What is effective for treating cervical spasms?

From the Guidelines

For cervical spasms, the most effective treatment option is to prescribe nerve-stabilizing agents, such as pregabalin, gabapentin, or duloxetine, as indicated by the American Society of Clinical Oncology clinical practice guideline endorsement of the American Cancer Society guideline 1.

Treatment Options

• Muscle relaxants such as cyclobenzaprine (Flexeril) at 5-10mg three times daily or baclofen (Lioresal) at 5-20mg three times daily can help reduce muscle tension, as supported by a systematic review of skeletal muscle relaxants for acute and chronic low back pain 1.
• Over-the-counter pain relievers like ibuprofen (400-600mg every 6 hours) or naproxen (220-500mg twice daily) can decrease inflammation and pain.
• Physical therapy focusing on gentle stretching, massage, and posture correction is often beneficial for long-term management.
• Heat therapy using warm compresses or heating pads for 15-20 minutes several times daily can relax tight muscles.
• Stress reduction techniques such as deep breathing exercises, meditation, or yoga may help as these spasms can be exacerbated by stress.

Important Considerations

• Maintaining proper posture, especially when sitting for long periods, and taking regular movement breaks can prevent worsening of symptoms.
• If symptoms persist beyond 1-2 weeks despite these measures, it's essential to consult a healthcare provider as cervical spasms may sometimes indicate underlying conditions requiring specific treatment.
• The American Society of Clinical Oncology clinical practice guideline endorsement of the American Cancer Society guideline recommends referring patients to a rehabilitation specialist for comprehensive neuromusculoskeletal management if cervical dystonia or neuropathy is found 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 The FDA drug label does not answer the question.

From the Research

Treatment Options for Cervical Spasms

• Ibuprofen and cyclobenzaprine are two common treatments for muscle spasms, including those in the cervix 2, 3, 4, 5, 6
• A study comparing ibuprofen, cyclobenzaprine, or both in patients with acute cervical strain found no significant differences between the groups in terms of pain relief or time to resumption of normal activities 4
• Another study found that cyclobenzaprine extended release (CER) 15- and 30-mg capsules were effective in treating muscle spasm associated with painful musculoskeletal conditions, including cervical strain 5
• Ibuprofen has anti-inflammatory and analgesic properties, and its use has been shown to reduce opioid requirements in postoperative pain management 6
• The use of ibuprofen 800 mg IV q6h was associated with significant reductions in morphine use and pain at rest and with movement compared with placebo in patients undergoing postoperative pain management 6

Safety and Efficacy

• All three treatments (ibuprofen, cyclobenzaprine, and combination therapy) were well tolerated, with no significant differences between treatments regarding the number of adverse events (AEs) reported or number of patients reporting AEs 2
• The most common AEs in all groups were fatigue, somnolence, dizziness, sedation, and nausea 2
• Ibuprofen has a good safety profile, especially at low doses, with a low risk of serious gastrointestinal events and little prospect of developing renal and associated cardiovascular events 3
• Cyclobenzaprine extended release (CER) was generally safe and well tolerated, with low rates of somnolence 5