Cannabis & Muscle Spasms
Providing relief for those in need of a solution
A muscle spasm is an involuntary contraction of a muscle that can cause pain and limit motion and activities. Muscle spasms may be due to injury or illness and may affect only one muscle, groups of muscles, or muscles throughout the body. More than 80% of individuals who have multiple sclerosis (MS) suffer from muscle spasms and associated muscle stiffness, reduced mobility, and pain.
Medical Cannabis: A New Therapeutic Option for Patients in Florida
Muscle spasms are often not treated adequately. Individuals with the following medical conditions may experience severe and persistent muscle spasms and may benefit from a trial of medical cannabis:
Multiple Sclerosis (MS)
Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s disease)
Parkinson’s Disease (PD)
Spinal cord diseases or spinal cord injury with intractable spasticity
The U.S. Food and Drug Administration has not approved Cannabis or cannabinoids for use in treating muscle spasms. However, the state of Florida allows patients suffering from severe and persistent muscle spasms access to medical cannabis for symptom relief.
Please follow the links below to quickly scroll to a section of interest:
How Can Medical Cannabis Help With Muscle Spasms?
Medical cannabis has shown promise in relieving muscle spasms and associated pain. While their mechanism of action is still being studied, active cannabinoids such as cannabidiol (CBD) and tetrahydrocannabinol (THC) have shown beneficial effects on a wide range of neurological disorders and their symptoms, including muscle spasms. Recent clinical studies of medical cannabis extracts have supported numerous patient reports that cannabis helps control muscle spasms and pain.
Studies of patients with multiple sclerosis have provided much of the evidence supporting the use of medical cannabis in the relief of muscle spasms. In several large, well-designed studies, the majority of patients who were treated with medical cannabis experienced reductions in the number and severity of muscle spasms, relief of pain, and improved mobility. Overall, many patients with multiple sclerosis in these studies felt that medical cannabis therapies were helpful in managing their condition. Limited evidence suggests that cannabinoids might protect the nervous system, but their effects on progression of neurological diseases, such as multiple sclerosis, have not been proven in human studies. For now, medical cannabis may provide a solution for bothersome symptoms such as muscle spasms and pain.
The National Multiple Sclerosis Society Supports Access to Medical Cannabis
Based on the evidence available today, the National Multiple Sclerosis Society has taken the following position on medical cannabis:
“The Society supports the rights of people with MS to work with their MS health care providers to access marijuana for medical purposes in accordance with legal regulations in those states where such use has been approved. In addition, the Society supports advancing research to better understand the benefits and potential risks of marijuana and its derivatives as a treatment for MS.”
Additional Support for Medical Cannabis from the National MS Society:
- “The National MS Society supports the ability of people living with MS to make an informed choice about their treatments, including the use of medical marijuana, with their MS health care providers.
- Recognizing that additional research is still needed, we are evaluating ways we can remove the barriers to allowing research on medical marijuana at the federal level, which is complex due to government restrictions.
- We advocate in support of legalizing medical cannabis at the state level.”
Ask The Experts
Following a review of the available information, the American Academy of Neurology (AAN) concluded that oral cannabis extract is effective for reducing spasticity, central pain, and painful spasms, including spasticity-related pain. In 2014, the American Academy of Neurology (AAN) published an evaluation of selected complementary and alternative treatments, including medical cannabis, in a document entitled “Summary of evidence-based guideline: Complementary and alternative medicine in multiple sclerosis.” This AAN guideline was developed by a group of medical experts in neurology based on their evaluation of the published research studies of medical cannabis. These experts made the following conclusions about medical cannabis:
Oral cannabis extract is probably effective in reducing patient-reported symptoms of spasticity and pain, but not MS-related tremor or spasticity measurable by tests administered by the physician.
An oral spray containing a Cannabis plant extract with an equal amount of CBD and THC that is approved in other countries outside of the United States is probably effective for improving patient-reported symptoms of spasticity, pain and urinary frequency, but not bladder incontinence, MS-related tremor or spasticity measurable by tests administered by the physician.
There is not enough evidence to assess the safety or efficacy of smoked cannabis for treating MS symptoms. Some evidence suggests an adverse impact of smoked cannabis on balance, posture, and cognitive performance.
The most commonly reported side effects of cannabis-derived products were dizziness, drowsiness, difficulty concentrating, and memory disturbance.
Summary of evidence, by product type:
- Oral Cannabis Extract
- Demonstrated strong evidence in patient-reported symptoms of spasticity and pain (excluding central neuropathic pain), muscle stiffness, and sleep.
- Tetrahydrocannabinol (THC)
- Demonstrated moderate evidence in patient-reported symptoms of spasticity and pain (excluding central neuropathic pain).
THC: CBD oromucosal cannabinoid spray
- Demonstrated moderate evidence in Patient-reported symptoms of spasticity, pain (excluding central neuropathic pain), and urinary frequency.
The American Academy of Neurology (AAN) provides a fact sheet for patients summarizing the current research on medical cannabis for treating certain neurological disorders, including those that cause muscle spasms and related symptoms. The AAN concluded that there is strong evidence that oral cannabis extract products, including those containing only cannabidiol (CBD), can help reduce spasticity symptoms as assessed by patients in the short term. Get the facts here…
Spotlight on Research
American Academy of Neurology - Systematic Review: Efficacy and Safety of Medical Marijuana in Selected Neurologic Disorders:
- This review article summarizes the available evidence of medical cannabis in the treatment of the symptoms of multiple sclerosis, epilepsy, and movement disorders as reviewed by a group of experts from the American Academy of Neurology. They concluded that oral cannabis extract is effective for reducing spasticity, central pain, and painful spasms, including spasticity-related pain.
- See Link to right
Cannabinoids in the Management of Spasticity Associated with Multiple Sclerosis:
- This review article summarizes the current understanding of cannabinoids in the nervous system, as well as the published animal studies and clinical studies of cannabinoid therapies in the management of muscle spasms associated with multiple sclerosis.
- See Link to right
June 16, 2016
AAN: Efficacy and Safety of Medical Marijuana in Selected Neurologic Disorders
American Academy of Neurology: "We performed a systematic review of medical marijuana (1948–November 2013) to address treatment of symptoms of multi…
July 7, 2016
Cannabinoids in the Management of Spasticity Associated with Multiple Sclerosis
Neuropsychiatric Disease and Treatment: This review article summarizes the current understanding of cannabinoids in the nervous system, as well as th…
Selected Clinical Studies
We’ve picked out a few key studies that demonstrate the potential of medical cannabis to relieve muscle spasms…
National Institute of Health - Multiple Sclerosis and Extract of Cannabis: Results of the MUSEC Trial:
- MS and Extract of Cannabis (MUSEC): Participants with stable MS were randomly assigned to receive oral cannabis extract (144 people) or placebo (135 people), and reported their perceptions of changes in muscle stiffness before and after 12 weeks of treatment. Muscle stiffness improved by almost twofold in the group taking cannabis compared to placebo, and improvements were also noted in body pain, spasms and sleep quality. The most frequent adverse events were urinary tract infections, dizziness, dry mouth and headache; no new safety concerns were observed (NIH, 2012)
- See link to left
Cannabinoids in Multiple Sclerosis (CAMS) Study
- First large study and one of the longer term studies designed to assess the beneficial effects of cannabinoids on MS symptoms
- Effectiveness and long-term safety of cannabinoids in MS: 630 subjects with stable MS and muscle spasticity, from 33 UK centers, were randomly assigned to receive oral THC (tetrohydrocannabinol, an active ingredient in marijuana), cannabis extract or placebo over 15 weeks. Oral derivatives of marijuana did not provide objective improvement in spasticity (as measured by a standardized assessment tool). However, significantly more participants in the treatment group reported subjective improvements in spasticity and pain (but not in tremor or bladder symptoms). In other words, participants reported feeling improvements that could not be confirmed by the study physicians.
- Source: Zajicek et al. Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up. J Neurol Neurosurg Psychiatry 2005;76:1664-1669 doi:10.1136/jnnp.2005.070136
- See link to left
Efficacy and Safety of Cannabinoid Oromucosal Spray for Multiple Sclerosis Spasticity:
This study describes the efficacy and safety of a cannabinoid oromucosal spray containing equal amounts of cannabidiol (CBD) and tetrahydrocannabinol (THC) for MS-related spasticity. This publication reports outcomes for 1,615 patients with multiple sclerosis who were included in a patient registry in Italy and treated with the cannabinoid oromucosal spray. This spray is approved in many countries outside of the US for MS-related spasticity.
Click the link here or to the left
July 7, 2016
JNNP: Multiple Sclerosis and Extract of Cannabis: Results of the MUSEC Trial
Journal of Neurology, Neurosurgery, and Psychiatry: MS and Extract of Cannabis (MUSEC): Participants with stable MS were randomly assigned to receive…
July 7, 2016
JNNP: Cannabinoids in Multiple Sclerosis (CAMS) Study
Journal of Neurology, Neurosurgery, & Psychiatry: Effectiveness and long-term safety of cannabinoids in MS: 630 subjects with stable MS and muscl…
July 7, 2016
JNNP: Efficacy and Safety of Cannabinoid Oromucosal Spray for Multiple Sclerosis Spasticity
Journal of Neurology, Neurosurgery, & Psychiatry:This study describes the efficacy and safety of a cannabinoid oromucosal spray containing equal a…
Evidence for Oral CBD Efficacy
For a summary of the available data on this cannabinoid oromucosal spray for MS-related spasticity, see the review article at the link below. This review article reports the results of studies involving thousands of patients with MS-related spasticity that provide evidence of the efficacy and safety of this cannabis-derived spray in moderate to severe spasticity associated with multiple sclerosis that cannot be fully relieved with available therapies. Of note, initial responders can be identified in a 4-week trial period, and this therapy must be titrated to the right dose for the patient
- Evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management of patients with spasticity due to multiple sclerosis: