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MULTIPLE SCLEROSIS RESEARCH INFORMS MASSAGE FOR MULTIPLE SCLEROSIS By Diana L. Thompson Research tells us that many people diagnosed with multiple sclerosis (MS) use some form of complementary and alternative medicine (CAM) to address a variety of symptoms. This CAM use primarily includes acupuncture, exercise, massage, and relaxation techniques, as well as herbal, mineral, and vitamin supplements. The major symptoms treated are pain, fatigue, and stress.1 Evidence of massage therapy as a method for reducing anxiety, depression, and stress is prevalent throughout massage-related research. Two articles studied patients with MS in particular, one using Feldenkrais as the intervention,2 the other using reflexology.3 The latter study purports that reflexology created a space for patients to talk about their worries and concerns, and to receive advice and support from the therapists, thus emphasizing the importance of the role of the therapeutic relationship in healing. Constipation and urinary tract symptoms affect many people with MS. One small study showed abdominal self-massage significantly improved constipation symptoms, as compared to advice on bowel management.4 In another small study, craniosacral therapy was effective for reducing signs and symptoms of urinary tract problems, and the hands-on therapy was found to improve MS patients' quality of life.5 In a fascinating series of mechanistic articles studying the pathogenesis of the central nervous system (CNS) and lymphatic drainage, it appears that the ability of lymph vessels to drain interstitial fluid and cerebral-spinal fluid is significant in maintaining positive immune responses and limiting CNS inflammation. The implications on MS and Alzheimer's are invaluable—facilitating cervical lymph drainage may be an effective therapeutic strategy for preventing the decline of cognitive function and improving immunological responses.6 No studies were found linking massage to the reduction of pain or fatigue in patients with MS, though many studies confirm the positive effects of massage on pain and fatigue for other conditions, such as aging, arthritis, and cancer. Survey data reflects that patients seek treatment for these symptoms with massage; this is an area where clinical trials are warranted. Notes 1. S.A. Olsen, "A Review of Complementary and Alternative Medicine (CAM) by People with Multiple Sclerosis," Occupational Therapy International 16, no. 1 (2009): 57–70. 2. S.K. Johnson et al., "A Controlled Investigation of Bodywork in Multiple Sclerosis," Journal of Alternative and Complementary Medicine 5, no. 3 (1999): 237–43. 3. P.A. Mackereth et al., "What Do People Talk About During Reflexology? Analysis of Worries and Concerns Expressed During Sessions for Patients with Multiple Sclerosis," Complementary Therapies in Clinical Practice 15, no. 2 (2009): 85–90. 4. D. McClurg et al., "Abdominal Massage for the Alleviation of Constipation Symptoms in People with Multiple Sclerosis: A Randomized Controlled Feasibility Study," Multiple Sclerosis Journal 17, no. 2 (2011): 223–33. 5. G. Raviv et al., "Effect of Craniosacral Therapy on Lower Urinary Tract Signs and Symptoms in Multiple Sclerosis," Complementary Therapies in Clinical Practice 15, no. 2 (2009): 72–5. 6. R.O. Weller et al., "Lymphatic Drainage of the Brain and the Pathophysiology of Neurological Disease," Acta Neuropathologica 117, no. 1 (2009): 1–14; R.O Weller et al., "Pathophysiology of the Lymphatic Drainage of the Central Nervous System: Implications for Pathogenesis and Therapy of Multiple Sclerosis," Pathophysiology 17, no. 4 (2010): 295–306. 60 massage & bodywork november/december 2012