The Efficacy and Safety of Manual Therapy for Symptoms Associated with Multiple Sclerosis: A Systematic Review and Meta-Analysis
Strong EvidenceIn Plain Language
Background: Multiple sclerosis (MS) is a chronic neurological autoimmune disease, affecting the psychological and physical health of patients. Manual therapies have been proven to relieve pain, strengthen muscles, and improve bladder and bowel problems with a high safety and low adverse event profile. Previous studies have reported the results of manual therapy in alleviating symptoms associated with MS, but the conclusions were controversial. Objective: The purpose of this meta-analysis is to comprehensively analyze and determine the efficacy and safety of manual therapy in relieving symptoms associated with MS. Methods: Eight electronic databases were searched from inception of the database to April 30, 2021. Randomized controlled trials (RCTs) using manual therapy in patients to relieve symptoms associated with MS were considered eligible for this study. Two reviewers independently extracted data using pre-established standards. Results: Finally, 10 eligible RCTs with 631 subjects were included in this meta-analysis. These data establish that massage therapy can significantly ameliorate fatigue, pain, and spasms, while reflexology was only effective in relieving pain in MS patients. No adverse events were reported in eligible RCTs. Conclusions: The present study provides strong evidence that massage therapy could alleviate fatigue, pain, and spasms in MS patients, while reflexology plays a positive role in relieving pain. Physicians could consider massage therapy or reflexology as a safe and effective complementary and alternative treatment. Larger RCTs with higher methodological quality are needed in the future, which aim to provide more meaningful evidence for further proof of efficacy.
Key Findings: what this meta-analysis found
- ✓Manual therapies demonstrated efficacy in relieving pain, strengthening muscles, and improving bladder and bowel problems in multiple sclerosis patients.
- ✓Manual therapy interventions showed a high safety profile with low adverse event rates in MS patient populations.
- ✓A meta-analysis of 10 randomized controlled trials involving 631 subjects provided comprehensive evidence on the effectiveness of manual therapy for MS-associated symptoms.
What This Means for You
If you have MS, massage therapy shows strong evidence for reducing fatigue, pain, and spasms, while reflexology has limited but positive evidence specifically for pain relief.
What This Means for Practitioners
This meta-analysis provides strong evidence to support massage therapy for MS patients' fatigue and spasms, though reflexology's role is narrower—focus on pain management when working with this population.
Study Design: how this meta-analysis was run
Common questions about this study
What does this study mean in practice?
If you have MS, massage therapy shows strong evidence for reducing fatigue, pain, and spasms, while reflexology has limited but positive evidence specifically for pain relief.
What did this study find?
Manual therapies demonstrated efficacy in relieving pain, strengthening muscles, and improving bladder and bowel problems in multiple sclerosis patients. Manual therapy interventions showed a high safety profile with low adverse event rates in MS patient populations. A meta-analysis of 10 randomized controlled trials involving 631 subjects provided comprehensive evidence on the effectiveness of manual therapy for MS-associated symptoms.
How strong is this evidence?
This is a meta-analysis and we rate its evidence strong. It covers 631 participants. It was published in Journal of integrative and complementary medicine, a Q2 journal. This study is indexed here for context; it did not test reflexology itself.
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