To understand how the experts determine what treatment to use for multiple sclerosis (MS) one needs to understand the different ways the disease is classified. There are three main types of MS depending on signs and symptoms.
Relapsing Remitting Multiple Sclerosis
About 85% of all MS cases start this way. Relapsing remitting MS (RRMS) simply means that the symptoms appear (relapse) and then either partially or completely go away (remit).
Clinically isolated syndrome (CIS) is a single attack of a single symptom suggestive of demyelination but the patient does not fulfill the criteria for an MS diagnosis.
Benign multiple sclerosis is considered part of this category and a patient’s MS is referred to this when after 10 to 20 years the condition hasn’t worsened and there is very little disability. This is not to say that a problem will not occur (relapse) at some future date. Although difficult to put figures to this type do the unpredictability of MS about 10 to 30% of people with MS fall into this category.
This is named secondary as most people with RRMS (about 65%) will see a progression in their symptoms within the 15 year mark. The progression may be very slow and so slight that the symtoms may not be noticed for a long time.
The third category of multiple sclerosis, primary progressive, (PPMS) is so called because, from the first, the symptoms are progressive. The symptoms of PPMS do not remit, instead they gradually get worse over time.
Keep in mind that we do not understand the cause of MS and that all of the suggested causes do not add up when one looks at the facts. Some of these are demographics, aging, race and skull shape, as well as trauma. As Dr. Flanagan puts it “despite decades and billions of dollars spent in research its cause remains a mystery.”
It’s time for a new direction which is the purpose of Dr. Flanagan’s book and this website, but until then, here are the current treatment regimes for the different classifications for MS. The following information is strictly an overview and anyone using these treatments should throughly research their options while consulting their treating physician. Ninety-five percent of the treatment regimens consist of drugs.
Drug Used to Treat RRMS
For acute attacks high, short term doses of corticosteroids are injected or taken orally. The intention is to end the exacerbation sooner, thereby, leaving fewer lastings deficits (losses in function). Note: both oral and injected are as effective but the oral can cause gastrointestinal symptoms, as well as psychiatric disorders.
There are medications used that are called disease-modifying treatments. Here is an overview of the drugs used:
1) interferons (also referred to as CRAB which is a pneumonic for the 4 drug choices-Capoxone, Rebif, Avonex, Betaseron). Interferons work by allowing communication between cells to trigger the protective defenses of the immune system that eradicate pathogens or tumors.
2) glatiramer acetate – may protect important myelin proteins by substituting itself as the target of an immune system attack.
3) mitoxantrone, – an immunosuppressant drug also used in cancer chemotherapy.
4) Tysabri The last and newest drug technically called natalizumab is a monoclonal antibody that binds to molecules on the surface of specific immune cells (lymphocytes that are involved in the inflammatory process) and is thought to act by preventing these cells from passing into the central nervous system via the blood brain barrier and causing nerve damage from inflammation.
All of these medications are marketed under different names and can be pulled up on the web by typing in the above names along with multiple sclerosis. Keep in mind all of these drugs have side effects and are not all equal in both side effects and results.
Alternative Physiological Agents in the Treatment of Multiple Sclerosis
The list of alternative agents is too long to go into here and will be discussed separately as this site develops. One particular agent that is currently getting a great deal of attention, however, is vitamen D. So far, the information on Vitamin D (D3) treatment results for multiple sclerosis is scanty. At the time this page was built we found one study conducted on mice by a company producing an experimental product and another study was done on individuals that were rated as “very mild” and suffered one relapse every other year on average. Vitamin D appears to suppress autoimmune responses thought to cause MS. T cell activity, part of the immune response, is said to have dropped significantly according to these studies.
Venoplasty, Stents and Valve Repair
The Liberation Procedure (CCSVI),a treatment used for multiple sclerosis, which was started by Paulo Zamboni, is a minimally invasive procedure that uses baloon venoplasty to dilate and thus improve venous blood flow through the internal jugular and azygous veins. The balloon is attached to the end of a thin wire that is guided to the site of the obstruction by motion picture x-rays. The wire also has an onboard camera to take picture from inside the blood vessels. In light of today’s technology, the images are stunning to say the least.
Instead of balloon venoplasty, some surgeons have elected to use stents. Stents are tubes that spring open when they are placed at the site of the obstruction. In contrast to ballooned veins, which are relatively weak and subject to collapse and re-stenosis, stents are much stronger and more dural. The problem is that stents can cause clots to form. They can also shift, as well as cause other problems.
Lastly, some surgeons remove what are considered to be faulty or inverted valves in the jugular veins. Sometimes they also correct faulty intrusions or growths inside the vessels walls such as septa. Septa are sheet-like curtains that can partially or fully divide the normal opening which can decrease the vessels effectiveness in draining the brain.
Specific Upper Cervical Correction as a Treatment for Multiple Sclerosis
There are many effective methods used by chiropractors to treat a wide range of musculoskeletal and neurological conditions. One of the best methods for the treatment of neurodegenerative diseases is specific upper cervical chiropractic. The reason is because misalignments of the upper cervical spine create tension, compression and shear forces in the upper cervical spine, as well as inside the cranial vault. Those forces are, in turn, transmitted to the contents of the foramen magnum and upper cervical spinal canal, which contain the brainstem and cord.
The foramen magnum and upper cervical canal contain the brainstem and spinal cord, as well as blood and cerebrospinal fluid (CSF) circulatory pathways to the brain and cord. Among other things, upper cervical misalignments can effect blood and CSF flow in the brain and cord.
There are several different types of specific upper cervical correction. Specific upper cervical methods use specific x-rays to analyze misalignments in the upper cervical spine. They also use specific analysis of the misalignment and use specific adjustments along specific lines to correct the upper cervical spine. Upper cervical correction has been shown to be highly effective for decompression of cervicomedullary cord, as well as blood and CSF pathways that pass through it. It also relieves tension and sheer stresses on the cord and brain. For information on this subject visit these pages chiropractic upper cervical care and orthogonal which are discussed separately on this site as it develops.
Special Spinal Decompression Tables
One of the most thoroughly researched, utilized and effective methods used by chiropractors for everything below the upper cervical spine is the Cox Method of spinal decompression. The Cox Method uses a special table that decompresses the spine and spinal canal by stretching and pulling the segments of the spine apart. In addition to pulling the spine apart along its length, the table further incorporates up and down pumping of the tailpiece or headpiece (Cox 7 model) in a flexing motion. Thus the method is referred to as flexion-distraction, which means to flex the segments while pulling them apart. Lastly, the table can further incorporate twisting, side bending and circular motion called circumduction, to the spine during flexion-distraction. Similar motions can be done with the patient in the face-up or face-down positions, as well as in the side posture positions.
Standing upright loads the spine vertically, which subjects it to compression. Compression squeezes fluids out of the cartilage called discs and the joints of the spine. Pulling the spine apart in traction decompresses the spine. Decompression of the spine draws fluids into the cartilage and joints of the spine. Compression squeezes fluids out. Alternating compression and decompression rhythmically moves fluids in and out of the discs and joint capsules of the spine. It also stretches connective tissues. In addition to its impact on connective tissues, cartilage and joints, spinal decompression tables also move blood and lymph in the spine and spinal canal.
Decompression tables are valuable for many complicated orthropedic conditions such as degenerated joints and degenerated discs of the spine. They are also good for neurological conditions such as stenosis (narrowing) of the spinal canal, as well as the openings in the canal for the passage of nerve roots to the body. The alternating compression and decompression of the spine helps move blood and CSF past the obstructions caused by the stenosis. Pumping helps reduce inflammation and edema. Moving blood and CSF also helps rehabilitate injured and damaged tissues.
The same principle and success seen in treatment of the spinal canal, cord and nerves can be applied and tested for neurodegenerative diseases of the brain such as Alzheimer’s, Parkinson’s and multiple sclerosis. The more we learn about the movement of blood and CSF in the brain and cord, the more these tables may play a role in many more neurological conditions. They will be discussed separately on this site as it develops.
Craniopathy and Craniosacral Therapy
Craniopathy and craniosacral therapy are too complex to go into here and will be discussed separately on this site. Craniosacral therapy has been around for decades and is widely used in Applied Kinesiology and Sacroocciptial Technique in the chiropractic profession, as well as by some osteopaths and trained craniosacral therapists. In brief, both are based on the theory of the craniosacral primary respiratory rhythm. The theory maintains that there is primary rhythm in the brain that is the product of neurological, cardiovascular and respiratory waves that use intracranial pressure to fluctuate. Among other things, the fluctuation in pressure moves CSF through the brain and cord and is transmitted to the bones of skull and spine. A loss of motion in the bones of the skull and spine can effect CSF flow and may play a role in multiple sclerosis.