Spasticity is a condition where certain muscles are constantly contracted, which makes muscles feel stiff, heavy, and difficult to move. Spasticity occurs when the nerve impulses of the central nervous system (brain or spinal cord) that control muscle movement are interrupted or damaged. Treatment usually starts with a low dose of medication, which is gradually increased based on an individual’s condition and symptoms. Some of the common medications used to treat spasticity include:
1. Sativex
Sativex is made from cannabis and is used to treat painful muscle spasms. This treatment is usually used for a minimum of 4 weeks; if a patient isn’t improving after that point, their healthcare provider will try a different medication.
2. Botulinum toxin (Botox)
Botox is not just for facelifts. This drug, derived from bacterium clostridium botulinum, is used by doctors in small doses to treat spasticity. Botox is injected into the affected area, working to relax the muscles that are overly tight.
3. Intrathecal baclofen
Baclofen is a muscle relaxant commonly used to treat spasticity. This treatment includes a surgery to place a small pump in the abdomen, which then automatically delivers specific doses of the medication.
4. Phenol
Phenol is an organic compound that can be injected via a lumbar puncture into the space around the spinal cord. Phenol is used only if a person has severe spasticity, and it is particularly effective in reducing spasticity in the legs.
5. Dantrolene
Dantrolene is used to treat muscle tightness and spasms caused by nerve disorders. It works by reducing the amount of calcium that is released into the sarcoplasmic reticulum of muscles. However, while it is helpful in reducing spasticity, dantrolene can also cause liver damage, especially if high doses are taken over an extended period of time. As a result, you may need frequent blood tests to check your liver function while using dantrolene.
6. Diazepam
Diazepam works by calming the brain and nerves and relieving muscle spasms. This medication can be administered intravenously or through an intramuscular injection. It can also be administered orally in the form of tablets.
7. Clonazepam
Clonazepam belongs to a group of medications called central nervous system (CNS) depressants. This medication is occasionally used to manage pain or spasticity when other medicines don’t work. Clonazepam is generally taken before bed in a dose of 0.5 to 1.0 mg.
8. Pregabalin
Pregabalin is an anticonvulsant drug that works by calming overstimulated nerve cells. This is helpful for muscle pain caused by spasticity.
9. Surgery
In rare cases, surgery is performed to reduce spasticity if medications are not sufficient. Orthopedic surgery may involve altering tendon, muscle, and bone to restore movement and flexibility. A surgery called selective dorsal root rhizotomy (SDR) is performed in very rare cases. SDR involves trimming some of the sensory nerve fibers to remove abnormal communication between the brain, spinal cord, nerves, and muscles.
Your doctor can provide more detailed information on the severity of your spasticity and the best treatment plan for you. Every patient responds differently to various medications, so your doctor should work with you to find the treatment that is the most helpful.
