From the Guidelines
Muscle spasms can be effectively managed with medications such as tizanidine, dantrolene, and oral baclofen, which are recommended for spasticity resulting in pain, poor skin hygiene, or decreased function. When considering treatment options, it's essential to weigh the benefits and risks of each medication.
- Tizanidine, for example, is specifically recommended for chronic stroke patients 1.
- Dantrolene and baclofen are also considered for spasticity, although there is limited evidence on their efficacy for low back pain 1.
- It's crucial to note that diazepam and other benzodiazepines are not recommended during the stroke recovery period due to potential deleterious effects on recovery and sedation side effects 1.
- Other treatment options, such as botulinum toxin, phenol/alcohol, and intrathecal baclofen, may be considered for selected patients with disabling or painful spasticity 1.
- Non-pharmacological interventions, including antispastic positioning, range of motion exercises, stretching, splinting, serial casting, or surgical correction, should also be considered as part of a comprehensive treatment plan 1.
From the FDA Drug Label
Cyclobenzaprine hydrochloride tablets are indicated as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions Cyclobenzaprine HCl relieves skeletal muscle spasm of local origin without interfering with muscle function.
The recommended medication for managing muscle spasm is cyclobenzaprine. It is used as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions 2. Cyclobenzaprine relieves skeletal muscle spasm of local origin without interfering with muscle function 2.
- Key points:
- Used for acute, painful musculoskeletal conditions
- Relieves skeletal muscle spasm of local origin
- Should be used only for short periods (up to two or three weeks) 2
From the Research
Recommended Medications for Managing Muscle Spasm
The following medications are recommended for managing muscle spasm:
- Cyclobenzaprine: a muscle relaxant that has been shown to be effective in relieving muscle spasm and pain 3, 4, 5
- Naproxen: a nonsteroidal anti-inflammatory agent that can be used in combination with cyclobenzaprine to relieve muscle spasm and pain 3
- Ibuprofen: a nonsteroidal anti-inflammatory agent that can be used in combination with cyclobenzaprine to relieve muscle spasm and pain 4
- Combination therapy: combining a muscle relaxant with a nonsteroidal anti-inflammatory agent, such as cyclobenzaprine and naproxen or ibuprofen, may be more effective than using a single agent alone 3, 4, 6
Considerations for Treatment
When selecting a medication for managing muscle spasm, consider the following:
- Efficacy: cyclobenzaprine and combination therapy have been shown to be effective in relieving muscle spasm and pain 3, 4, 6
- Safety: cyclobenzaprine and combination therapy may be associated with more side effects, such as drowsiness and dizziness, than nonsteroidal anti-inflammatory agents alone 3, 4, 7
- Cost-effectiveness: cyclobenzaprine represents a cost-effective approach to the management of acute muscle spasm due to its rapid symptomatic relief 5
Alternative Options
Other medications that may be used to manage muscle spasm include:
- Benzodiazepines: such as diazepam and triazolam, although their use is not recommended due to the risk of adverse events 7
- Non-benzodiazepine agents: such as zopiclone, although their efficacy in relieving muscle spasm is unclear 7
- Trigger point injections: may be used to relieve muscle spasm in myofacial pain and low-back pain 6