There is still a great deal of scepticism amongst many doctors and health professionals about CAM in relation to MS. This is because many CAM therapies have not been fully evaluated using controlled clinical trials – the main way through which conventional medicine is assessed (see Chapter 18). In this situation positive information about CAM is often
from CAM practitioners themselves who have a vested interest in their success. Thus people with MS may feel they are caught in the middle, with outright medical scepticism on the one hand, and very partial and enthusiastic support from CAM practitioners on the other hand. Another issue is that many doctors, compared with people with Multiple Sclerosis, may have very different views and interpretations about the value of CAM therapies in a situation where there is no cure for MS. The way forward, pending more formal assessments of CAM therapies, is to provide as accurate and unbiased information as possible for those who are considering their use.
There are certain key questions that you should ask yourself in relation to any CAM therapy, particularly a new one about which substantial claims are being made:

• What detailed evidence is there that the CAM therapy might help my MS?
• Who has endorsed the therapy? Have leading MS Research Centres or the MS Society supported the use of the therapy?
• What are the possible side effects?
• How expensive is it in relation to the assumed benefits?
• How easy is it to access and undergo?
• Are its practitioners well trained, professionally recognized and insured?
• Would it involve you giving up, or not taking, professional medical advice or treatments?

One of the difficulties for people with MS in relation to many CAM therapies is that, for the most part, they are focused on treating ‘the whole person’ and on general health, rather than specifically focused on the MS. Thus there is little precise information about any effects on the MS itself. However, as a broad principle, even if the course of your MS is not changed but your general health is improved, this can be helpful in managing your life with MS.
Of course there are many stories about individual cases where a CAM therapy is argued to have dramatically changed the course of Multiple Sclerosis. Although such stories are very attractive and enticing to people with a condition such as MS, you would be right to be sceptical yourself about whether the CAM therapy itself had caused this change, and even more so about the general effects of such a therapy on all people with MS. You should be very wary about claims of ‘miraculous’ or ‘amazing’ results from a CAM therapy. If the claims sound too good to be true, they are just that. Also be concerned about the main evidence for a CAM being given in the form of individual testimonials, rather than through more
systematic research. MS is notoriously unpredictable and thus it requires a very careful and controlled study to eliminate any other reasons for a change in the MS.
As a broad guide, the issue for people with MS considering using a CAM therapy is balancing what you consider to be the personal benefits against any side effects and the costs incurred. Realistically it is unlikely that a cure will be found for MS from amongst CAM therapies. However, by feeling better through using them, you may consider that your symptoms have been eased and you feel a lot better about day-to-day living – not least because, unlike many professional staff in the hard- pressed NHS, many complementary therapists have the time to discuss your concerns at length.
A book called Therapeutic Claims in Multiple Sclerosis (see Appendix 2) evaluates many therapies proposed for MS. It covers over a hundred different therapies. It has to be said that the evaluation is from a very robust scientific point of view, the evaluations are decisive and usually dismissive on the grounds of lack of scientific evidence for effectiveness. Nevertheless, descriptions of the main aspects of the therapy are helpfully given. A book more sympathetic to the possibilities of CAM therapies in MS, but which is still based on rigorous evaluations, has been written by A. C. Bowling (Alternative Medicine and Multiple Sclerosis), and there is an associated website that may be helpful to people with MS.
For another sympathetic view of the possible benefits of complementary medicine, you might try the Institute of Complementary Medicine (see Appendix 1), which adopts a very rigorous approach to the evaluation of such therapies, or the individual professional associations of the therapy concerned. This would also enable you to check the qualifications, experience and regulation of their members.