Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord. There is currently no cure for ALS, and treatments focus on slowing disease progression and managing symptoms. While conventional treatments are limited, some people with ALS look to complementary and alternative medicine for additional symptom relief and improved quality of life. Here we explore some of the holistic treatments that have been studied for ALS.
What is ALS?
ALS causes the death of motor neurons, which are nerve cells that control muscle movement. As motor neurons die, the brain loses its ability to initiate and control muscle movement. People with ALS experience muscle weakness, twitching, and eventually paralysis as the disease progresses. ALS usually starts with muscle weakness in one region of the body before spreading to other areas. The average life expectancy after diagnosis is 3-5 years.
While the exact causes of ALS are not fully understood, both genetic and environmental factors appear to play a role. About 10% of cases are inherited. Smoking, military service, and exposure to heavy metals or pesticides may increase ALS risk in some people.
There is no cure for ALS at this time. Treatment focuses on slowing progression and relieving symptoms to improve quality of life. The FDA has approved two drugs for ALS – riluzole and edaravone. Riluzole may extend life by a few months. Edaravone appears to slow decline in daily functioning. Beyond medications, treatment may include physical therapy, occupational therapy, speech therapy, nutritional support, breathing assistance, and assistive devices for mobility and communication.
What are holistic treatments?
Holistic medicine aims to treat the whole person by addressing the interconnectedness of mind, body, and spirit. Practitioners evaluate all aspects of a person’s health and lifestyle when determining the best treatments. Holistic medicine encompasses a variety of modalities including:
- Natural products: Herbs, vitamins, minerals, probiotics, Medical marijuana
- Mind-body practices: Acupuncture, yoga, meditation, hypnotherapy, guided imagery, progressive muscle relaxation
- Manipulation-based practices: Spinal manipulation, massage therapy
- Energy therapies: Reiki, therapeutic touch, electromagnetic field therapy
- Whole medical systems: Naturopathy, homeopathy, traditional Chinese medicine, Ayurveda
People with ALS may turn to holistic treatments to help manage symptoms when conventional approaches fall short. Some of the most bothersome aspects of ALS include pain, fatigue, stress and emotional health, sleep disturbances, and muscle cramps. Holistic therapies that target these concerns may improve wellbeing. However, it is important to note that no complementary or alternative therapies have been proven to modify the ALS disease process itself.
Natural Products
Medical Marijuana
Medical marijuana refers to the use of cannabis products for medicinal purposes, such as treating symptoms or side effects. Marijuana contains many biologically active compounds, but two have been most studied for medical use: delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).
THC is the main psychoactive component of marijuana that produces the “high” sensation. CBD does not cause a high but has shown anti-inflammatory, neuroprotective, analgesic, anti-anxiety, and muscle relaxant effects in studies.
Trials investigating cannabinoids for ALS have had mixed results but generally show modest benefits for symptoms like pain, appetite loss, spasticity, drooling and cramps. A review of studies through 2007 concluded that oral cannabis extract was ineffective, smoked marijuana was mildly effective for appetite stimulation, and oromucosal sprays combining THC and CBD held the most promise for reducing spasticity.
A 2017 survey of 127 patients with ALS taking edible cannabis found 70% reported improved appetite and 60% improved sleep quality. Just over half reported reduced anxiety or depression. Adverse events were generally mild.
While medical marijuana holds some promise for symptomatic relief, more research is still needed, especially regarding optimal THC:CBD ratios, dosing, and delivery methods. As with any treatment, the risks and benefits should be carefully weighed. Side effects of cannabinoids include impaired cognition, anxiety, paranoia, dry mouth, and dizziness.
Antioxidants
Oxidative stress is implicated in the progression of ALS. Antioxidants are substances that neutralize free radicals and may counter oxidative damage. Some antioxidants like vitamin E, vitamin C, and coenzyme Q10 have been trialed for ALS, but results are inconclusive. While generally safe at moderate doses, high-dose antioxidants could potentially interact with medications or cause side effects.
Herbal Remedies
Certain herbs used in traditional medicine systems may benefit people with ALS according to preliminary studies. For example, extracts of ashwagandha, an Ayurvedic herb, improved motor function in ALS mouse models. Ginkgo biloba modestly slowed functional decline in a small human trial. Many other herbs like milk thistle, bacopa, and ginger have antioxidant and anti-inflammatory properties that could theoretically help with ALS symptoms, but clinical evidence is limited thus far.
Mind-Body Practices
Acupuncture
Acupuncture is an ancient Chinese medicine technique involving inserting thin needles into specific points on the skin to restore the flow of energy. A few small studies indicate acupuncture may reduce pain, drooling, spasms, and cramps in people with ALS when combined with medication. However, high quality evidence is lacking.
Meditation and Yoga
Meditation and yoga are practices that integrate the mind and body through focusing awareness and controlled breathing. Several studies have found yoga improves quality of life, mood, and sleep in ALS patients. There is less research on meditation specifically, but it may likewise reduce anxiety and stress.
Hypnotherapy
Hypnotherapy uses guided relaxation, intense concentration, and focused attention to achieve a heightened state of awareness. This trance state may help alleviate pain, anxiety, sleep issues, and depression. Small studies on hypnotherapy in ALS have had encouraging results, including a pilot study in which 90% of patients experienced reduced pain and 80% less anxiety and depression. However, more research is needed.
Manipulation-Based Practices
Massage Therapy
Massage therapy applies pressure and movement to muscles and joints to reduce tension, pain, and stiffness. Massage improves circulation, relaxes muscles, and promotes release of endorphins. While strong clinical evidence is lacking, many people with ALS report massage helps relieve muscle cramps and pain, aids relaxation, and improves quality of life.
Spinal Manipulation
Spinal manipulation performed by chiropractors and other health professionals can adjust alignment of the vertebrae. There are a handful of reports suggesting manipulation may lessen muscle spasms and pain for some ALS patients. However, studies are very limited and manipulation should be approached cautiously given potential risks.
Energy Therapies
Reiki
Reiki is an energy healing therapy that involves a practitioner placing their hands over or on the body. The goal is to facilitate the flow of “life force energy” and promote healing and well-being. A few small studies found Reiki lessened fatigue, anxiety, and pain in people with ALS immediately after treatment. But these studies had design limitations.
Magnetic Field Therapy
Magnetic field therapy uses magnets or pulsed electromagnetic fields with the aim of improving circulation and cell function. A couple small studies in ALS patients found reduced spasticity or pain after magnetic field treatment. However, high quality research is still needed.
Whole Medical Systems
Whole medical systems incorporate a wide variety of practices and therapies based on overarching theories of health, disease, and healing. Such systems include naturopathy, homeopathy, and Ayurvedic and traditional Chinese medicine.
There is scarce evidence regarding the efficacy and safety of whole medical systems specifically for ALS. However, they may offer options for supportive care under the guidance of an experienced practitioner. For example, Ayurveda emphasizes herbs, massage, and dietary changes that could alleviate certain symptoms.
Other Complementary Therapies
In addition to the practices discussed above, people with ALS may find benefit from trying other complementary approaches including:
- Counseling or support groups – help cope with psychological stress of diagnosis
- Music therapy – reduces anxiety and depression, aids expression
- Pet therapy – companionship improves mood and quality of life
- Aromatherapy – uses essential oils to promote relaxation
- Light therapy – exposure to bright light may increase energy and mood
Conclusion
ALS has no established cure and can be extremely challenging both physically and emotionally. While holistic therapies have not been shown to alter the course of ALS itself, they may provide supportive care to help manage symptoms and improve quality of life.
The holistic approaches with the most evidence for symptomatic relief in ALS are marijuana-based products, mind-body practices like meditation and yoga, massage therapy, and certain herbal remedies. Acupuncture, hypnotherapy, energy therapies, and some whole medical systems like Ayurveda and traditional Chinese medicine may also have potential benefits.
It is important to consult your healthcare providers before trying any complementary treatments, as some can interact with medications or cause side effects. Holistic medicine should not replace conventional ALS therapy but may offer additional ways to support your overall wellbeing.