Introduction

This information is for people who have multiple sclerosis. It tells you about medicines that relax your muscles to help muscle spasms in multiple sclerosis. It is based on the best and most up-to-date research.

Do they work?

We're not sure. Even though these medicines are widely used, the research isn't good enough to say for certain whether they work to ease muscle spasms caused by MS.

What are they?

Doctors use several drugs to treat muscle spasms. We've listed below the drugs that have been studied in MS (and their brand names):

• tizanidine (Zanaflex)

• baclofen (Lioresal)

• dantrolene (Dantrium)

• cannabis.

Tizanidine, baclofen, and dantrolene are tablets that you swallow. They're designed to relax your muscles and reduce the muscle spasms that you might get.

The studies looking at cannabis for muscle spasms looked at tablets or sprays containing extracts of cannabis. Cannabis tablets aren't usually available in the UK, but there is a cannabis spray, called Sativex. It's illegal to possess most other kinds of cannabis in the UK.

British doctors are advised to use baclofen (brand name Lioresal) or another drug called gabapentin (brand name Neurontin) as the first choice of medicines to treat muscle spasms from MS.^[2] (To learn more about gabapentin, see Gabapentin to help muscle spasms.)

Your doctor will prescribe dantrolene and tizanidine only if these other treatments haven't helped you.

How can they help?

We don't know for certain whether medicines to relax your muscles can help. This is what the research says:

• Baclofen tablets may not work better than dummy (placebo) tablets to reduce muscle tightness caused by MS.^[106]

• Tizanidine tablets may work better than placebo tablets to reduce muscle tightness, but we can't be sure because of problems with the research.^[106]

• Studies comparing baclofen tablets to tizanidine tablets found they had about the same effect on muscle tightness.^[106]

• There are no good studies looking at dantrolene tablets for people with MS.

It's frustrating when studies don't give us clear results. However, just because the research isn't good, doesn't mean these medicines won't work for you. Individual patients with MS may well find these drugs helpful. Talk to your doctor about which drugs he or she thinks are most likely to work for you.

There have also been some studies looking at cannabis.

• Two studies found that cannabis tablets didn't work any better than a dummy treatment (a placebo).^[83][84] But there's not enough research to know for certain whether these tablets work or not.

• Several studies have looked at Sativex, the cannabis spray. The research isn't clear, but it hints that the spray could help with muscle spasms.^[81] However, this treatment might not help everyone, and the benefits may be small. For example, one study found that people rated their muscle spasms as improving by just 0.5 on a scale of 0 to 10.^[82]

To read more about this treatment, see our information on cannabis.