatments for MS, they often come in wanting to do complementary therapies, and I say if those therapies are not harmful, OK. If you want to do this, it’s up to you — but take your DMT.”
How acupuncture works
For those of us living with MS who are taking a DMT, abiding by the regimen as instructed by our neurologist helps manage the progression of the disease. I have taken four different DMTs since 2003, beginning with injections three times a week, then transitioning in 2014 to an oral medication. None of the more than 20 approved DMTs was developed to address symptoms like tripping.
Acupuncture might be able to help treat some of these symptoms, but it’s not a therapy for averting progression of the disease.
Acupuncture is an element of Southeast Asian medicine, commonly known as Chinese medicine, based on a theory that health depends on the body’s energy flow, Qi (Chi), along paths called meridians.
Licensed or certified acupuncturists undergo years of training. Mohr-Boscaino received a New York State master’s degree in acupuncture after three years of study, a second master’s in oriental medicine after two more years of part-time study, followed by a National Certification Commission for Acupuncture and Oriental Medicine Certificate of Acupuncture.
“I don’t have the capacity to heal, only the capacity to ask the body to heal itself,” says Mohr-Boscaino. “The body has an innate ability to heal,” she emphasizes. By strategically inserting needles, “I am asking the body to do what it can.”
There are 365 separate acupuncture points in the body. Deciding where to place the needles is based on a conversation with a patient that determines where energy deficiencies are located. “Your body has to learn what Qi is, what it does. You need a couple of treatments to train the body,” she says.
Mohr-Boscaino uses Japanese-style needles that are solid, short stainless steel coated in silicone, not like the longer ones used for DMTs. Inserted needles prompt the body to move the excess energy to the deficient areas.
“In MS, there is a drought of energy, but the question is: In which meridian is it situated? With needles, I open the dam a little and tell [the body] where the excess should go to the drought,” she says. “I tonify all the droughts and move the excess.”
In my case, several needles were placed in the top of my head, where there is much excess energy because the brain is very active. Then, in various points of the upper body, like shoulders and hands. Lastly, the ankles, the closest point to the deficiency in my foot.
Acupuncture as healthcare
Nilay Shah, MD, an MS specialist practicing in New Jersey, has been recommending acupuncture for his patients to help alleviate the effects of some ailments.
“As a healthcare provider, I recognize that we don’t have a monopoly on medical knowledge in the western or allopathic model,” Shah says. “There is plenty of information on how the body works and energetics that we don’t fully understand but have been ascertained from other forms of healthcare and medicine, such as the Chinese medicine tradition known as acupuncture.
“I don’t poo-poo it. It must have its role and benefit for all sorts of symptoms in MS, like pain, bladder problems, spasticity, numbness, tingling, depression, fatigue and mood disorders.”
Mount Sinai’s Miller agrees. “Acupuncture is basically a harmless procedure,” Miller says. “It has a long tradition in Chinese medicine, and I think it pretty convincingly works in some circumstances, particularly for a variety of pain syndromes.”
But he points out that some may be experiencing a placebo effect with acupuncture. “I don’t have anything against placebo effects if the placebo is safe and well tolerated,” Miller says. They can be useful for “subjective complaints that the patient experiences that we as providers cannot see, like pain and fatigue. If the patient gets relief from pain, even if it were a placebo that was producing the effect, I’m all for that.”
Fifty percent of the people with MS Mohr-Boscaino treats tell her there were perceptible changes in their conditions. They say it’s worth trying. But the 50% who were not satisfied do not recommend it.
“We don’t have full understanding of MS, don’t have a full understanding of the nervous system, so some of these blanks may be filled by other traditions of medicine, such as acupuncture, reiki or chiropractic,” Shah tells his patients. “Used in conjunction with traditional western approaches, they go hand in hand and can have a synergistic effect and benefit on the patient and various symptoms they may be feeling.”
Fees for acupuncture vary. Mohr-Boscaino, for example, charges $180 for the first visit and $130 for each follow-up.
Some insurance companies cover acupuncture, and it is usually included in a policy rider. Medicare only covers acupuncture for lower back pain, and coverage just began in 2019.
A few states, such as California, have designated acupuncture an established health benefit (EHB), but New York and many other states have not. EHB designation by a state legislature is important because it will compel insurance companies to cover acupuncture generally.
The American Association of Acupuncture and Oriental Medicine (AAAOM), the main professional organization for licensed acupuncturists in the U.S., has long been advocating for designating acupuncture as an EHB.
Sticking with what works
I continue to journey — now from home in New York City to Pleasantville — for acupuncture, mainly for basic maintenance for a very relaxing hour and, on occasion, to tend to a new or recurring symptom.
Finishing dinner one Friday evening at one of our neighborhood restaurants, I felt I might not be able to walk the three blocks home. Both feet suddenly were totally numb, a symptom I had not previously experienced.
I was determined to walk home and, holding my wife’s hand, did so slowly and cautiously to avoid stumbling. We made it home without difficulty. The next morning, I almost canceled my scheduled acupuncture appointment because of the lack of feeling in my feet, but I decided to go anyway.
By the end of the session, normalcy had been restored to both feet. I’m not sure how long the bizarre condition would have lasted without the acupuncture treatment, but there is no question that it worked for me, as it had before.
I told my neurologist about my experience. He ordered new bloodwork and an MRI, and all turned out to be normal.
“Acupuncture is a last resort for people in general after they treat a symptom with medications that didn’t work or had severe side effects,” says Mohr-Boscaino. “I hope acupuncture will eventually be part of the medical team.”