What are the treatments for muscle spasms?

From the Guidelines

Treatments for muscle spasms should prioritize botulinum neurotoxin as a highly effective option for relieving symptoms, particularly for upper and lower limb spasticity in adults, as evidenced by the most recent and highest quality study 1. When considering treatment for muscle spasms, it's essential to address the underlying cause, whether it's overuse, poor posture, or a medical condition. For immediate relief, rest the affected muscle, apply ice for 20 minutes several times daily during the first 72 hours, then switch to heat therapy. Gentle stretching and massage can help relax the muscle. Over-the-counter medications like ibuprofen (400-600mg every 6-8 hours) or naproxen (220-440mg twice daily) can reduce pain and inflammation. Some key points to consider in the management of muscle spasms include:

• Botulinum neurotoxin is effective in treating upper and lower limb spasticity in adults and improving passive function, as shown in the study 1.
• For chronic or recurrent spasms, physical therapy focusing on strengthening and flexibility exercises is beneficial.
• Staying hydrated and maintaining proper electrolyte balance with potassium, calcium, and magnesium can prevent spasms, especially during physical activity.
• Muscle relaxants such as cyclobenzaprine (5-10mg three times daily), methocarbamol (1500mg four times daily), or baclofen (5-25mg three times daily) may be prescribed for severe spasms, as suggested by the study 1. It's crucial to note that while various treatment options are available, the most recent and highest quality study 1 supports the use of botulinum neurotoxin as a highly effective treatment for muscle spasms, particularly for upper and lower limb spasticity in adults.

From the FDA Drug Label

Cyclobenzaprine hydrochloride tablets, USP are indicated as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions. Improvement is manifested by relief of muscle spasm and its associated signs and symptoms, namely, pain, tenderness, limitation of motion, and restriction in activities of daily living Cyclobenzaprine hydrochloride tablets should be used only for short periods (up to 2 or 3 weeks)

The treatment for muscle spasms includes:

• Cyclobenzaprine as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions 2
• The medication should be used for short periods only (up to 2 or 3 weeks)
• Rest and physical therapy are also recommended in addition to medication 2

From the Research

Treatments for Muscle Spasms

• Muscle spasms can be reduced by heat as well as by therapeutic cold, however, in upper motor neuron lesions, cold is more effective in reducing the spasticity 3
• Water immersion supports the reduction of muscle tone and pain may be reduced by both thermal stimuli 3
• Cyclobenzaprine hydrochloride is a muscle relaxant that is effective in improving muscle spasm, reducing local pain and tenderness, and increasing range of motion in acute, painful musculoskeletal conditions 4
• A lower dose of cyclobenzaprine (5 mg TID) was as effective as 10 mg TID, and was associated with a lower incidence of sedation 4
• Cyclobenzaprine has also been used to treat levator ani syndrome, with a patient experiencing resolution of symptoms after 3 days of treatment 5
• Exertional heat cramps can be treated by replacing salt and water lost from sweating to restore the extracellular volume and interstitial fluid spaces 6
• Cold pack therapy can produce significant temperature falls in cutaneous and subcutaneous superficial tissues, which can help reduce pain, muscle spasm, and edema 7

Instructions for Muscle Spasms

• Apply heat or cold therapy to the affected area to reduce muscle spasm 3
• Use cyclobenzaprine hydrochloride as directed by a healthcare professional to improve muscle spasm and reduce pain 4
• Replace salt and water lost from sweating to prevent exertional heat cramps 6
• Use cold pack therapy to reduce pain, muscle spasm, and edema 7
• Consider water immersion to support the reduction of muscle tone and pain 3