Once you and your neurologist create a therapeutic plan that is right for you, the two of you, along with your caregiver, may think about adding complementary and alternative therapies to your care plan as well.
Complementary and alternative medicine or CAM is a name given to a range of therapies that are more often practiced in eastern than in western countries, such as acupuncture. Acupuncture has been practiced for centuries in China. In the past few decades, several scientific investigations have established that certain forms of needle acupuncture can trigger release of the body's natural opioids and other chemicals that may help with healing. Studies on meditation and relaxation, massage therapy, yoga and Tai Chi have also shown that they can have positive impact if delivered by well-trained practitioners.
In 1998, the National Institute of Health (NIH) established the National Center for Complementary and Alternative Medicines (NCCAM) in order to boost research into these therapies to see if they can work -- because lots of people were spending money on these therapies, even though it was unclear if they worked. The good news is that several CAM therapies appear to have significant (better than placebo) and positive effects on health.
Choosing a CAM Therapy and a Practitioner
- To help you choose a CAM therapy that is right for you, talk with your neurologist and make sure that the therapy in question poses no undue risks to you.
- NEVER listen to any CAM therapist who tells you that levodopa is toxic or that Parkinson’s disease can be cured via their therapy.
- Make sure that the therapist is a licensed, certified practitioner and that the license is obtained from a reputable source.
- Ask the therapist if your health insurance will help cover the costs. Many therapists have to present educational and training credentials to insurance companies before the insurance companies will cover their clients. Always prefer therapies that are covered by insurance, it both keeps your costs down and it helps establish the legitimacy of the therapist.
- Ask the therapist about the risks associated with the treatment and how those risks will be minimized in your case.
- Ask the therapist how many treatment sessions are necessary before you can expect to feel positive results.
If you do not receive satisfactory answers to these questions, or if the therapist can present no credentials then it may be wise to seek an alternative therapist.
During acupuncture, sterile needles (about the size of a human hair) are inserted into various regions of the body, like the earlobe, the back, the buttocks and the legs in order to re-balance "energy flows" in the body. Usually several treatment sessions are required lasting anywhere from a half hour to an hour. After the needles are put into place the therapist turns on some relaxing music and leaves the room. You then relax and allow the needles to do their work. After a few minutes the needles are removed and that’s it.
To date, only a single study has evaluated effects of acupuncture on Parkinson's disease and that study found no improvement of motor or mood symptoms in the 20 patients who had the treatments. These same patients, however, reported that they felt a bit better and slept a bit better.
Common sense suggests that if you feel stiffness, pain and rigidity in your muscles, massage will help. It is no wonder then that many people with PD utilize various forms of massage therapy to relieve some of their symptoms. Most often this use of massage therapy is supported by PD specialists as long as the massage therapist is a trained and certified therapist.
There are many forms of massage therapy including Swedish massage, neuromuscular therapy, Shiatsu, acupressure, craniosacral therapy and many others besides. To date only neuromuscular therapy (NMT) has been assessed with adequately controlled experimental designs. NMT focuses on manipulating "trigger points" in the body -- places in muscle tissue that have become "knots" and painful discomfort. These trigger points are gently massaged until they dissolve away. The good news is that the available evidence suggests that NMT appears to have significant beneficial effects on both motor and non-motor symptoms of PD. All of the other forms of massage therapy have been assessed in less rigorous ways but they too generally show significant positive impact on PD symptoms.
How does massage work? It very likely makes you feel good to start with. This "feel good" effect alone may boost your mood and relieve muscle tension. Massage can also increase blood supply to your muscles and increase your range of motion in those muscles thus decreasing rigidity in those muscle groups.
Don’t be deterred by the expense involved in massage therapy if it helps you. More and more therapeutic massage is being covered by insurance –- especially if your doctor prescribes it as medically necessary.