From the Guidelines
Adjunct treatments for muscle spasms beyond NSAIDs, stretching, and muscle relaxants include nerve stabilizing agents such as pregabalin, gabapentin, and duloxetine, as well as botulinum toxin type A injections into the affected muscles for pain management and spasm control as indicated. These treatments have been recommended in a systematic review of rehabilitation and exercise recommendations in oncology guidelines 1. The use of nerve stabilizing agents can help combat pain and spasms, making it easier for patients to undergo physical therapy and stretching exercises.
Some key points to consider when using these adjunct treatments include:
- Pregabalin, gabapentin, and duloxetine can be prescribed to manage pain and spasms, and may also help ease physical therapy and stretching devices 1.
- Botulinum toxin type A injections can be used to directly target affected muscles and provide relief from spasms 1.
- It is essential to weigh the potential benefits and harms of these treatments and consider individual patient needs and circumstances.
- Other treatments such as heat therapy, cold therapy, physical therapy, massage therapy, acupuncture, and transcutaneous electrical nerve stimulation (TENS) may also be effective in managing muscle spasms, but the most recent and highest quality evidence supports the use of nerve stabilizing agents and botulinum toxin type A injections 1.
In terms of specific treatment options, pregabalin, gabapentin, and duloxetine are recommended as first-line treatments for muscle spasms, due to their ability to stabilize nerves and reduce pain and spasms 1. Botulinum toxin type A injections can be used in more severe cases or when other treatments have failed. It is crucial to consult with a healthcare professional to determine the best course of treatment for individual patients.
From the Research
Adjunct Treatments for Muscle Spasm
There are several adjunct treatments for muscle spasm beyond Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), stretching, and muscle relaxants. These include:
- Transcutaneous electrical stimulation (TENS) [ 2, 3 ]
- Electrical stimulation of injected muscles to boost botulinum toxin effect on spasticity [ 4, 5,6 ]
- Dynamic electrical neurostimulation 5
- Botulinum toxin therapy 4, 5, 6
Mechanism of Action
These adjunct treatments work by:
- Decreasing the excitability of the receptor apparatus 5
- Optimizing microcirculatory processes 5
- Producing analgesic and antispasmodic effects 2, 5
- Boosting the effect of botulinum toxin type A (BoNT-A) 4, 6
Efficacy
The efficacy of these adjunct treatments has been demonstrated in various studies, including:
- A study that found TENS to be effective in 81% of patients with hemifacial spasms 2
- A systematic review that found electrical stimulation to be effective in reducing spasticity in patients with post-stroke spasticity 6
- A study that found dynamic electrical neurostimulation and botulinum toxin therapy to be effective in reducing spasticity in patients with post-stroke spasticity 5