From the Guidelines
For severe muscle cramping and spasm relief, I strongly recommend using baclofen (10mg/day, with a weekly increase of 10mg/day up to 30mg/day) as it has been shown to be effective in patients with muscle cramps 1.
Immediate Relief Measures
To alleviate severe muscle cramping and spasm, the following measures can be taken:
- Gently stretch and massage the affected muscle to increase blood flow and relax the muscle fibers
- Apply heat to the affected area to further relax the muscle
- Over-the-counter medications like ibuprofen (400-600mg every 6-8 hours) or naproxen sodium (220mg every 8-12 hours) can reduce inflammation and pain
Preventive Measures
To prevent recurring muscle cramps, the following measures can be taken:
- Magnesium supplements (300-400mg daily) to support proper muscle function
- Staying well-hydrated with 2-3 liters of water daily to prevent dehydration
- Regular stretching before and after physical activity to maintain muscle flexibility
- Proper electrolyte balance (particularly potassium, calcium, and sodium) to support normal muscle contraction
Medical Evaluation
If cramps are severe, persistent, or accompanied by swelling or weakness, medical evaluation is necessary to rule out underlying conditions like peripheral artery disease or nerve compression.
Skeletal Muscle Relaxants
Skeletal muscle relaxants such as cyclobenzaprine (5-10mg three times daily) or methocarbamol (750mg every 4 hours) may be prescribed for severe cases, but require a doctor's evaluation due to potential side effects including drowsiness 1. It is essential to note that the use of diuretics, such as furosemide, should be discontinued if severe muscle cramps develop 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 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
- Severe muscle cramping and spasm relief can be achieved with cyclobenzaprine hydrochloride tablets as an adjunct to rest and physical therapy for acute, painful musculoskeletal conditions 2.
- The medication is intended for short-term use (up to two or three weeks) for relief of muscle spasm and its associated signs and symptoms.
From the Research
Severe Muscle Cramping and Spasm Relief
- Severe muscle cramping and spasm can be caused by various factors, including disturbances of water and salt balance, sustained abnormal spinal reflex activity secondary to fatigue of the affected muscles, and other underlying medical conditions 3.
- Treatment options for muscle cramps and spasms include non-pharmacological interventions such as electro-neuromuscular stimulation, acupuncture, and rehabilitation programs targeting spasticity, which have shown moderate to low evidence of effectiveness 4.
- Heat and cold therapies are also commonly used to relieve muscle cramps and spasms, 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 5.
- However, the evidence for the effectiveness of these therapies is limited, and more high-quality research is needed to determine the best treatment approaches for severe muscle cramping and spasm relief 4, 5.
- In some cases, muscle cramps and spasms may be a symptom of an underlying condition, such as a neuromuscular disease, and a thorough diagnostic approach is necessary to determine the underlying cause and develop an effective treatment plan 6.
- Diltiazem, a calcium channel blocker, has been shown to be effective in treating certain types of muscle cramps and spasms, particularly those related to coronary artery spasm, but its use in other types of muscle cramps and spasms is not well established 7.