“Herbal or vitamin supplements, acupuncture, massage, and meditation have all been used to help with symptom relief, increase mobility, and improve mood and outlook after stroke,” says Koto Ishida, MD, clinical director of the Center for Stroke and Neurovascular Diseases at NYU Langone in New York City. Here are six evidence-backed ways to treat a stroke using complementary and alternative medicines:

1. Acupuncture Reduces Pain and Depression

Acupuncture is an ancient Chinese complementary medicine that involves penetrating the skin with fine needles. In addition to being safe and inexpensive, acupuncture is a promising alternative approach to stroke recovery. “Studies suggest that acupuncture after a stroke may improve problems with pain, spasticity, physical functions, quality of life, and cognitive functions,” says Yu-Ching Hsu, Chinese medicine doctor at Tainan Hospital, Ministry of Health and Welfare, in Tainan, Taiwan. Acupuncture has been used as a form of stroke rehabilitation in China for thousands of years, though it’s becoming increasingly practiced in Western countries, according to a study published in the journal Acupuncture in Medicine. “While acupuncture may also facilitate recovery of function and independence, it also has the added advantage of improving nervous system function more directly,” Narda G. Robinson, DO, President and CEO of the CuraCore Integrative Medicine & Education Centers in the United States and Canada, says. “Acupuncture works by sending corrective signals into the nervous system to activate self-healing processes and encourage proper firing of nerve impulses in the brain, spinal cord, and peripheral nerves. It also relaxes tense muscles and reduces inflammation, thereby helping with the pain and spasticity that stroke patients may experience.” A review published in October 2017 in the International Journal of Molecular Sciences looked at the effectiveness of acupuncture as a treatment for ischemic stroke and found that the treatment promotes the growth and development of tissue in the central nervous system, regulates cerebral blood flow in the ischemic area, and improves long-term memory after a stroke. Additionally, a study published in March 2017 in the journal Medicines found that accupuncture may have beneficial psychological effects on patients after they had a stroke, lowering the risk for depression.

2. Yoga Can Help Increase Range of Motion

Problems with balance and coordination are common after a stroke, and practicing yoga may help you improve those impairments. A study published in 2014 in American Journal of Recreation Therapy examined the effects of yoga on 26 individuals with chronic stroke. After an eight-week yoga intervention, participants reported improved emotional regulation, increased stability and range of motion, and improvements in activity and participation. According to Dr. Robinson, yoga can help patients achieve more independence with activities of daily living and lessen their fear of falling. “Yoga therapy may assist patients in improving their balance as well as their quality of life,” Robinson says. “Working intentionally with stretch, strengthening, body awareness, and balance exercises are some of the ways in which yoga therapy can produce benefits for stroke patients.”

3. Tai Chi Helps Improve Balance

Tai Chi is an ancient Chinese tradition that involves a series of slow movements and stretches coupled with deep breathing. The body and mind work together to perform coordinated movements by focusing on each posture as it flows to the next, according to the Mayo Clinic. Research shows that the practice can help stroke patients improve balance, too. A review published in May 2018 in the journal Clinical Rehabilitation looked at 10 studies involving over 700 participants who suffered from neurological disorders and found that tai chi was effective in reducing fall incidences in Parkinson’s disease and stroke.

4. Massage Therapy Can Improve Fine Motor Skills

Massage therapy is the manipulation of body tissues in order to enhance a person’s health and well-being. A study published in 2012 in the Journal of Chinese Integrative Medicine found that Thai massage and herbal treatments can improve daily function, mood, sleep patterns, and pain in individuals who have suffered a stroke. Massages can help people who have had a stroke by relieving pain, and improving sleep and mood. There’s also research to support that certain types of massage can lead to improvements in fine motor skills. In a case report published in April 2012 in The Journal of Alternative and Complementary Medicine, a woman suffering from postpartum stroke showed improvements in her speech and fine motor skills after 14 sessions of urut Melayu, the traditional Malay massage.

5. Aromatherapy Relieves Stress

Aromatherapy is the use of essential oils and plant extracts in massages or baths for relaxation. This natural stress-relieving remedy has even been shown to help with depression, migraines, pain, anxiety, and restless leg syndrome. For stroke patients, aromatherapy may be an alternative therapy option. A small study published in August 2017 in the Journal of Physical Therapy Science divided 14 stroke patients into two groups: one was administered a back massage and foot bath using an essential oil five times in one week, and the other group received the same therapy without the oils. Researchers found that participants who received aromatherapy in addition to massage reported significantly lower physical and psychological stress as well as an improvement in mood. Additionally, the group that received aromatherapy reported higher sleep satisfaction than the control group.

6. Herbal Supplements May Improve Neurological Function

Herbal supplements, also called botanicals, have been used for thousands of years for medicinal purposes. After evaluating 28 trials that included over 2,000 patients, in a meta-analysis published in December 2017 in the journal Medicine, researchers found that some patented Chinese herbal supplements — Shuxuetong, Mailuoning, Xuesaitong, and Buchang Naoxintong — may improve neurological function and the ability to participate in activities of daily living in stroke patients. “For some of the supplements, it is important to note that these are not FDA-approved [Food and Drug Administration] and therefore do not undergo the rigorous screening requirements of prescription medications,” Dr. Ishida says. “This means you can’t be as certain about the purity or quality of the ingredients and there may be differences across brands or even batches within the same brand.” Ishida recommends always speaking with your doctor before using supplements because there could be risks or interactions with other drugs.