From the Guidelines
Treatment for Involuntary Muscle Spasms
Involuntary muscle spasms can be effectively treated with muscle relaxants such as baclofen (10-20 mg orally, 3-4 times daily) or tizanidine (2-4 mg orally, 3-4 times daily) to alleviate symptoms 1. In some cases, benzodiazepines like clonazepam (0.5-2 mg orally, 2-3 times daily) may be prescribed for short-term use.
Botulinum Toxin Injections
Botulinum toxin injections (50-200 units, administered every 3-4 months) can be effective in treating localized muscle spasms, particularly in cases of focal dystonia or blepharospasm 1. These injections are recommended to reduce spasticity, improve passive or active range of motion, and improve dressing, hygiene, and limb positioning 1.
Other Treatment Options
Other treatment options include:
- Physical modalities such as NMES or vibration applied to spastic muscles may be reasonable to improve spasticity temporarily as an adjunct to rehabilitation therapy 1.
- Intrathecal baclofen therapy may be useful for severe spastic hypertonia that does not respond to other interventions 1.
- Postural training and task-oriented therapy may be considered for rehabilitation of ataxia 1.
Important Considerations
It is essential to note that the use of splints and taping are not recommended for prevention of wrist and finger spasticity after stroke 1. Additionally, oral antispasticity agents can be useful for generalized spastic dystonia but may result in dose-limiting sedation or other side effects 1.
From the FDA Drug Label
Baclofen USP, is a muscle relaxant and antispastic, available as 10 mg and 20 mg tablets for oral administration. Tizanidine’s capacity to reduce increased muscle tone associated with spasticity was demonstrated in two adequate and well controlled studies in patients with multiple sclerosis or spinal cord injury.
Involuntary muscle spasms can be treated with:
- Baclofen: a muscle relaxant and antispastic
- Tizanidine: demonstrated capacity to reduce increased muscle tone associated with spasticity 2 3
From the Research
Treatments for Involuntary Muscle Spasms
- Botulinum toxin injection is a treatment for involuntary muscle spasms, with studies showing significant improvement in symptoms 4, 5
- Intrathecal baclofen infusion is another treatment option, which has been shown to be effective in reducing severe spasticity in patients who are unresponsive or cannot tolerate oral baclofen 6, 7
- Transdermal delivery of tizanidine invasomes using a derma roller has also been investigated as a potential treatment for skeletal muscle spasms, with promising results 8
- Combined treatment of intrathecal baclofen infusion and botulinum toxin has been shown to be effective in managing spasticity in patients with cerebral palsy 7
Efficacy of Treatments
- Botulinum toxin injection has been shown to have a response rate of 90-95% in treating craniocervical muscle spasms 5
- Intrathecal baclofen infusion has been shown to be effective in reducing severe spasticity, with level 2 evidence supporting its short-term effectiveness and level 3 evidence supporting its long-term effectiveness 6
- Transdermal delivery of tizanidine invasomes has been shown to achieve maximum drug plasma concentrations within 3 hours of gel application and maintain them for 24 hours 8
- Combined treatment of intrathecal baclofen infusion and botulinum toxin has been shown to improve spasticity, pain, quality of life, and self-care in patients with cerebral palsy 7
Safety and Side Effects
- Botulinum toxin injection has been associated with side effects such as ptosis, dysphagia, and facial numbness 4, 5
- Intrathecal baclofen infusion has been associated with side effects such as sedation, excessive weakness, and dizziness 6
- Transdermal delivery of tizanidine invasomes has been shown to be safe and well-tolerated 8
- Combined treatment of intrathecal baclofen infusion and botulinum toxin has been shown to be safe and effective, with no side effects reported 7