Muscle Spasms (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is a muscle spasm?
- What causes a muscle spasm?
- What are the symptoms and signs of muscle spasms?
- How are muscle spasms diagnosed?
- How are muscle spasms treated?
- Muscle Spasms At A Glance
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 skeletal muscle go into spasm, 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]), 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.
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.
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