Introduction
Multiple sclerosis is an autoimmune disease that affects the human central nervous system. As a neurodegenerative disease, this condition is characterized by demyelination inflammation. A McGinley (2021) study shows that multiple sclerosis affects at least 900,000 Americans, mostly young adults. In addition, they found that the main complications of the disease are cognitive impairment, physical disability, and poor quality of life (Dobson & Giovannoni, 2018). The use of disease-modifying therapy contributed to a reduction in the number of relapses per year from 29% to 68% (McGinley, 2021). Prescribing medications can make a big difference, but there is a risk that patients will face serious negative consequences. Side effects include adverse reactions to injections, infections, heart blocks, autoimmune thyroid disease, bradycardia, and infusion reactions. Immunotherapy, acupuncture, physiotherapy, and support groups mainly contribute to reducing ataxia and increasing the patient’s life expectancy and quality of life.
Health Effects of Multiple Sclerosis
Multiple sclerosis, also known as MS or RRMS, is a chronic neurodegenerative disease that causes central nervous system inflammation. Inflammation damages the myelin sheath. The myelin sheath is a layer of protein that protects nerve cells in the central nervous system (Dobson & Giovannoni, 2018). If the myelin sheath is compromised enough, it will cause holes in the nerve fibers, negatively affecting their function and eventually leading to their death. The predominantly affected population includes children, young people, and the elderly. Multiple sclerosis is an autoimmune disease involving gene modification that causes the disease to be inherited from generation to generation.
According to research, the main problem of this disease is associated with inflammation of the brain and spinal cord. That leads to a negative reaction from the central nervous system and degeneration of the myelin sheath (Dobson & Giovannoni, 2018). In the area of loss of myelin, connective scar tissue is formed, which can distort or completely block the transmitted impulses (Dobson & Giovannoni, 2018). For a while, the nervous system compensates for failures. However, as the disease progresses, the severity of symptoms steadily increases from mild numbness of the limbs to paralysis and/or blindness (Bourque & Hawiger, 2021). Despite assessing the disease, practitioners claim that drugs treat most of the symptoms due to various disorders caused by the human body’s nervous system. One factor includes reducing the effects of ataxia, a state of loss of complete control over body movements. Physiotherapy is one of the non-drug methods of treating patients, which is aimed at improving muscle flexibility.
Physiotherapy Treatment
Exercise or active rehabilitation is a non-drug approach that people with MS increasingly use to improve their quality of life and engage in daily activities. Physical therapy has a strong positive impact on potential recovery from multiple sclerosis. Research shows that this process includes exercises that strengthen the muscles and increase the pace to improve coordination and balance (Gil-González et al., 2020). Exercise can target two interrelated signs of disease, such as immune system dysregulation and inflammatory synaptopathy (Physiotherapy, 2022). Exercise may work by activating the autonomic part of the vagus nerve, which is an important modulator of both the innate and adaptive immune systems. Physical exercises may reduce the peripheral inflammation that drives the synaptic pathology and neurodegeneration that occurs in the brains of multiple sclerosis patients (Physiotherapy, 2022). The involvement of the patient improves the maintenance of movement, preventing the occurrence of muscle contractions.
Physiotherapy in the treatment of multiple sclerosis has its characteristics. Electrotherapeutic procedures are applied locally, in dosages of small impact: in case of paralysis – personalization of the hands or feet; with spasticity – ultratonotherapy of the extremities, ultrasound on the lower thoracic – upper lumbar segments of the spine; for violations of the function of the pelvic organs – electrophoresis of atropine or pilocarpine according to the transverse technique, electrical stimulation of the bladder (Physiotherapy, 2022). The more severe the degree of damage to the nervous system, the more gentle electrotherapy methods should be used (Physiotherapy, 2022). As a result of this physiotherapy, gait, sensitivity, and bladder function improved (Gil-González et al., 2020). Physiotherapy is a necessary corrective approach in people diagnosed with multiple sclerosis, as it helps slow down the disease’s symptoms. Nevertheless, physiotherapy is rational only in the complex treatment of patients with MS.
Immunotherapy
Recent studies have confirmed the mandatory participation of the immune system – primary or secondary – in the pathogenesis of multiple sclerosis. As already mentioned, disturbances in the immune system are associated with the peculiarities of the set of genes that control the immune response. In patients with multiple sclerosis of different nationalities and ethnic groups, this genetic identity can determine the characteristics of the onset of the disease, clinical forms, type of treatment, duration, and outcome.
Since multiple sclerosis occurs primarily due to a defect in the immune system, immune cells are a prime target for treating this disease. Medicines registered for the treatment of multiple sclerosis are divided into immunomodulators (beta-interferons and glatiramer acetate) and immunosuppressants (mitoxantrone, cyclophosphamide, and azathioprine) (Bourque & Hawiger, 2021). Some researchers are exploring the possibilities of the method of T-cell autovaccination (Bourque & Hawiger, 2021). In addition, high-dose immunosuppressive therapy with hematopoietic stem cell transplantation has been convincingly demonstrated in recent years (Bourque & Hawiger, 2021). An analysis of modern approaches to treating multiple sclerosis indicates that there is currently no ‘gold standard’ in treating this disease. In these conditions, preference should be given to those methods the effectiveness of which has been proven by clinical trials. The method of high-dose therapy with hematopoietic stem cell transplantation deserves special attention, as it allows a high rate of stabilization or improvement in the course of the disease without needing maintenance treatment (Bourque & Hawiger, 2021). Research into new treatments for multiple sclerosis is ongoing in many countries.
Acupuncture
Acupuncture is one of the branches of Chinese traditional medicine. According to the ideas underlying this method, the functioning of the human body is associated with the flow of energy, known as ‘qi,’ and circulating in 14 directions (meridians) (Leskowitz, 2022). According to the theory of Chinese medicine, the development of various diseases is associated with an imbalance or disturbances in the distribution of these energy flows (Leskowitz, 2022). According to representatives of various acupuncture schools, the impact on certain points in the human body leads to the restoration of balance and “unblocking” of energy flows and, consequently, recovery.
Acupuncture can relieve some symptoms associated with multiple sclerosis, including pain, numbness and tingling, spasticity, bladder problems, and depression (Acupuncture, 2022). However, there is no evidence that acupuncture can reduce the frequency of multiple sclerosis flares or slow the progression of disability. Theoretically, acupuncture can stimulate the immune system. This assumption is based on some positive experiences of the effects of acupuncture in diseases such as cancer, and AIDS, when stimulation of the immune system leads to an improvement in the condition of patients (Acupuncture, 2022). Stimulating the immune system can lead to the activation of immune system cells that attack myelin. Immunotherapy is critical to any treatment options because the long-term success of MS therapy ultimately depends on limiting the underlying autoimmune process.
Group Counselling Therapy
The effects of multiple sclerosis on the nervous system can cause depression and other psychological problems. In addition, people with MS face many difficulties, which can be exacerbated by unstable morale. Group counseling is one of the most important bodily and psychological rehabilitation methods for patients with multiple sclerosis (Turner & Knowles, 2020). Rejection of multiple sclerosis occurs in people who have just learned about the disease, as well as in those who have worsened. Deterioration occurs in episodes, sometimes abruptly and unexpectedly for a person. Often people are not ready for this; even if they are, it is difficult to accept (Turner & Knowles, 2020). Therefore, people fall into a state of depression when they find themselves without help and the support of loved ones or others. Stress greatly affects people with this disease, so group therapy is important to achieve calmness, get away from depression and learn to cope with feelings.
Multiple sclerosis, like other psychological disorders, not only involves patients in self-discovery but also makes the brain less active. The disease makes patients worry about their future, the ability to be economically and physically independent, and manage a family. One of the benefits of participating in group consultations is that participants can express their feelings and ask questions (Turner & Knowles, 2020). In most cases, asking and answering questions reveals important information about the participants and helps them identify their feelings and how to confront them (Turner & Knowles, 2020). As a result, patients can learn to reduce anxiety and remain calm.
Conclusion
Multiple sclerosis is a chronic autoimmune disease that affects the myelin sheath of nerve fibers in the brain and spinal cord. Patients may have central and peripheral cranial nerve palsies. Multiple sclerosis affects muscle strength, sensitivity, coordination, and visual and cognitive functions. It is important to establish active aspects that contribute to the individual’s rehabilitation. The main goal of therapy is to reduce the frequency of strengthening and slow the progression of multiple sclerosis. Treatment of multiple sclerosis depends on the course of the disease and requires an individual approach. Evidence-based life-saving methods that have a strong impact on recovery include physical therapy, immunotherapy, acupuncture, and group counseling. Multiple sclerosis requires a multidisciplinary approach to therapy that includes comprehensive rehabilitation interventions.
References
Acupuncture. National Multiple Sclerosis Society. (2022). Web.
Bourque, J., & Hawiger, D. (2021). Current and future immunotherapies for multiple sclerosis. Missouri medicine. Web.
Dobson, R., & Giovannoni, G. (2018). Multiple sclerosis–a review. European Journal of Neurology, 26(1), 27-40. Web.
Gil-González, I., Martín-Rodríguez, A., Conrad, R., & Pérez-San-Gregorio, M. Á. (2020). Quality of life in adults with multiple sclerosis: A systematic review. BMJ Open, 10(11), e041249. Web.
Leskowitz, E. (2022). A cartography of energy medicine: From subtle anatomy to energy physiology. EXPLORE, 18(2), 152–164. Web.
McGinley, M. P., Goldschmidt, C. H., & Rae-Grant, A. D. (2021). Diagnosis and treatment of multiple sclerosis: A review. Jama, 325(8), 765-779. Web.
Physiotherapy for multiple sclerosis. Multiple Sclerosis Society UK. (2022). Web.
Turner, A. P., &Knowles, L. M. (2020). Behavioral interventions in multiple sclerosis. U.S. National Library of Medicine. Web.