A variety of mind-body approaches are used by people with MS for therapeutic effect, including Yoga, biofeedback, music therapy, pet therapy, hypnosis, meditation, prayer, and guided imagery. There have been a limited number of systematic studies evaluating the benefits of these mind-body approaches.
Yoga is a spiritual, physical, and mental discipline developed thousands of years ago that involves exercise, relaxation, and healing, with origins in Indian philosophy. Yoga may have been practiced as long ago as 5,000 years, but the first known work describing the practice was the Yoga Sutras, written over 2,000 years ago. Although Yoga is now widely practiced in the West, there have been only a limited number of clinical studies to evaluate its effectiveness in MS. One well-designed study conducted in people with MS did find that people who practiced Yoga or took part in conventional exercise were significantly less likely to suffer from fatigue compared with those who did not. While Yoga is generally safe, and can and should be modified for people with disabilities, it may involve difficult postures and vigorous exercise that may pose a risk for a woman with MS who is pregnant, as well as for those who have problems including fatigue, difficulty with balance, bone loss, or respiratory or cardiovascular conditions.
Guided imagery is a technique involving the use of mental images to promote relaxation. Guided imagery is often used in combination with other relaxation techniques. There has only been one small study evaluating the benefits of guided imagery in people with MS. Results from this study showed that guided imagery was effective in reducing anxiety. However, the intervention had no effect on other common MS symptoms, including depression. Results from studies of guided imagery in other health conditions have shown possible benefits, including reductions in anxiety, depression, sleep problems, and pain.
Many cultures have traditions involving the use of hypnosis (induced trances or altered states of consciousness) for religious purposes, dating back to ancient Egypt, Africa, India, China, and the Americas. One of the seminal figures of traditional Chinese medicine, Wong Tai, referred to the use of hypnosis in 2,600 BC. The term hypnosis comes from the Greek word hypnos for sleep and the use of hypnosis as a medical intervention in modern times dates back to the 18th century, with the Austrian doctor Franz Anton Mesmer. Although its precise therapeutic mechanism is not understood, hypnosis appears to affect a number of parameters in the body, including body temperature, heart rate, blood pressure, brain wave pattern, and immune response. Hypnosis has been endorsed as a medical intervention by medical associations in the US and Europe, with the US National Institutes of Health citing solid evidence in favor of the use of hypnosis to treat chronic pain (particularly in the setting of cancer). Although systematic studies of the use of hypnosis in people with MS are lacking, the intervention may be useful as a treatment for symptoms that are common in MS, including pain, anxiety, and sleep difficulties.
Music therapy has a long history as a healing art that stretches back to ancient times in Western (ancient Greek) and non-Western (Native American, Chinese) cultures. In India, for instance, traditional musical modes called ragas have long been used to bring about certain states of mind conducive to healing. The modern practice of music therapy may have originated in the 18th century in France with Louis Roger’s theoretical work A Treatise on the Effects of Music on the Human Body. Music therapy is a standard intervention used in rehabilitation clinics, psychiatric hospitals, as well as in nursing homes, hospice care facilities, and in facilities for developmentally disabled individuals. Evidence for the effectiveness of music therapy is strongest in terms of its benefits for mood improvement, relaxation, and stress reduction. Music therapy may also have therapeutic benefit in people with sleep problems, pain, and depression. There have been only a small number of studies evaluating the effects of music therapy in MS. Results from these studies suggest benefits including improved self-esteem and mood, as well as possible improvements in breathing in patients with respiratory difficulties.
Meditation has been practiced in various forms for thousands of years, with many techniques developed within the world’s religions, including Hindu, Buddhist, and Judeo-Christian traditions. Meditation has become very popular and is often practiced apart from any religious tradition and is used widely in healthcare settings. Meditation is also an integral part of numerous other mind-body and alternative medicine systems, including Yoga and traditional Chinese medicine. Although different approaches to meditation exist, many forms appear to involve a suspension of conscious thought via a focusing of attention, with the goal of attaining a state described as “thoughtless awareness.”
Meditation is among the most commonly used CAM approaches and has been shown to result in changes in several parameters in the body, including brain function (changes in brain waves and blood flow to the brain), breathing (oxygen consumption), as well as production of certain hormones. The strongest evidence for the therapeutic benefit of meditation in certain health conditions (cancers) is in stress reduction, decreased blood pressure, and improved quality of life. However, meditation may provide benefits in terms of mood, pain, balance, fatigue, and other symptoms of importance to people with MS. However, the evidence for benefit in these areas is not strong enough to make any definitive conclusions as to the efficacy of meditation. Regular daily practice of meditation for at least 20 minutes may be required for obtaining health benefits.