Multiple Sclerosis

What is Multiple Sclerosis?

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system marked by inflammation, loss of myelin (demyelination) and nerve cell damage.^[1] It usually begins in young adults, and the symptoms depend on where the damage occurs.^{[1, 2]}

MS has several courses. Relapsing-remitting MS, with attacks followed by recovery, is the most common at the start. Primary progressive MS worsens gradually from the beginning, and secondary progressive MS follows an earlier relapsing phase.^[1]

Common symptoms

Symptoms vary from person to person and over time. Common ones include:^[1]

• Fatigue, one of the most common and disabling symptoms
• Numbness, tingling or weakness in the limbs
• Vision problems, including optic neuritis
• Balance, coordination and walking difficulty
• Muscle stiffness or spasms (spasticity)
• Bladder and bowel problems
• Pain, sleep problems, low mood and thinking or memory difficulty

Relapses often recover partly or fully over weeks or months, but incomplete recovery can build up over time as disability.^[1]

Causes and risk factors

The exact cause is unknown. MS is thought to arise from an interaction between genes and environment.^[2] Low vitamin D levels, cigarette smoking and obesity are among the recognized environmental factors.^[3] It is more common in women than in men.

How it is diagnosed and treated conventionally

Diagnosis relies on the history, a neurological examination and MRI, sometimes with spinal fluid testing and other tests to rule out look-alike conditions. Typically, evidence of damage in more than one place and at more than one time is required.^{[1, 2]}

Early treatment with disease-modifying medicines aims to reduce relapses and MRI activity and to limit permanent disability. Care also includes steroids for relapses, rehabilitation, and treatment of symptoms such as bladder trouble, depression, cognitive difficulty, fatigue and sleep problems.^{[1, 3]}

Why Multiple Sclerosis calls for a whole-person approach

MS is an immune disease treated by neurologists, and no integrative therapy has been shown to slow it. At the same time, symptoms such as fatigue, pain, poor sleep and stress affect daily life in ways that disease-modifying medicines do not fully address. A comprehensive management program that includes lifestyle, wellness and management of other health problems is advised for everyone with MS.^[3]

The factors below are where supportive care has most often been studied. Much of the research is early or of low quality.

Fatigue

More than 65 percent of people with MS experience fatigue.^[4] It has many causes, including the disease itself, poor sleep, mood and some medicines, so more than one approach is often needed.

Sleep, mood and stress

Sleep disturbance is a recognized part of MS and is addressed as part of care.^[1] In one trial in relapsing-remitting MS, real acupuncture was associated with better sleep and lower scores for depression and some other psychological symptoms than sham needling.^[5]

Pain and stiffness

Pain and muscle stiffness are common. In one small trial, electroacupuncture was associated with less pain and depression and better quality of life than sham treatment.^[6]

Medicines and their side effects

Disease-modifying medicines and steroids have side effects and can affect immune defenses, which is why herbs and supplements must be reviewed by your treating team.^[3]

Acupuncture as supportive care in Multiple Sclerosis

What the research shows

Acupuncture may help with some MS symptoms, but the evidence is limited by small trials and a high risk of bias. A 2024 meta-analysis of six studies (four randomized trials) found less fatigue and better quality of life with acupuncture, and the authors noted the risk of bias and need for larger studies.^[7] A 2025 meta-analysis of 11 trials with 574 patients found better disability scores and quality of life when acupuncture was added to medicine, and rated the evidence generally low because the studies differed so much. Acupuncture-related adverse events were rare and mild.^[8]

A 2026 network meta-analysis of 23 trials with 1,384 patients compared acupoint stimulation methods for fatigue, disability and daily activity. It suggested possible benefit with standard treatment but called the findings exploratory because of methodological limitations.^[9]

Individual trials point in different directions. In 60 people with relapsing-remitting MS, adding 10 acupuncture sessions over 4 weeks to usual treatment reduced fatigue more than usual treatment alone, although there was no sham group.^[4] A 12-week sham-controlled trial of 62 people reported better cognitive scores, less fatigue and better sleep with real acupuncture.^[5] A trial of 31 patients with sham electroacupuncture reported improved quality of life, less pain and less depression.^[6]

Other trials were less encouraging. A sham-controlled trial of 66 people found no measurable effect of 4 weeks of acupuncture on blood inflammatory markers or quality of life.^[10] In a 14-person trial in secondary progressive MS, a minimal acupuncture comparison group improved more on one psychological score than the Chinese acupuncture group, and the authors called the results inconclusive.^[11]

How acupuncture may work

The mechanism in MS is not established. In a mouse model of MS, electroacupuncture reduced demyelination and inflammatory cell infiltration, an animal finding that may not translate to people.^[12] Whether effects on sleep, stress or pain play a part in the symptom benefits seen in some trials has not been tested.

What treatment involves

Treatment uses fine, sterile, single-use needles, usually left in place for about 20 to 40 minutes. Trials in MS gave 10 sessions over 4 weeks in one case and twice-weekly sessions for 12 weeks in another, and we reassess after a short course of visits.^{[4, 5]}

Serious problems are rare. In prospective studies, about 9 in 100 patients had a minor reaction such as brief bleeding, soreness or redness at a needle site, and serious events occurred in about 1 in 10,000 patients.^[13] Tell your practitioner first if you have a bleeding disorder, take blood thinners, are pregnant, have a pacemaker (relevant to electroacupuncture), or take medicines that lower your immune defenses. Heat sensitivity is common in MS, so tell us if warmth, as in moxibustion, worsens your symptoms.

Ayurvedic medicine as supportive care in Multiple Sclerosis

The Ayurvedic view

Ayurveda has no classical condition that corresponds exactly to MS. In this traditional framework, numbness, weakness, stiffness and tremor are generally described as disorders of Vata, the principle said to govern movement and the nervous system, sometimes with other doshas involved. This is a traditional way to organize care, not a biomedical explanation.

Therapies that may be used

Care is chosen for the individual and, once your neurologist confirms your condition is stable, may include:

• Diet and daily routine intended to calm Vata, such as regular meals, rest and steady sleep hours
• Gentle oil massage for comfort and relaxation
• Breathing, relaxation and gentle movement practices; yoga has been studied for MS symptoms^[14]
• Herbs prescribed individually by a qualified practitioner, after review of your medicines, such as turmeric, which has been tested in MS^[15]

Panchakarma, the traditional cleansing program, is not appropriate during pregnancy, acute illness or a relapse, in frailty, or while on strong immune-suppressing treatment unless your physician agrees. Heat-based therapies need extra caution because heat can worsen MS symptoms. We do not use Panchakarma to treat MS.

What the research shows

No clinical trials of Ayurvedic medicine as a system were found for MS. A meta-analysis of seven randomized trials of yoga in MS found short-term benefit for fatigue and mood compared with usual care, but the results were not robust against bias, and the authors made no recommendation for routine use.^[14]

A review of curcumin, the main compound of turmeric, in autoimmune disease found only two MS trials, at least one of which reported improvement in clinical outcomes, and called for larger trials. The number of patients was too small for a pooled analysis.^[15]

Herbal medicine as supportive care in Multiple Sclerosis

Herbs and formulas that have been studied

Chinese herbal formulas have been tested alongside conventional treatment in MS. The herbs most often used in relapse trials included Angelica sinensis (dang gui), licorice, red peony and prepared rehmannia.^[16] Transdermal medication therapy, meaning herbal preparations applied to the skin, may be discussed where relevant, but no study has tested it in MS.

What the research shows

The evidence is limited. A 2025 meta-analysis of 28 randomized trials with 1,971 people found that Chinese herbal medicine added to conventional treatment was associated with lower disability scores, fewer relapses and less fatigue, but the methodological quality of the trials was suboptimal. No serious adverse effects were reported.^[17] An earlier review of 20 trials in acute relapse reached a similar conclusion and judged the evidence insufficient to recommend routine use because of poor quality and variation between trials.^[16]

All of this research tested herbs added to conventional treatment, and none of it shows that herbs can replace disease-modifying medicine.

Safety and herb-drug interactions

Herbs are active substances and can interact with medicines. Reports describe St John's wort lowering blood levels of ciclosporin and tacrolimus, and ginkgo or danshen increasing bleeding risk with blood thinners.^[18] Herbs claimed to act on the immune system should not be combined with disease-modifying medicines without your neurologist's agreement.

About one fifth of Ayurvedic products bought online contained detectable lead, mercury or arsenic in one study.^[19] Herbal and dietary supplements are a recognized cause of liver injury, which matters because some MS medicines also affect the liver.^[20] Tell us if you are pregnant or breastfeeding, have liver or kidney disease, or have surgery planned.

Translating traditional medicine into modern biological language

This section is interpretation, not equivalence. Chinese medicine often describes MS-type weakness and numbness as deficiency of kidney, liver or spleen qi, or as blocked flow of qi and blood in the channels. Researchers instead measure inflammatory signaling, myelin damage and nervous system function, in part in animal models.^[12]

Ayurveda's aggravated Vata describes movement, sensation and nerve symptoms. No study has shown that a dosha corresponds to a specific biological process, and no trial has tested these ideas in MS.

How this care fits with your medical care

MS needs ongoing care from a neurologist. For a condition like this, we ask that you are under a physician's care for it and that your treating team knows you are receiving complementary care. We do not diagnose MS, interpret MRI results, adjust medicines or replace your physicians.

Do not stop or change disease-modifying medicines, steroids or symptom medicines because of anything on this page. Please bring your diagnosis, recent MRI reports, a full list of medicines and supplements, and your neurologist's contact details. Tell us if you have recently had a relapse or an infusion.

When to seek urgent medical care

New or worsening neurological symptoms can be a relapse that needs prompt medical assessment.^[1]

• Sudden vision loss or pain with eye movement
• New weakness, numbness or loss of balance that comes on over hours or days
• New trouble passing urine or controlling the bowels
• Trouble speaking or swallowing, or sudden confusion
• Fever, burning with urination or other signs of infection, which can worsen MS symptoms
• Thoughts of harming yourself, in which case call or text 988

If any of these are severe or sudden, call 911 or go to the nearest emergency department.