Muscle Spasms (cont.)

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How are muscle spasms treated?

Prevention is the key to most skeletal muscle spasm episodes. Since they are often associated with dehydration and electrolyte disturbances, it is important to keep the body well hydrated. If the fluid loss is due to an illness with fever or vomiting and diarrhea, controlling the symptoms will help limit fluid loss and prevent spasms. Similarly, for those who work or exercise in a hot environment, drinking enough fluids to keep hydrated is very important.

Muscles should also be prepared for the activity that they are expected to do. Just as athletes stretch and warm up before the game, nonathletes should warm up before heavy labor, including jobs like raking, mowing, and shoveling snow.

Should a large skeletal muscle go into spasm (often referred to as a charley horse), the initial treatment is to gently stretch the muscle back to length to break the spasm cycle and resolve the acute situation.

Further treatment will depend upon the underlying cause of the muscle spasms. For muscles that have been damaged or strained, medications may be required for short-term pain relief, including anti-inflammatories (ibuprofen [Advil, Motrin]), narcotics, and muscle relaxants.

The treatment of smooth muscle spasm also depends upon the underlying cause. Often, pain control will occur simultaneously with the care provider's efforts to make the diagnosis.

Nocturnal leg cramps are difficult to control and treat. Historically, quinine has been prescribed to help with the muscle spasms, but this drug can have side effects including abnormal bleeding problems. Other medications including B-complex vitamins, gabapentin and diltiazem, may be helpful.

There is no one effective treatment for the dystonias. Medication may used to try to restore balance to the brain's neurotransmitters. The decision as to which medication to use depends upon the patient's presentation. It may take trial and error to find the right medication in the right dose to control symptoms.

  • Anti-Parkinsonism drugs, like trihexyphenidyl HCl (Artane) and benztropine mesylate (Cogentin), decrease acetylcholine levels.
  • Muscle relaxants like diazepam (Valium) and baclofen (Lioresal) affect GABA receptors.
  • Levodopa (Sinemet) and reserpine (Harmonyl) affect dopamine levels.
  • Carbamazepine (Tegretol), a seizure-control drug, may be useful in some patients.
  • Botulinum toxin type A (Botox) may be injected into a specific muscle to paralyze it and relieve the muscle spasm. This was initially used for blepharospasms but is now able to be used where other muscles are involved.

REFERENCE:

Bucholz, R.W., J.D. Heckman, and C.M. Court-Brown. Rockwood and Green's Fracture in Adults. 6th ed. Philadelphia: Lippincott, Williams & Wilkins, 2006.


Medically Reviewed by a Doctor on 7/17/2013

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