What causes abdominal muscle spasms?

From the Guidelines

Abdominal muscle spasms can be effectively managed with antispasmodics, which have been shown to reduce global symptoms and abdominal pain in patients with irritable bowel syndrome (IBS) 1. When considering treatment options for abdominal muscle spasms, it is essential to prioritize the reduction of morbidity, mortality, and improvement of quality of life.

• The use of antispasmodics, such as dicycloverine, propantheline, otilonium bromide, and hyoscine butylbromide, has been found to be effective in reducing intestinal motility and alleviating symptoms of IBS 1.
• A meta-analysis of 26 RCTs, containing 2811 patients, demonstrated that antispasmodics significantly reduced the incidence of persistent global symptoms and abdominal pain (RR 0.65; 95% CI 0.56 to 0.76) 1.
• In addition to antispasmodics, other treatment options such as rest, gentle stretching, and over-the-counter pain relievers like ibuprofen or acetaminophen may also be beneficial in managing abdominal muscle spasms.
• It is crucial to note that while antispasmodics can be effective, they may also have side effects, such as abdominal pain, bloating, nausea, and constipation, which can limit their tolerability 1.
• Therefore, the use of antispasmodics, in conjunction with other treatment options, is recommended for the management of abdominal muscle spasms, with careful consideration of potential side effects and individual patient needs 1.

From the Research

Abdominal Muscle Spasms

• Abdominal muscle spasms can be a symptom of various conditions, including irritable bowel syndrome, functional dyspepsia, and centrally mediated abdominal pain syndrome 2
• Antispasmodic agents are often used to treat abdominal pain in these conditions, with different mechanisms of action, including anticholinergic/antimuscarinic agents, calcium channel inhibitors, and direct smooth muscle relaxants 2, 3
• The efficacy and safety of antispasmodics can vary significantly, and each agent should be considered on an individual basis rather than being prescribed based on information across the broad class of agents 2
• Some antispasmodics, such as hyoscine-N-butyl bromide and mebeverine, are considered primary treatments for gastric and intestinal cramping pain, while others, such as drotaverine and alverine, are undergoing clinical trials 3

Treatment Options

• Cyclobenzaprine hydrochloride is a muscle relaxant that has been shown to be effective in improving muscle spasm, reducing local pain and tenderness, and increasing range of motion in acute, painful musculoskeletal conditions 4, 5
• Heat and cold therapies are also used to treat musculoskeletal injury, with cold therapy reducing pain, blood flow, edema, inflammation, muscle spasm, and metabolic demand, and heat therapy providing pain relief and increasing blood flow, metabolism, and elasticity of connective tissues 6
• Fixed-dose combinations of antispasmodics and NSAIDs or two different antispasmodics can improve patient compliance and synergistically reduce gastric and intestinal cramping pain 3

Efficacy and Safety

• The efficacy and safety of antispasmodics and other treatments for abdominal muscle spasms can vary depending on the specific agent and individual patient 2, 3
• Cyclobenzaprine has been shown to be well-tolerated, with somnolence and dry mouth being the most common adverse effects, which are mild and dose-related 4
• More research is needed to fully understand the efficacy and safety of different treatments for abdominal muscle spasms, including head-to-head studies and clinical trials 2, 3, 6