From the Guidelines
Muscle spasms can be effectively treated with botulinum neurotoxin, which has been shown to be safe and effective in reducing muscle tone and improving passive function in adults with upper and lower limb spasticity 1.
Treatment Options
The treatment of muscle spasms depends on their severity and underlying cause. For immediate relief, the following options can be considered:
- Resting the affected muscle and applying heat or cold therapy for 15-20 minutes several times daily
- Over-the-counter medications like ibuprofen (400-600mg every 6-8 hours) or naproxen (220-440mg twice daily) to reduce inflammation and pain
- Muscle relaxants such as cyclobenzaprine (5-10mg three times daily) or baclofen (5-25mg three times daily) for more severe spasms, but should only be used short-term due to sedative effects
Prevention
To prevent future muscle spasms, it is essential to:
- Stay hydrated by drinking 8-10 glasses of water daily
- Ensure adequate intake of potassium, calcium, and magnesium through diet or supplements
- Avoid fatigue, dehydration, electrolyte imbalances, or nerve irritation, which can trigger muscle spasms
Medical Evaluation
If muscle spasms persist beyond a week, are severely painful, or recur frequently, medical evaluation is necessary to rule out underlying conditions. A healthcare professional may prescribe botulinum neurotoxin injections, which have been shown to be effective in treating muscle spasms and improving quality of life 1.
Key Considerations
When treating muscle spasms, it is crucial to consider the potential benefits and harms of each treatment option. For example, skeletal muscle relaxants have been associated with a higher total number of adverse events and central nervous system adverse events compared with placebo 1. Therefore, these medications should be used with caution and only when necessary.
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 treatment options for muscle spasms include:
- Cyclobenzaprine as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions 2
- Rest
- Physical therapy
Note: Cyclobenzaprine is not effective in the treatment of spasticity associated with cerebral or spinal cord disease, or in children with cerebral palsy 2.
From the Research
Treatment Options for Muscle Spasms
The treatment options for muscle spasms include:
- Oral treatments such as baclofène and tizanidine 3
- Botulinum toxin 3, 4
- Intrathecal baclofène 3, 4
- Local application of alcohol or phenol 3
- Cyclobenzaprine hydrochloride, 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 5, 6
- Dantrolene, diazepam, and clonidine, which are also used to treat spasticity 7, 4
- Gabapentin, which has shown efficacy in treating spasticity, although more studies are required to confirm its place in therapy 4
First-Line Treatments
First-line treatments for muscle spasms include:
- Oral treatments and botulinum toxin, which can be considered depending on the local or diffuse nature of the spasticity and depending on the etiology 3
- Cyclobenzaprine 5 mg TID, which was found to be as effective as 10 mg TID, and was associated with a lower incidence of sedation 5
Pharmacotherapy
Pharmacotherapy for muscle spasms is generally initiated at low dosages and then gradually increased in an attempt to avoid adverse effects 4. Optimal therapy is the lowest effective dosage. The choice of pharmacotherapy should be tailored to the individual patient, and both patient and care giver should have realistic expectations.