Introduction

This information is for people who have multiple sclerosis. It tells you about using a baclofen pump to help muscle spasms in multiple sclerosis. It is based on the best and most up-to-date research.

Does it work?

We're not sure. If baclofen tablets haven't improved your muscle spasms, a device that pumps baclofen directly to the nerves of your spinal cord might help. (For more on baclofen tablets, see Medicines that relax your muscles to help muscle spasms.) But more research is needed on this treatment to say how well it works.

What is it?

A baclofen pump is one of the treatments that specialists consider giving to people with MS if other medicines for muscle spasms haven't helped.^[99]

Baclofen is a drug that relaxes your muscles. The brand name of the kind of baclofen used in pumps is Lioresal Intrathecal.

A surgeon will put a small pump in your back, under your skin. Each day, it will pump some baclofen right into the space around your spinal cord.

You'll need to have more baclofen put into your pump every 10 to 12 weeks. But this can be done through your skin, so you won't have to have the pump taken out.^[2]

How can it help?

If you get a pump with baclofen, it might help to reduce your muscle stiffness and cut the number of spasms you have, within a few days.^[2] But more research is needed to know for sure.

How does it work?

Baclofen relaxes your muscles and stops them getting stiff and tight and going into spasm. You can take baclofen as tablets (brand name Lioresal). But if your spasms are very bad, you may not be able to take enough of the tablets to help you. Also, taking too many tablets can make you sleepy.

Pumping the drug directly to the nerves of your spinal cord, where it's needed most, may work better than taking lots of tablets.

Can it be harmful?

Yes. There's a risk that your pump could come loose. It could also stop working or cause you some pain.^[2] Baclofen treatment shouldn't be stopped suddenly. You should stop taking it gradually over one to two weeks.^[100]

How good is the research on a baclofen pump?

There haven't been many studies on baclofen pumps for treating multiple sclerosis (MS), but some people with very bad muscle spasms find them helpful.

We found one small study (a randomised controlled trial) that compared a baclofen pump with a pump containing a liquid without the medicine.^[99]

The study included 19 people who had severe muscle spasms from MS or from a head injury. Baclofen tablets hadn't helped them. Researchers found that muscle stiffness and spasms became milder in people who had baclofen pumped into their spinal cord. The effects of the treatment lasted as long as the treatment was given.

But this study is too small to rely on, and not everyone in the study had MS. This makes it hard to say how relevant the results are.

Glossary

randomised controlled trials

Randomised controlled trials are medical studies designed to test whether a treatment works. Patients are split into groups. One group is given the treatment being tested (for example, an antidepressant drug) while another group (called the comparison or control group) is given an alternative treatment. This could be a different type of drug or a dummy treatment (a placebo). Researchers then compare the effects of the different treatments.

For more terms related to Multiple sclerosis

Citations