CAM Use in MS

Several studies have evaluated CAM use in MS. One of the earliest studies was conducted in Massachusetts and California in the 1990s (5). Approximately 60 percent of people had used CAM, and, on average, people used two to three different types of CAM. We conducted a similar survey, in 1997, at the Rocky Mountain Multiple Sclerosis Center and found that approximately two-thirds of those who responded to the survey used CAM.

Several subsequent studies have investigated CAM use in people with MS. If one evaluates the results of various U.S. studies of CAM use among people with MS, and if one uses a definition of CAM that includes therapies that have ever been used and excludes two widely used therapies (prayer and exercise), 50 to 88 percent of people with MS have used CAM (5-9). As noted previously, a 2002 study of the general population in the U.S., using a similar definition of CAM, found that 50 percent of people use CAM. It is difficult to compare studies with such different methodologies. However, rough comparisons of these various studies indicate that the use of CAM in people with MS appears to be similar to or somewhat higher than that in the general population.

A different type of study, reported in 1999, examined visits to CAM practitioners by people with MS (10). This study did not evaluate overall CAM use and, of note, most people who use CAM do not visit a practitioner. CAM practitioner use in this study, which was about one-third, was higher than the rate of about 10 percent reported for CAM practitioner use in several studies of the general population done during the 1990s.

The use of CAM among people with MS does not appear to be an American phenomenon. Studies of other countries indicate similar results for the percentage of people with MS who use CAM: 82.5 percent in Australia, 70 percent in Canada, 27 to 55 percent in Denmark, and 41 percent in Spain (11-14).

In surveys of people with MS and of the general population, a consistent finding is that CAM usually is used in conjunction with conventional medical therapy. In other words, CAM usually is used in a complementary way. Approximately 90 percent of people who use CAM also use conventional medicine. This leaves a relatively small fraction of people who use CAM in a truly alternative manner.

It is sometimes erroneously believed that only two preference groups for medical therapy exist: one group that uses only conventional therapy and another group that uses only CAM therapy. In fact, a third "mixed" group combines conventional medicine and CAM. Of importance, the studies of CAM use in people with MS demonstrate not only that this "mixed" group exists but also that it actually appears to represent the majority of people with MS.

With a large number of people with MS pursuing CAM therapies, it is essential for people to be knowledgeable about the therapies they choose and for physicians, other health care providers, and CAM practitioners to be aware that multiple conventional and CAM therapies are in use and that interactions among them are possible.

People with MS use a wide range of CAM therapies. Those that appear to be especially popular include massage, dietary supplements, diets, chiropractic medicine, acupuncture, meditation and guided imagery, and yoga.

The reasons why people with MS pursue CAM are as varied as the different CAM modalities used. "Curing MS" is not a frequently cited reason for using CAM. Common reasons include decreasing the severity of MS-associated symptoms, increasing control, improving health, and using a method that accounts for the interrelation of mind, body, and spirit. Some people are drawn to CAM because of the lack of effectiveness of conventional medications and anecdotal reports of benefits or recommendations from friends, relatives, or physicians (5,8,12). One study of CAM use in people with MS and other chronic diseases concluded that CAM was an important component for self-care and was not generally embraced as a rejection of conventional medicine or an unrealistic search for a cure (15).

Some characteristics have been reported more frequently in those with MS who use CAM. These include being female, having a lower level of health, and being more highly educated. One recent study also found that people who used CAM were less likely to use one of the FDA-approved MS medications and were more likely to have a lower level of physical well-being (9).

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