Complementary Therapies and Parkinson's

Parkinson’s:complementary a guide for hometherapies care workers and Parkinson’s

1 This information is for It’s not possible to cover all the people interested in using many complementary therapies complementary therapies, available in this guide, but we’ve tried to bring together the most alongside their Parkinson’s popular therapies, chosen by treatment, to help manage people with Parkinson’s and their symptoms. If you’re their carers. a carer, family member or friend you may also find It’s designed to give you the basic this information useful. information you need to help you decide which complementary Although there’s little scientific therapies, if any, are right for you. evidence that complementary It also explains how people use therapies slow, stop or reverse the each therapy and where you can development of Parkinson’s, we go to find out more. have heard from many people with the condition who have had positive experiences of complementary therapies.

As with all treatments for Parkinson’s, di
erent therapies work for di
erent people. So we encourage anyone a
ected by the condition who is interested in complementary medicine to explore the range of therapies available. Contents

What is complementary therapy? ...... 4 Why do people use complementary therapies? ...... 6 Are complementary therapies safe? ...... 8 Accessing complementary therapies...... 12 I’m a carer? Would I benefit from using complementary therapies? ...... 13 What are the main complementary therapies used by people with Parkinson’s? ...... 13 Acupuncture ...... 17 Alexander technique ...... 19 Aromatherapy ...... 21 Art therapy ...... 23 Ayurveda ...... 25 Bowen technique ...... 26 Chiropractic...... 28 Conductive education ...... 30 Feldenkrais method ...... 31 Herbal medicine ...... 33 Homeopathy ...... 35 Kinesiology ...... 37 Massage therapy ...... 38 Meditation and relaxation techniques ...... 40 Music therapy ...... 43 Osteopathy ...... 44 Reflexology ...... 46 Reiki ...... 48 Shiatsu ...... 49 More support and information ...... 50 What is complementary therapy?

For the purposes of this e
ect of some complementary information, complementary therapies. For other therapies, therapy refers to treatment used there is no research to prove it alongside conventional medicine. has any benefits for people with It shouldn’t be confused with: Parkinson’s. But we hear from many people a
ected who feel it y alternative medicine, which helps them. replaces evidence-based, conventional medicine with It will also depend on what you medicine based on historical or expect from complementary cultural traditions therapies. For example, you may y integrated medicine, a term feel a particular therapy is not which describes the combined having a positive e
ect on your use of conventional and Parkinson’s symptoms, but you complementary therapies may enjoy the experience. For you, this might be enough of a reason While conventional medicine to continue. focuses on the treatment of symptoms, complementary We’ve included comments from therapies adopt a more holistic people a
ected by Parkinson’s who approach. This means considering have tried some of the therapies. all aspects of how a condition may We hope this will give you a better a
ect someone, rather than just idea of what people are trying and focusing on medical symptoms. how they found it. But remember that everyone will have a Are complementary di
erent experience. therapies beneficial? There’s no simple answer to this. Please remember these are people’s There are so many types of therapy personal opinions. Parkinson’s that it’s impossible to generalise. UK doesn’t endorse any There’s evidence of the beneficial particular therapy. 4 5 Why do people use complementary therapies?

People may use complementary Complementary therapies therapies alongside prescribed are not as rigorously tested. medication for many reasons, Some therapies, for example such as the following examples. aromatherapy, are not medicine- based. This means they don’t need y Conventional medicine might to go through this form of testing. not always control Instead, researchers will look at someone’s symptoms. a therapy and what practitioners y Complementary therapy is a say it can be used for. They then way of taking control of your study it to see how e
ective it is own health. when put into practice. Methods of testing can be varied. Some y Group therapy can be an therapies work for some people opportunity to socialise. Equally, and not for others. complementary therapies can be a time to enjoy your own Which evidence should I trust? company. There’s a lot of information on complementary therapies, y Complementary therapies can particularly on the internet, that be relaxing. claims to be based on scientific The evidence about evidence. But it’s not all reliable. complementary therapies To help make sure you’re reading accurate and useful information – Conventional medication goes that’s not misleading – you may through a thorough testing process find it helps to ask yourself the before it becomes available. It’s following questions. tested in clinical trials and needs to meet scientific standards to prove y Where is the research published? it works and is safe. Common side Research should normally be e
ects are also clearly stated on ‘peer-reviewed’ in professional the patient information leaflet. journals. This means that before

6 the details are released, it has Can I use complementary been reviewed by other experts therapies instead of taking not involved in the study. Parkinson’s medication? y How many patients were Complementary therapies don’t involved in the study? The higher work as a replacement for the number, the more reliable the Parkinson’s medication. Stopping or study usually is. making changes to your Parkinson’s medication can be dangerous y Is the result of the study a without the guidance of your ‘one-o
’ or have other specialist or Parkinson’s nurse. scientists confirmed it? Why have you included therapies with no scientific evidence? The therapies in this information have all been chosen because they’re popular with people a
ected by Parkinson’s.

Just because a therapy can’t be proven to work in a medical trial, or there hasn’t been enough research about whether it helps people with Parkinson’s, it doesn’t mean you won’t find it useful. In fact, we’ve heard from many people who tell us they have benefited from using these therapies.

Many of our local groups organise complementary therapy sessions at their meetings to encourage members to give them a try.

Throughout this information, we highlight what scientific evidence there is to support the use of each therapy.

7 are complementary therapies safe?

Generally speaking, the therapist if you’re trying for or complementary therapies listed expecting a baby. in this information are considered safe. But before taking tablets, It’s not always easy to tell what is pills or capsules, applying creams or isn’t safe and many organisations or drops or drinking teas, you o
ering therapy give the should talk to your GP, specialist or impression of being reliable even Parkinson’s nurse. This is because when they’re not. some herbs and remedies may have side e
ects or clash with Is a therapy unsafe if it’s not medications you’re already taking. statutorily regulated? Your healthcare professional may Not necessarily. Some also be able to recommend a complementary therapies are therapist, or advise you on other regulated by statutory law, sources of information. including osteopaths, chiropractors and art therapists. This means that, The Medicines and Healthcare in the same way GPs and specialists products Regulatory Agency have to register with the General (MHRA) is the government agency Medical Council, these therapists responsible for making sure that must register with a statutory medicines and medical devices regulator before they can practise. work, and are safe. You can find out more at www.mhra.gov.uk One reason for statutory regulation is the level of risk linked to a Some complementary therapies particular therapy. For example, (for example herbal remedies) may the government considered not be safe during pregnancy. So regulating acupuncture, but it’s essential that you tell not only took the view that because your GP, specialist or Parkinson’s acupuncturists were well nurse but also your complementary self-regulated, it wasn’t needed.

8 The Complementary and Natural Healthcare Council The Complementary and Natural Healthcare Council (CNHC) was established with government support to regulate some therapies.

Therapies regulated by the Council include: y Alexander technique y aromatherapy y Bowen therapy y massage therapy y reflexology y Reiki y Shiatsu The list of CNHC-regulated therapies discussed in this booklet is not exhaustive. Because registration of these therapies with CNHC is voluntary, not all the practitioners of the therapies are registered. To find out more and to see the full list of CNHC-regulated therapies, visit their website www.cnhc.org.uk

Other complementary therapies are gradually moving towards a system of stricter self-regulation. See below for more information on professional associations.

9 How do I find a good y someone else with Parkinson’s, therapist? a friend or family member Before choosing a therapist y your Parkinson’s local adviser it’s important to find out if (see ‘More information and they’re reputable, insured and, support’ for how to find your where relevant, belong to a nearest one) regulatory body (see ‘Professional associations’). Always check the therapist’s credentials. Some complementary You may find it helpful to ask: therapists use the ‘Dr’ title, but that doesn’t necessarily mean y your GP, specialist, Parkinson’s they’ve studied conventional nurse or other healthcare medicine. An honest, reliable professional. Many hospitals and practitioner won’t mind you asking GP surgeries now work together about their qualifications. with complementary therapists

10 Professional associations When you find a therapist, here are Many therapists are members a few questions you should ask. of reputable, professional y What, if any, risks are associated organisations. These organisations with the treatment you o
er can be useful sources of and what steps will you take to information. Be aware that some prevent problems? organisations may make claims that aren’t backed up by good y What professional organisations evidence (see ‘Why do people use are you registered with? complementary therapies?). y How much does the treatment We list a number of professional cost and how long will it last? organisations for each Finally, it’s important to find a complementary therapy. If therapist you feel comfortable with you’re doing your own research, and who you like. This will help bear in mind that a high quality make your therapy more successful professional association requires its and enjoyable. members to: y complete some kind of formal qualification, which will usually include a training programme and an exam y stay up to date in their field by continuing their professional training and development y follow a code of ethics and professional conduct y have insurance y report any side e
ects when they happen

11 accessing complementary therapies

Are complementary you may have to pay. Costs for therapies available on complementary therapies will vary, the NHS or the HSC in depending on the type of therapy you want, the length of the Northern Ireland? treatment and where you live. This will depend on the type of therapy you want and the policy At your first session the therapist in your area. will usually take a medical history and get to know you a bit better. As Some hospitals and GP practices a result the first session may cost o
er a few complementary more than any follow-up sessions. therapies like acupuncture, aromatherapy, massage, Practitioners usually recommend osteopathy and chiropractic several treatment sessions. Before treatments. committing yourself to a course of treatment, make sure you ask about Speak to your GP, specialist or the cost. Parkinson’s nurse about what’s available locally. Your Parkinson’s You may also find it useful to ask local adviser may also be able to when you can expect to feel any help you. improvement – and when to call it a day if you don’t see the results Some GPs have training in you’re hoping for. complementary therapies. If they can’t provide the treatment Private health insurance may pay themselves, they may be able to for some types of complementary refer you to a therapist on the NHS. therapy. Before you book a treatment session, ask your insurer How much does it cost? if it’s covered by your policy and If your chosen therapy isn’t how to arrange payment. available on the NHS or HSC, 12 I’m a carer. Would I benefit from complementary therapies?

We’ve heard from many carers good way to have time to yourself, who have tried complementary reduce stress and do something therapies, some with very you enjoy. positive experiences. Again, it’s a personal choice. In some areas, the NHS, local councils and charities o
er free or If you care for someone with low-cost therapies to carers. Speak Parkinson’s, it’s important to look to your GP or a Parkinson’s local a¥er your own physical and mental adviser about what’s available in health. You may find that your area. complementary therapies are a

What are the main complementary therapies used by people with Parkinson’s?

The rest of this information looks at On the next page you’ll find a quick some complementary therapies you reference table setting out some may find helpful. Please remember of the reasons why people with that although we’ve included them Parkinson’s use particular therapies. here, we can’t recommend any particular therapy. Please remember these are recommendations from people Our forum is a great place to find with Parkinson’s, not those of out what people are trying and how Parkinson’s UK, and there they feel about di
erent therapies. may not be any supporting Visit parkinsons.org.uk/forum scientific evidence. 13 Why people with Parkinson’s use complementary therapies         Sense of wellbeing speech Improve Improve  mobility Improve Improve  symptoms Ease motor motor Ease

  Relaxation

      Pain relief Pain Acupuncture Feldenkrais method Alexander Alexander technique Aromatherapy Art therapy Ayurveda Bowen technique Chiropractic Conductive education Herbal medicine Homeopathy 17 31 19 21 23 25 26 28 30 33 35 Page Page 14        Sense of wellbeing speech Improve Improve   mobility Improve Improve symptoms Ease motor motor Ease        Pain reliefPain Relaxation Kinesiology Massage Massage therapy Meditation Meditation and relaxation techniques Music therapy Music Osteopathy Reflexology Reiki Shiatsu 37 38 40 43 44 46 48 49 Page Page 15 16 Acupuncture

What is it? Excellence (NICE), which provides Acupuncture is a form of ancient guidelines to the NHS, only Chinese medicine. It involves a recommends using acupuncture therapist inserting thin needles at to treat chronic, tension-type particular points on your body. headaches and migraines.

Traditional practitioners believe However, some people have said that energy flows round the body it’s helped them with depression, through channels which, when anxiety and insomnia too. blocked, can cause illness. Studies have found acupuncture The role of acupuncture is to has led to some improvement in unblock the channels. Parkinson’s symptoms. For example, studies in a rat model of Parkinson’s Some scientists believe the needles suggested that acupuncture can act to stimulate muscles and promote the survival of dopamine- nerves, which is what causes producing brain cells (the cells the e
ects. Parkinson’s a
ects).

Acupuncture needles are very fine What about safety? so shouldn’t cause a lot of pain. When a qualified practitioner Your therapist will stimulate them carries it out, acupuncture is manually using heat, pressure, generally very safe. It may have electrical currents or laser light. some minor side e
ects but these are short-lived. These may include How might it help? slight pain, bleeding or bruising Acupuncture is used to control and where the needle pierced the skin, relieve pain. This includes and feeling sick, drowsy or faint headaches, joint pain and neck pain. a¥er treatment. The National Institute for Clinical

17 Make sure your acupuncturist is Where can I learn more? fully qualified and that they use disposable needles at every Acupuncture Association of treatment session. Chartered Physiotherapists A professional network for Acupuncture isn’t regulated by the physiotherapists who o
er government. In 2009, the acupuncture as part of their Department of Health ran a physiotherapy treatment. consultation about whether to 01733 390007 introduce regulation, but concluded [email protected] that the voluntary regulation www.aacp.org.uk already in place was robust enough. British Acupuncture Council As acupuncture involves piercing A self-regulating body for the the skin, all acupuncturists must practice of traditional acupuncture register with their local authority in the UK. for health and safety reasons. 020 8735 0400 [email protected] Acupuncturists may also voluntarily www.acupuncture.org.uk register with a number of regulatory bodies (see below) all British Medical Acupuncture of which have guidelines and codes Society of conduct. If you decide to use A registered charity which acupuncture, check that your encourages the use and scientific chosen practitioner is qualified understanding of acupuncture and registered with one of the within medicine. Members are listed bodies. regulated healthcare professionals who o
er acupuncture as part of Some healthcare professionals, their practice. including doctors and 01606 786 782 physiotherapists, o
er [email protected] acupuncture alongside regular www.medical-acupuncture.co.uk medical treatment.

18 Alexander Technique

What is it? NICE clinical guidelines recommend The Alexander technique teaches that people with Parkinson’s improved posture and movement. consider the Alexander technique During a number of lessons you’re to help with balance or taught to be more aware of your motor problems. body, how to improve poor posture and move more e§ciently. What about safety? Alexander technique lessons Teachers of the Alexander shouldn’t be painful. technique believe this helps get rid of tension in your body and relieves Alexander technique teachers problems including back pain, neck aren’t statutorily regulated but may ache, sore shoulders and other register with the Complementary musculoskeletal problems. and Natural Healthcare Council.

During a class, your teacher will Where can I learn more? probably ask you to perform some The Society of Teachers of the simple movements before guiding Alexander Technique (STAT) your body as you move to relieve Aims to ensure the highest tension. Sessions can be one-to- standards of teacher training and one or in groups. professional practice, promote public awareness and How might it help? understanding of the Alexander There’s evidence from one scientific technique, and encourage research. study of fewer than 100 people 020 8885 6524 that the Alexander technique may o’[email protected] help to relieve symptoms of www.stat.org.uk Parkinson’s, including pain, speech, tremor, depression and balance.

19 The Complementary and Natural Healthcare Council (CNHC) I was getting a lot of Alexander technique teachers pain in my neck and are able to register with the “ shoulders, made worse Complementary and Natural Healthcare Council. You can check by working at a computer the Council’s website to find a keyboard as part of my CNHC-registered Alexander working week. technique teacher in your area, or to find out if your teacher is registered. I have since learned more 020 3668 0406 about the Alexander [email protected] technique and how to use www.cnhc.org.uk my posture di
erently, Interactive Teaching Method which helps to reduce the Association stress I put on my neck. Promotes the Alexander technique, act as a point of contact between Anna ” teachers and the public, maintains teaching standards and provides support and continuing professional development for teachers. www.alexandertechnique-itm.org

20 Aromatherapy

What is it? your GP, specialist or Parkinson’s Aromatherapists use essential oils nurse about availability in your area. from plants to treat symptoms such as anxiety, stress, insomnia What about safety? and depression. The oils are diluted Aromatherapy is generally very and can be massaged into the skin, safe. However essential oils are inhaled or used in creams or in the highly concentrated and shouldn’t bath. The oils are said to have be swallowed. They should be chemical properties that can diluted before being applied to the positively a
ect your physical and skin to avoid irritation. Some people mental health. may have an allergic reaction to some essential oils. How might it help? Many people use aromatherapy to Speak to your GP, specialist or help them relax. There hasn’t been Parkinson’s nurse before you use much research on how essential oils, especially if you’re aromatherapy may help with pregnant or have epilepsy, heart Parkinson’s. Research suggests it problems, high blood pressure, can have a mild, temporary calming asthma or diabetes. e
ect on anxiety, but another study said the evidence available Aromatherapists aren’t statutorily wasn’t good enough to prove regulated but can register with the aromatherapy could e
ectively Complementary and Natural treat any condition. Healthcare Council.

Aromatherapy is one of the more commonly o
ered therapies in NHS hospitals with complementary medicine programmes. Speak to

21 Where can I learn more? The International Federation of Complementary and Natural Aromatherapists Healthcare Council (CNHC) There’s no single professional Aromatherapists can register with association for aromatherapy. the Complementary and Natural However, the International Healthcare Council. You can check Federation of Aromatherapists can the Council’s website to find a help you find a reliable, registered CNHC-registered aromatherapist in and qualified aromatherapist. your area, or to find out if your 0208 567 2243 practitioner is registered. www.ifaroma.org 020 3668 0406 [email protected] www.cnhc.org.uk

22 Art therapy

What is it? professionals just as the General Art therapy is a form of Medical Council regulates GPs and psychotherapy that uses art as a specialists. Art therapists must be way of communicating feelings and registered to practise. thoughts. Practitioners believe it is an e
ective way to express specific Where can I learn more? emotional and physical issues. You Art classes can do sessions with qualified art Some local Parkinson’s UK groups therapists in groups or individually. o
er regular creative sessions, including art classes. Find your local How might it help? group at parkinsons.org.uk/ While there’s evidence that art localgroups or call our helpline on therapy can be e
ective for people 0808 800 0303 for details of with depression or stress, there’s your nearest meeting. no evidence in the case of people with Parkinson’s. You can also make the most of creative activities by speaking to an However, many people with occupational therapist. In some Parkinson’s have told us that being areas, you can contact an creative helps them to focus their occupational therapist directly mind, relax and express their through your local social services or emotions in a positive way. social work department. Otherwise, your GP, specialist or What about safety? Parkinson’s nurse should be able to refer you. Art therapy is regulated by the Health and Care Professions Council Find out more: see our and is available through the NHS. information sheet Occupational The Council is a government body therapy and Parkinson’s. which regulates health

23 The British Association Health and Care Professions of Art Therapists Council The professional organisation You can contact this organisation to for art therapists in the UK, check an art therapist’s registration. with its own Code of Ethics 020 7582 0866 of Professional Practice. [email protected] 020 7686 4216 www.hcpc-uk.org [email protected] www.baat.org

24 Ayurveda

What is it? What about safety? Ayurveda is a traditional Indian Some therapies used in Ayurveda medical system. It’s called a system may react with certain medications. because more than one technique It’s essential that you talk to your is involved. What technique is GP, specialist or Parkinson’s nurse used depends on the person before you start treatment. being treated. In the past the UK Medicines and Ayurveda can combine treatments Healthcare products Regulatory such as diet and lifestyle advice, Agency has issued warnings about herb supplements, and physical dangerous or contaminated treatments such as full-body supplies of Ayurvedic medicines. massage and meditation. Look online at www.mhra.gov.uk if you have any concerns. The aim is to cleanse the body, reduce symptoms, increase Ayurveda practitioners aren’t resistance to disease and promote regulated by law. Check that your mental calm. therapist is registered with a professional body and is insured. How might it help? People may use Ayurveda to build Where can I learn more? and maintain an overall sense of Ayurvedic Practitioners good health and wellbeing. Association An independent, professional Although there have been some association of Ayurvedic small studies of Ayurveda, none practitioners. You can contact them have been of a good enough quality to find out more about Ayurveda to prove its e
ectiveness. Larger, and find therapists local to you. better-designed studies are needed 01273 500 492 before we can be sure how [email protected] e
ective Ayurveda is. www.apa.uk.com 25 Bowen technique

What is it? What about safety? Bowen technique is a very gentle, Bowen therapists aren’t regulated touch-based therapy. Practitioners by law, but they can register with aim to restore balance in the body the Complementary and Natural by so¥ly manipulating muscles and Healthcare Council. so¥ tissue. They use their fingers and thumbs to make small, rolling Where can I learn more? movements over precise points on The Complementary and Natural your body. Healthcare Council (CNHC) Bowen therapists can register with How might it help? the Complementary and Natural Healthcare Council. You can check Bowen technique may be used for a the Council’s website to find a range of physical and emotional CNHC-registered Bowen therapist conditions, including pain, muscular in your area, or to find out if your problems, stress and di§culties practitioner is registered. sleeping. There have been some 020 3668 0406 small studies for its use in pain [email protected] relief and stress, but a recent www.cnhc.org.uk review of the evidence showed that more detailed studies were needed.

There have been no scientific studies to support the use of Bowen therapy in Parkinson’s. However, people with Parkinson’s have found it helpful.

26 Bowen Therapy Professional The Bowen Association UK Association Provides technical and practical An independent, professional support for Bowen therapists and association of Bowen therapy their clients, and a practitioner practitioners. You can contact them referral service for the to find out more about the Bowen general public. technique, find qualified teachers 01205 319100 and read about how they assess o’[email protected] their members. www.bowen-technique.co.uk 0844 561 7173 [email protected] www.bowentherapy.org.uk

27 Chiropractic

What is it? Chiropractic can also be used to Chiropractors believe the spine treat mental health conditions, influences all aspects of our health, such as phobias, depression and so chiropractic treatment focuses anxiety, but there is little evidence on bringing bones, joints, muscles of its e
ectiveness. and the nervous system into balance. Chiropractors tend to There are no studies on the e
ects focus on the area around the spine, of chiropractic on people using spine manipulation. with Parkinson’s.

Typically, the first session will What about safety? involve an assessment of your There’s statutory regulation for health, medical history and a chiropractic in the UK. This means physical examination. The it’s illegal for anyone to practise or chiropractor will then use manual to call themselves a chiropractor techniques to manipulate the spine unless they’re registered with the and may also work on joints, General Chiropractic Council. muscles and so¥ tissue. Chiropractors may also give Chiropractic isn’t usually painful, advice on health, diet, exercise but some people may experience and lifestyle. mild side e
ects up to 24 hours a¥er a chiropractic session, How might it help? including sti
ness, fatigue and pain. Chiropractic is commonly used for conditions a
ecting the muscles, There’s a risk of more serious bones and joints. Most people use problems, such as stroke, from chiropractic to relieve pain, spinal manipulation, but the risk is especially back and neck pain. extremely small. There’s some evidence that chiropractic can help with this. 28 Where can I learn more? General Chiropractic Council Chiropractic is available on the NHS Regulates the chiropractic in some areas. Ask your GP, profession. You can contact them specialist or Parkinson’s nurse to find out more about chiropractic, about availability. Be aware that find a chiropractor near you, or to funding is limited and most people check if a chiropractor is registered. pay for chiropractic if they choose 020 7713 5155 it as a treatment option. [email protected] www.gcc-uk.org

29 Conductive education

What is it? What about safety? Conductive education is a Always check that the conductor is rehabilitation system. As the name registered with a professional body suggests, its approach is and is insured. educational rather than therapeutic. It aims to teach adults Where can I learn more? and children with neurological Some Parkinson’s UK local groups conditions that a
ect movement, o
er conductive education like Parkinson’s, how to overcome sessions. Find your local group at everyday problems. parkinsons.org.uk/localgroups or call our helpline on How might it help? 0808 800 0303 for details Some people find that conductive of your nearest meeting. education helps to control the physical symptoms of Parkinson’s, National Institute of Conductive including tremor, rigidity and Education slowness of movement. By learning A UK charity based in Birmingham. strategies which help overcome 0121 449 1569 movement and other everyday foundation@conductive- problems, conductive education education.org.uk can increase feelings of confidence www.conductive-education.org. and independence. uk

Although conductive education is well established as a treatment for Parkinson’s, there is little supporting medical evidence for its e
ectiveness.

30 Feldenkrais method

What is it? What about safety? The idea of Feldenkrais is that by Feldenkrais is generally safe for becoming more aware of your own everyone. But check your teacher movements, you can improve your is registered with a professional mobility and general well-being. body and is insured. The method is based on martial- arts theory and has been Where can I learn more? developed to help people with The Feldenkrais Guild UK everyday problems, like di§culties This organisation can help you find with balance or turning over in bed. Feldenkrais teachers and classes across the UK. It’s regarded as educational rather 07000 785 506 than therapeutic. Lessons may [email protected] involve doing a sequence of www.feldenkrais.co.uk movements that involve thinking, sensing, moving and imagining.

How might it help? Studies show that Feldenkrais helps with balance and mobility. People also use it to find relief from tension and pain, to improve breathing and performance, and for general wellbeing. As yet, there have been few studies of the method specifically for the treatment of Parkinson’s, but there are some indications that the method improves quality of life.

31 32 Herbal medicine

What is it? St John’s Wort is also o¥en mixed Herbal medicine is the use of plants with other components to create and plant extracts to treat illnesses. di
erent brands of the herbal They are o¥en taken as drops, remedy. This could increase the capsules or tea. Herbal medicines possibility of side e
ects can be quite powerful. Many of and interactions. today’s common drugs come from plants or are based on chemicals Small trials have been carried out found in them. with plants commonly used in Ayurvedic medicine to relieve Herbalists, who prescribe complex Parkinson’s symptoms (see the herbal mixtures, can o
er section on Ayurveda on page X). professional advice and will also More research is needed to recommend diet, exercise and establish conclusively whether lifestyle measures. Some herbal herbs are helpful in the treatment medicines are sold in health food of Parkinson’s symptoms. shops and pharmacies. What about safety? How might it help? You should always talk to your GP, Herbs are used for a wide variety specialist or Parkinson’s nurse of conditions. There is some before taking herbal medicines or evidence that certain herbs, like St supplements in case they have John’s Wort, may help with serious side e
ects or interfere depression and some skin with your usual medication. conditions. But be aware that the St John’s Wort, which can be used Some herbal medicines shouldn’t be for depression, is not recommended taken during pregnancy – again, for people with Parkinson’s. This is check with your GP. because St John’s Wort can interact with your Parkinson’s drugs. 33 Make sure your herbal medicine National Institute of Medical comes from a reliable source. Herbalists In the past the UK Medicines and 01392 426 022 Healthcare products Regulatory [email protected] Agency has found supplies of www.nimh.org.uk contaminated herbs. (Check at www.mhra.gov.uk or ask your Register of Chinese Herbal GP about any recent alerts). Medicine 01603 623 994 Where can I learn more? [email protected] Herbalists aren’t regulated by law. www.rchm.co.uk Contact any of the following organisations to find out more Unified Register of Herbal about herbal medicine, find Practitioners qualified practitioners and read 07539 528 857 about how they regulate www.urhp.com their members. British Herbal Medicine International Register of Association Consultant Herbalists and 0845 680 1134 Homeopaths [email protected] 01594 368 443 www.bhma.info o’[email protected] www.irch.org

34 Homeopathy

What is it? gel or cream for use on the skin Homeopaths believe conditions can as well. be cured by giving someone an extremely diluted dose of a remedy How might it help? that, in large doses, would trigger Homeopaths believe homeopathy the symptoms. can help with any condition in which the body has the potential to Homeopaths believe this ‘like for self-repair. As a result, they like’ principle stimulates the body’s suggest homeopathy can be used own healing power so it clears itself to treat a wide range of acute and of any imbalance. The remedies chronic medical conditions. come from various sources, including plants, animals Homeopathy is popular. However, and minerals. despite extensive research, there’s no good quality evidence that Homeopaths will discuss your homeopathy is e
ective as a medical history, symptoms and treatment for any health condition. how these a
ect you. They may There are no studies on also ask about your lifestyle, homeopathy for Parkinson’s. eating habits and preferences, and your personality. Homeopathy isn’t widely available on the NHS. In 2017, NHS England At the end of the consultation the recommended that GPs and other homeopath may give you a prescribers should stop providing it. prescription and advise you on how It is available privately. o¥en you should take the medicine. Homeopathic remedies are usually Practitioners taken in pill form, but are also Some health professionals, available as a liquid or powder. You including doctors, nurses and may be prescribed a homeopathic pharmacists, are trained in 35 homeopathy and use it alongside Alliance of Registered conventional medical treatment. Homeopaths They’re all regulated by their 01825 714 506 relevant professional body – for [email protected] example, GPs are regulated by the www.a-r-h.org General Medical Council. British Homeopathic Association Some homeopaths aren’t medically 01582 408 675 qualified. Currently, there are no [email protected] national standards of training and www.britishhomeopathic.org accreditation for these practitioners. If you decide to see a Faculty of Homeopathy homeopath who isn’t medically 01582 408 680 qualified, you should check they’re www.facultyofhomeopathy.org insured and registered with a Homeopathic Medical professional body. Association www.the-hma.org What about safety? Homeopathic remedies are International Register of generally safe, and the risk of a Consultant Herbalists and serious adverse side e
ect from Homeopaths taking them is thought to be small. 01594 368 443 o’[email protected] There’s no research to suggest www.irch.org homeopathic medicines react negatively with Parkinson’s Scottish Association of medication, but you should always Professional Homoeopaths speak to your GP, Parkinson’s nurse 0141 954 7350 or specialist before taking any kind www.scottish-homeopath.org. of medication. uk

Where can I learn more? Society of Homeopaths 0845 450 6611 Contact any of the following [email protected] organisations to find out more www.homeopathy-soh.org about homeopathic medicine, find qualified practitioners and read about how they regulate their members. 36 Kinesiology

What is it? How might it help? Kinesiology means ‘the study of Kinesiology is used to diagnose and body movement’. The treatment treat a variety of health problems. you receive will depend on your There are no good quality studies kinesiology practitioner. demonstrating that kinesiology is e
ective. Kinesiologists believe each muscle is connected to an organ. What about safety? Therapists apply pressure to Kinesiologists aren’t currently di
erent parts of the body to see regulated by law. Check that your how the muscle responds therapist is registered with a (sometimes known as muscle professional body and is insured. testing). If the muscle’s weak, they believe it means there’s a problem with the organ. How muscles Where can I learn more? respond to gentle pressure reveals Kinesiology Federation how the whole body is functioning Contact this organisation to find and helps locate any imbalance. out more about kinesiology and to find practitioners local to you. At the end of the session you may 0845 260 1094 be advised on lifestyle changes admin@kinesiologyfederation. (particularly dietary changes), co.uk given specific exercises to do or www.kinesiologyfederation. recommendations on supplements. co.uk

37 Massage therapy

What is it? What about safety? People have used massage for Massage therapy shouldn’t hurt, thousands of years to heal injuries, although there may be some promote relaxation and encourage discomfort if pressure is applied to better movement. There are many injured areas, or where your body is di
erent types of massage from very tense. traditions around the world. Massage may not be suitable for A massage therapist may use people with certain medical various techniques including conditions, a history of blood clots, stroking, kneading and rubbing to or weak or broken bones. manipulate the body using pressure. Massage may be gentle If you have wounds or bruises you or vigorous and may focus on one should wait until these are healed area or the whole body. before booking a massage appointment. How might it help? Research suggests that massage Massage therapists aren’t regulated may help to reduce pain and by law, but they may register with anxiety and depression, although the Complementary and Natural there’s no conclusive evidence. Healthcare Council. Abdominal massage may also help with constipation.

Many people with Parkinson’s and their carers have told us they find massage therapy useful as a way to relax and to have time to themselves.

38 Where can I learn more? General Council for Massage The Complementary and Natural Therapies Healthcare Council The governing body for massage Massage therapists can register therapies and all body work and with the Complementary and so¥ tissue techniques in the UK. Natural Healthcare Council. You can Contact them to find a massage check the Council’s website to find therapist local to you or visit the a CNHC registered massage website to find links to other therapist in your area, or to find out professional organisations for if your practitioner is registered. massage therapy. 020 3668 0406 0870 850 4452 [email protected] [email protected] www.cnhc.org.uk www.gcmt.org.uk

39 Meditation and relaxation techniques

What is it? There is some evidence that Meditation has been used meditation and related techniques worldwide for thousands of years. can help with stress and anxiety. Although o¥en associated with religion and spirituality, it’s What about safety? increasingly used for Meditation is generally considered health reasons. to be safe. Currently, meditation teachers are not regulated by law. There are many forms of Check that your therapist is meditation but they all aim to registered with a professional body create a sense of calm. During and is insured. meditation, the mind is in a state of restful alertness while the body Where can I learn more? becomes more relaxed. You can Because there are many di
erent meditate in a group or alone. types of meditation and relaxation classes, it isn’t possible to list them Guided imagery or visualisation all, or suggest which is best for you. (forming pictures in your mind) are related techniques which are Relaxation and meditation are sometimes combined with muscle o
ered in hospitals and community relaxation. Tai chi, mindfulness and centres that provide complementary yoga all incorporate elements therapies. Your GP, specialist, of meditation. Parkinson’s nurse, local council or library may be able to tell you How might it help? about nearby classes. Some People use meditation to relieve Parkinson’s UK local groups o
er pain, stress, depression and relaxation therapies. Visit insomnia, and to achieve a general parkinsons.org.uk/localgroups sense of wellbeing. or call our helpline on 0808 800 0303 for details. 40 I am a long term meditator (Transcendental Meditation) “and love the benefits it gives me. During my 20-minute meditation my tremor subsides and stops completely. I feel great calm a¥erwards. It feels like prior to meditation a current of electricity is flowing through my arms, which is switched o
by the meditation and I feel calm.

This quiet time meditating gives me a sense of control over the tremor. Knowing that I can ‘switch it o
’ with meditation, gives me the belief that I can switch it o
inbetween meditations. Keith ”

41 42 Music therapy

What is it? What about safety? Music therapy is the use of music Music therapists are regulated by by trained professionals as a the Health and Care Professions treatment for some physical and Council and must be registered mental conditions. You don’t need to practise. to know anything about music to enjoy music therapy. Where can I learn more? Music therapy is available in some How might it help? areas on the NHS. Ask your GP, It’s been suggested that music can specialist or Parkinson’s nurse improve movement and speech and about availability in your area. help people to relax or talk about their feelings or ideas. British Association for Music Therapy Some people with Parkinson’s find This organisation has information that listening to strong rhythmic about music therapy and how to music can improve their walking, find a music therapist in your area. prevent hesitations and overcome 020 7837 6100 freezing episodes. [email protected] www.bamt.org In general, research indicates that music seems to help people with conditions such as Parkinson’s improve their emotional sense of wellbeing.

43 Osteopathy

What is it? What about safety? Osteopaths stretch, move and Generally, osteopathy is classed as massage muscles and joints to safe. There are some reports that treat health problems. They’ll use manipulation techniques have their hands to find areas of caused serious complications like tenderness, restriction or strain in spinal injury or stroke, but these your body. are rare. Some osteopathic manipulations are unsuitable for How might it help? people with bone problems, bleeding disorders or other Osteopathy is commonly used for conditions. They are also not conditions caused by problems with recommended for people on the nerves, joints and muscles, blood-thinning medication, such as back and neck problems, such as warfarin. joint pain or injuries. NICE guidelines recommend that You should check that your osteopathy be considered as a osteopath is qualified and also let treatment for back pain. them know about any health problems and medications you’re Some osteopaths believe they can taking. A¥er treatment, you may also help relieve general health feel some mild side e
ects, such as problems such as asthma, jaw sti
ness, discomfort or tiredness. problems and painful periods. All UK osteopaths must be qualified However there is no good evidence and registered with the General that this is true. Osteopathic Council.

44 Where can I learn more? Osteopathy is available on the NHS in some areas, though most people will have to pay for private treatment. Ask your GP, specialist or Parkinson’s nurse about what’s available in your area.

General Osteopathic Council The General Osteopathic Council regulates the practice of osteopathy in the UK. The website features information about osteopathy, how to find qualified practitioners and what to expect from a treatment session. 020 7357 6655 www.osteopathy.org.uk

45 Reflexology

What is it? What about safety? Reflexology is based on the theory Reflexologists aren’t regulated by that di
erent points on the feet law, but they may register with the and hands correspond with Complementary and Natural di
erent areas of the body. By Healthcare Council . massaging chosen areas of the feet and hands, the corresponding area Check that your therapist is of the body can be treated. registered with a professional body and is insured. How might it help? Reflexology is o¥en used to Reflexology may not be suitable promote relaxation, and to help if you have diabetes, epilepsy, with a wide range of problems, thyroid or foot problems or a including digestive and hormonal blood disorder. issues, sti
ness in the back and neck, and insomnia. During treatment, some areas of your feet may feel tender. Some There’s no conclusive evidence that people experience a reaction to reflexology works for any medical their first treatment, such as condition. A very small study has feeling emotional or needing to shown that reflexology may help pass urine. with the well-being of people with Parkinson’s. However, a larger study is needed to confirm this.

46 Where can I learn more? Reflexology Forum British Reflexology Association This is a developing regulatory A professional association that aims body in the UK for reflexology. to promote reflexology in Great Contact the organisation to find Britain and abroad. out more about reflexology and www.britreflex.co.uk to find a therapist in your area. 0800 037 0130 The Complementary and Natural renee.tanner@ Healthcare Council intfedreflexologists.org Reflexologists may register with the www.reflexologyforum.org.uk Complementary and Natural Healthcare Council. Check the website to find a CNHC-registered reflexologist in your area, or to find out if your practitioner is registered. 020 3668 0406 [email protected] www.cnhc.org.uk

47 Reiki

What is it? What about safety? Reiki was originally developed in Reiki therapists aren’t regulated by Japan. In Japanese, ‘Reiki’ means law, but may register with the universal life energy. Complementary and Natural Healthcare Council. Practitioners believe that Reiki promotes healing by bringing you into harmony and balance. Where can I learn more? The Complementary and Natural During treatment, the practitioner Healthcare Council channels healing energy by placing Reiki therapists can register with their hands on or near your body. the Complementary and Natural The whole person is treated, rather Healthcare Council. You can check than specific symptoms. the Council’s website to find a CNHC-registered Reiki therapist in How might it help? your area, or to find out if your practitioner is registered. Practitioners use Reiki to bring 020 3668 0406 comfort and to support healing for [email protected] a range of conditions. A study www.cnhc.org.uk showed that Reiki may have some benefits for pain relief. Reiki Council This organisation has links to Reiki is also used to treat anxiety several professional Reiki and depression, although a study organisations. concluded it didn’t have a [email protected] significant e
ect. www.reikicouncil.org.uk

48 Shiatsu

What is it? Shiatsu therapists aren’t regulated Shiatsu is a Japanese form of by law but they may register with massage therapy. A practitioner the Complementary and Natural uses touch, pressure and Healthcare Council. manipulative techniques to adjust the body’s physical structure and Where can I learn more? balance its energy flow. It’s The Complementary and Natural designed to support and Healthcare Council strengthen the body’s natural Shiatsu practitioners can register ability to heal itself. with the Complementary and Natural Healthcare Council. You can How might it help? use the Council’s website to find a Shiatsu is o¥en used to help with CNHC-registered Shiatsu relaxation. Shiatsu is sometimes practitioner in your area or to check used to treat frozen shoulder, a if your practitioner is registered. symptom associated with 020 3668 0406 Parkinson’s. However, there’s no [email protected] clinical evidence to prove its www.cnhc.org.uk e
ectiveness. Shiatsu Society This is a non-profit organisation What about safety? which represents all styles and the Shiatsu is generally safe. A¥er the majority of Shiatsu practitioners, first few treatments, some people schools and students in the UK. can experience side e
ects Contact them to find out more including headaches, sti
ness, about Shiatsu, how they regulate stomach upsets, diarrhoea, the their members and find qualified desire to urinate frequently or practitioners. lethargy. Speak to your practitioner 0845 130 4560 before starting treatment if you www.shiatsusociety.org have any concerns. 49 more information and support

Useful contacts NHS Choices website www.nhs.uk The Complementary and Natural There is a good library of online Healthcare Council information about complementary 020 3668 0406 therapies. There are also links [email protected] to professional organisations, www.cnhc.org.uk so you can learn more and find a qualified therapist. Health and Care Professions Council NHS National Library for Health 020 7582 0866 www.library.nhs.uk www.hpc-uk.org Designed for NHS health professionals, it’s also freely National Center for accessible to the public and is an Complementary and Alternative excellent resource for information Medicine (USA) about the latest research. This American website is a rich source of high quality The Research Council for information on many di
erent Complementary Medicine complementary therapies. www.rccm.org.uk www.nccam.nih.gov For anyone interested in the scientific evidence supporting complementary therapies. The website is based at the Royal London Hospital for Integrated Medicine (part of the NHS).

50 Your public library Information and support Increasingly, health information is from Parkinson’s UK available on the internet. If you do You can call our free confidential not have access to the internet, helpline for general support and you may be able to use it free of information. Call 0808 800 0303 charge at your local public library. (calls are free from UK landlines and Your library may also o
er training most mobile networks) or email [email protected] on how to use the internet. Sometimes the librarian can help Our helpline can also put you you find information online. in touch with one of our local advisers, who provide one-to-one Many public libraries now have information and support to anyone links to the NHS and other a
ected by Parkinson’s. They can services, so feel free to ask for also provide links to local groups local information. and services.

Your local public library may have a Our website has information good selection books on about your local support team complementary therapies. and how to contact them at parkinsons.org.uk/localtoyou Parkinson’s nurses Parkinson’s nurses provide expert You can find details of our local advice and support to people with groups and your nearest meeting at Parkinson’s and those who care for parkinsons.org.uk/localgroups them. They can also act as a liaison between other health and social You can also visit care professionals to make sure parkinsons.org.uk/forum to chat your needs are met. to other people with similar experiences on our online Parkinson’s nurses may not be discussion forum. available in every area, but your GP or specialist can tell you about local services. You can find out more at parkinsons.org.uk/nurses

51 Thank you to everyone who Our information contributed to or reviewed All of our most up-to-date this booklet: information is available at parkinsons.org.uk/ The late George Lewith, informationsupport Professor of Health Research If you’d prefer to read one of in the Department of Primary our printed leaflets or booklets, Care at the University of find out how to place an order Southampton and a director of the International Society at parkinsons.org.uk/ for Complementary Medicine orderingresources or by calling Research 0300 123 3689. Hazel Russo, Complementary We make every e
ort to ensure and Natural Healthcare Council that our services provide current, (CNHC) unbiased and accurate information. Thanks also to our information We hope that this will add to any review group and other people professional advice you receive and a
ected by Parkinson’s who help you to make any decisions you provided feedback. may face. Please do continue to talk to your health and social care team if you are worried about any Can you help? At Parkinson’s UK, we are totally aspect of living with Parkinson’s. dependent on donations from individuals and organisations to If you’d like to find out more about how we put our information fund the work that we do. There together, including references and are many ways that you can help us the sources of evidence we use, to support people with Parkinson’s. please contact us at [email protected] If you would like to get involved, please contact our Supporter Services team on 0800 138 6593 or visit our website at parkinsons. org.uk/donate. Thank you.

Image credits: iStock - Page 16 UntitledImages, page 22 botamochi, page 29 ChesiireCat, page 39 Wavebreakmedia, page 47 101dalmatians. 52                  1. Please choose the option that you. best fits or email [email protected] Parkinson’s 215 UK, Vauxhall Bridge Road, London SW1V 1EJ as possible. Please return to Information Content team, will help us ensure our resources are as useful and easy to understand youDo have any feedback about this information? Your comments Complementary therapies (PKB102/2018) 3. it answered Has your all questions? 2. Where did you get this information from? 4. How easy was it to understand? Other (please specify) to Call the helpline Parkinson’s local UK adviser Parkinson’s nurse GP Other (please specify) I’m aprofessional working with people with Parkinson’s Ihave afriend or family member with Parkinson’s Icare for someone with Parkinson’s Ihave Parkinson’s and was diagnosed in Not sure Easy Very easy Partly Yes, mostly Yes, completely        Ordered directly from us Parkinson’s local UK group Specialist Very difficult Quite difficult Not atall Not sure . Thank you!Thank . 

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How would you prefer us to contact you?  Email  Post  Phone We will not pass on your details to any other organisation or third party. To find out more, read our privacy policy at parkinsons.org.uk/termsandconditions  55 Every hour, two people in the UK are told they have Parkinson’s – a brain condition that turns lives upside down, leaving a future full of uncertainty.

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We want everyone to get the best health and social care. So we bring professionals together to drive improvements that enable people to live life to the full.

Ultimately, we want to end Parkinson’s. That’s why we inspire and support the international research community to develop life-changing treatments, faster. And we won’t stop until we find a cure.

Together we can bring forward the day when no one fears Parkinson’s.

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