Multiple sclerosis — acupuncture and Chinese medicine

By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham, Berkshire

Acupuncture and Chinese medicine cannot cure multiple sclerosis, and no one should claim they can. What they can do, and what the published evidence supports cautiously, is help manage some of the most disabling symptoms — fatigue, spasticity, neuropathic pain, bladder dysfunction and low mood — alongside conventional disease-modifying treatment. The evidence base is small and the studies are of variable quality, but it is consistent enough that the UK MS Society lists acupuncture among the complementary therapies many people with MS find useful. This article explains the realistic picture, the TCM view of the condition, and what to expect from a course of treatment.

On this page

1. What is multiple sclerosis?
2. The TCM view of MS — Wei syndrome
3. What the research actually shows
4. Symptoms acupuncture may help
5. Chinese herbal medicine
6. Diet, vitamin D and lifestyle
7. Working alongside conventional MS care
8. Cautions and what to avoid
9. When to see a practitioner
10. Frequently asked questions
11. Related reading
12. References

1. What is multiple sclerosis?

Multiple sclerosis is a chronic autoimmune condition in which the body’s immune system attacks the myelin sheath that insulates nerve fibres in the brain and spinal cord. The resulting demyelination disrupts nerve signal transmission and, over time, causes a wide range of neurological symptoms — fatigue, muscle weakness and spasticity, sensory disturbances, balance problems, bladder and bowel dysfunction, cognitive and mood changes, and visual symptoms including optic neuritis. The cause is not fully understood but is thought to involve a combination of genetic susceptibility, immune dysregulation, environmental triggers (notably Epstein-Barr virus exposure), and low vitamin D status.

MS most commonly presents in adults aged 20–40 and is roughly three times more common in women than men. Around 150,000 people are estimated to live with MS in the UK. The condition has four main patterns: clinically isolated syndrome (CIS, a single first attack), relapsing-remitting MS (RRMS, the commonest presentation), secondary progressive MS (SPMS, the eventual progression of many RRMS cases), and primary progressive MS (PPMS, around 10–15% of cases). Modern disease-modifying therapies (DMTs) have transformed the management of RRMS and PPMS in particular; this article assumes the reader is already under specialist neurology care.

2. The TCM view of MS — Wei syndrome

Traditional Chinese medicine recognised the clinical picture of progressive muscular weakness with sensory disturbance long before MS was identified as a distinct disease in the 19th century. The classical category that maps most closely onto MS is Wei Zheng — “atrophy syndrome” or “flaccidity syndrome” — characterised by progressive loss of muscular function in the limbs, often with sensory changes. The classical text Su Wen (around the 2nd century BCE) devotes an entire chapter to it.

In TCM theory, Wei syndrome typically arises from a combination of:

• Kidney and Liver deficiency — the Kidney governs the bones and marrow (in TCM the brain is the “Sea of Marrow”); the Liver governs the sinews and ligaments. Their decline produces the characteristic weakness, spasticity and tremor of advanced neurological disease.
• Spleen deficiency — the Spleen governs the muscles. Chronic Spleen Qi deficiency produces the heavy, weak, easily-fatigued quality of limbs that many MS patients describe.
• Damp-Heat in the channels — an acute inflammatory pattern that overlays the deficiency picture. In modern terms this maps reasonably well onto a relapse with active demyelination.
• Du Mai (Governing Vessel) involvement — the Du Mai runs along the spine and connects to the brain. Disorders affecting the central nervous system are often understood through this channel.

The TCM treatment principle in MS is therefore to tonify the Kidney and Liver, strengthen the Spleen, clear residual Damp-Heat from the channels, and regulate the Du Mai. None of this maps directly onto the modern immunological model of demyelination, but the clinical targets — reducing muscle weakness, improving fatigue, addressing spasticity, and supporting the constitution through the relapse-remission cycle — line up usefully with the symptoms a person with MS actually experiences.

3. What the research actually shows

The evidence base for acupuncture in MS is small but consistent. The most cited systematic review remains:

• Karpatkin HI, Napolione D, Siminovich-Blok B. (2014). “Acupuncture and multiple sclerosis: a review of the evidence.” Evidence-Based Complementary and Alternative Medicine, 2014:972935. The authors reviewed 17 studies of variable quality and concluded that the data was suggestive of benefit across four MS-relevant outcomes — fatigue, pain, spasticity and bladder dysfunction — while emphasising that the trials were small, methodologically heterogeneous, and not designed to detect changes in disease progression or MRI activity.

Beyond this review, individual small trials and observational series have reported benefit for MS-related fatigue (one of the most disabling symptoms in MS, with limited conventional treatment options), spasticity, neuropathic pain, urinary urgency and depressed mood. Survey data consistently shows that around a third of people with MS in Western countries try complementary therapies, with acupuncture among the most-used.

What the evidence does not show, and what no honest practitioner will claim:

• Acupuncture has not been shown to alter disease progression, prevent relapses or reduce lesion load on MRI.
• Chinese herbal medicine has very limited modern trial evidence in MS specifically — the traditional formulae used are based on classical Wei syndrome theory rather than RCT data.
• No complementary therapy has been shown to substitute for disease-modifying therapy (DMT). The DMT decision belongs with your neurologist.

The UK MS Society’s position on acupuncture is appropriately neutral: it is recognised as a complementary therapy that some people find helpful for symptom relief, used alongside (not instead of) conventional care.

4. Symptoms acupuncture may help

In my clinical experience, the MS symptoms that most often respond to acupuncture are:

Fatigue

MS-related fatigue is distinct from ordinary tiredness — it is often described as a sudden, overwhelming heaviness that can stop the day in its tracks. It is poorly served by conventional medication. Acupuncture targeting Spleen Qi tonification (ST 36, SP 6, BL 20, CV 12) and Kidney support (KD 3, BL 23) is one of the more reliable interventions I see clinically. A typical course is one session per week for six to eight weeks, with maintenance treatments through the worst periods.

Spasticity

Lower-limb spasticity can be partially relieved by acupuncture, particularly through the Bladder channel along the spine (BL points), GB 34 (the influential point for sinews) and local points at affected joints. The effect is usually modest but useful as an adjunct to physiotherapy and antispasmodic medication.

Neuropathic pain and dysaesthesia

The peculiar burning, electric or pins-and-needles sensations of MS are often poorly controlled by gabapentinoids and amitriptyline. Acupuncture, particularly with electroacupuncture along affected dermatomes, can take the edge off in many patients.

Bladder symptoms

Urinary urgency and nocturia respond to acupuncture in some patients, with the strongest TCM evidence base coming from points around the lower abdomen (CV 3, CV 4) and lower back (BL 23, BL 28).

Mood and sleep

Depression, anxiety and broken sleep are common in MS and worsen quality of life out of proportion to the neurological disability. These respond well to acupuncture; treatment overlaps significantly with the protocols I use for depression, anxiety and insomnia in non-MS patients.

Heat sensitivity (Uhthoff’s phenomenon)

The worsening of MS symptoms with raised body temperature has interesting parallels with the TCM concept of internal Heat affecting the channels. While there is no specific research on acupuncture for Uhthoff’s, the broader heat-clearing principles can be incorporated into a treatment plan.

5. Chinese herbal medicine

Chinese herbal medicine in MS is prescribed individually according to the patient’s presentation; there is no single “MS formula”. Classical formulae used in Wei syndrome patterns include:

• Bu Yang Huan Wu Tang — the classical formula for Qi deficiency with Blood stasis affecting the limbs, originally prescribed for post-stroke hemiparesis but conceptually applicable to MS-related weakness.
• Liu Wei Di Huang Wan and its variants — for Kidney Yin deficiency presentations (the more “hot”, restless MS picture with night sweats and fatigue).
• You Gui Wan or Jin Gui Shen Qi Wan — for Kidney Yang deficiency presentations (cold, exhausted, weak picture with cold extremities and low motivation).
• San Miao San / Si Miao San — classical formulae for Damp-Heat in the lower limbs, used during acute relapses with new lower-body symptoms.
• Da Bu Yin Wan — for marrow depletion presentations.

These traditional patterns are well-described in TCM literature but it is important to be clear that modern controlled-trial evidence for Chinese herbal medicine in MS specifically is very limited. I prescribe pharmaceutical-grade granules from Sun Ten in Taiwan, always within an individualised formula and always with awareness of any disease-modifying medication the patient is taking. Several MS medications — including some DMTs — have potential interactions with Chinese herbs, and I check this on every prescription.

6. Diet, vitamin D and lifestyle

Several lifestyle and nutritional measures have meaningful evidence in MS and form an important part of any holistic approach:

• Vitamin D supplementation — large epidemiological and clinical-trial evidence supports the role of vitamin D in MS risk and disease activity. The UK MS Society and NICE acknowledge the rationale for maintaining vitamin D levels in the optimal range (typically 75–125 nmol/L). This is one of the few supplements with reasonable evidence specifically in MS.
• Regular exercise — aerobic and resistance exercise tailored to ability has strong evidence for reducing MS-related fatigue, maintaining function and improving mood. The UK MS Society publishes detailed exercise guidance.
• Smoking cessation — smoking is associated with faster MS progression and worse outcomes; stopping is one of the most evidence-based lifestyle interventions in MS.
• Diet — the evidence for any specific MS “diet” is mixed. The Mediterranean and modified ketogenic patterns have the most reasonable supporting data; very restrictive regimens (Swank, Wahls protocol) are popular but the trial evidence is limited.
• Stress management and sleep — stress is a recognised trigger for symptom flares; consistent sleep and stress-reduction practices like tai chi, yoga and mindfulness have observational evidence for improving quality of life.
• From a TCM dietary angle — favour cooked, warm, easily digested foods that nourish the Spleen and Kidneys: bone broth, congee, root vegetables, lentils, eggs, walnuts and black sesame. Limit cold, raw, damp-producing foods (excessive cold salads, dairy in damp-prone patients, very heavy meats) particularly during relapses.

7. Working alongside conventional MS care

Modern MS care — particularly the high-efficacy disease-modifying therapies that have come into routine use in the last decade — has transformed the outlook for many patients. Acupuncture and Chinese medicine should sit alongside this care, never replace it. Specifically:

• Continue with your neurologist’s prescribed DMT and any symptomatic medications. Your MS team are the experts on your specific disease course.
• Tell your neurologist and MS nurse that you are using acupuncture and Chinese herbs. Most are supportive; many will refer for symptom-management adjuncts.
• Coordinate the timing of acupuncture sessions around infusion DMTs (some patients prefer not to have acupuncture in the days immediately after natalizumab or ocrelizumab infusion).
• Disclose any Chinese herbal prescription before starting a new DMT — some combinations need adjustment.
• Continue with the physiotherapy, occupational therapy and continence services that are central to MS symptom management. Acupuncture supplements these; it does not replace them.

8. Cautions and what to avoid

• Anyone claiming to “cure” MS with acupuncture or herbs is not telling you the truth. If you encounter this claim, walk away.
• Do not stop or reduce DMTs to start a complementary therapy. The most predictable cause of MS relapses is treatment cessation.
• Heat-generating treatments (intensive moxibustion, deep heat therapy) need careful consideration in heat-sensitive patients; gentler approaches are preferred.
• Self-prescribed Chinese herbal supplements should be avoided — the potential for interaction with DMTs and immunomodulators is real. Only take prescribed formulae from a registered herbalist.
• Beware over-investing in any single dietary protocol — balance and sustainability matter more than purity in a chronic condition managed over decades.

9. When to see a practitioner

Reasonable indications to consider acupuncture and Chinese medicine in MS include:

• Persistent fatigue not adequately addressed by conventional measures
• Spasticity not fully controlled by baclofen, tizanidine or physiotherapy
• Neuropathic pain incompletely controlled by gabapentinoids or amitriptyline
• Bladder urgency where antimuscarinic side effects are limiting
• Mood and sleep disturbance interacting with the neurological symptoms
• The general wish to optimise wellbeing alongside conventional care

10. Frequently asked questions

Can acupuncture cure multiple sclerosis?

No. There is no evidence that acupuncture, Chinese herbs or any other complementary therapy alters the underlying disease process in MS. What acupuncture can do, with reasonable supporting evidence, is help manage some of the most disabling symptoms — fatigue, spasticity, pain, bladder symptoms and mood.

Is acupuncture safe in MS?

Yes, when delivered by a fully qualified practitioner. Sterile single-use needles, gentle technique adapted to neurological sensitivity, and avoidance of overheating are the relevant precautions. Acupuncture has no interaction with DMTs.

How many sessions before I notice anything?

For MS-related fatigue and pain, most patients notice some change within three to four sessions and meaningful benefit by six to eight. Spasticity often takes a little longer. If there has been no detectable change after eight sessions, the treatment is unlikely to be the right intervention for that particular symptom.

Can I take Chinese herbs alongside my DMT?

Often yes, but only after a qualified herbalist has reviewed the specific DMT and any other medications. Some combinations need adjustment; a small number of herbs are best avoided. Never self-prescribe Chinese herbs when on a DMT.

What about the Wahls protocol or Swank diet?

Both have followers in the MS community and some supportive observational data, but the controlled-trial evidence is limited. The broader principles — reducing processed food, adequate vegetables, considered protein, adequate omega-3, attention to vitamin D — are reasonable. Very restrictive regimens are harder to maintain long-term and the balance of benefit and quality of life needs honest assessment for each patient.

Will my insurance cover acupuncture for MS?

A number of UK private health insurers cover acupuncture from BAcC-registered practitioners (I am a member of the British Acupuncture Council). Check with your insurer for specific eligibility and whether MS is a covered indication.

I have relapsing-remitting MS. Can acupuncture reduce relapses?

There is no evidence that it can. DMTs are the appropriate intervention for relapse prevention. Acupuncture can help with symptom management between and during relapses, and may help with the fatigue and recovery period that follows a relapse.

11. Related reading

• Chinese medicine for autoimmune disease
• Neurowellness and acupuncture
• Chronic fatigue syndrome
• Depression
• Insomnia
• Acupuncture
• Chinese herbal medicine
• UK MS Society — the definitive UK patient resource
• NICE Guideline NG220 — Multiple sclerosis in adults: management

12. References

The acupuncture evidence summarised above is drawn from:

• Karpatkin HI, Napolione D, Siminovich-Blok B. Acupuncture and multiple sclerosis: a review of the evidence. Evidence-Based Complementary and Alternative Medicine. 2014;2014:972935. PMID: 25045394. [PMC4086829]
• UK MS Society guidance on acupuncture.
• NICE Guideline NG220, Multiple sclerosis in adults: management, 2022 update.
• Munger KL et al. Vitamin D intake and incidence of multiple sclerosis. Neurology. 2004 (and subsequent epidemiological literature).

This article is for general information and does not constitute medical advice. Always consult your neurologist or MS team before making changes to your treatment.