What Causes Muscle Spasms? Can Medical Cannabis Help?

Muscle spasms or involuntary muscle contractions can be triggered by a variety of health conditions. These spasms range from mild twitches to painful cramps, impacting mobility and quality of life for millions worldwide.

Dystonia affects an estimated 300,000 patients living in North America. Worldwide, the World Health Organization (WHO) estimates there may be as many as 12 million individuals living with a painful condition called muscle spasticity. Over 80% of patients diagnosed with cerebral palsy and multiple sclerosis (MS) experience the debilitating effects of spasticity and permanent muscle weakness, which has no cure.

Patients who are living with chronic muscle spasms often find that the symptom is treatment-resistant; they have difficulty finding prescription medications or over-the-counter remedies that can help. Treating muscle spasms can be complex.

As traditional treatments sometimes fall short, there’s growing interest in exploring alternative therapies, such as medical cannabis, to help moderate frequent muscle spasms and provide pain relief.

The First FDA-Approved Cannabis Prescription Medication

Epidiolex made history as the first FDA-approved prescription medication derived from cannabis. Specifically developed to treat Dravet Syndrome, a severe form of epilepsy affecting children, Epidiolex contains purified cannabidiol (CBD), a non-psychoactive component of cannabis. Its approval marked a significant milestone in recognizing cannabis-based treatments in mainstream medicine, particularly for conditions involving severe muscle spasms and seizures.

Dravet Syndrome, characterized by frequent and prolonged seizures, often leads to developmental delays and other neurological impairments. Epidiolex’s approval provided hope to families grappling with the challenges of managing these debilitating symptoms, offering a potential alternative when conventional treatments prove insufficient to address muscle spasms caused by chronic diseases.

Cannabinoids Proven Effective For Relief Of Moderate to Severe Muscle Spasms

The effectiveness of Epidiolex in managing Dravet Syndrome underscores cannabis’s therapeutic potential, particularly in mitigating involuntary muscle spasms and seizures. Cannabidiol’s mechanism of action involves interacting with the body’s endocannabinoid system, which plays a crucial role in regulating various physiological functions, including muscle control and neurological activities.

Epidiolex helps reduce the frequency and severity of seizures, thereby improving the quality of life for patients. This breakthrough not only validated the therapeutic benefits of cannabis in a regulated medical context but also paved the way for further research into its broader applications in treating neurological disorders characterized by muscle spasms and seizures.

Understanding Hypotonia and Muscle Spasticity

Hypotonia and muscle spasticity are conditions affecting muscle tone and control, often seen in patients who have been diagnosed with neurological disorders. The sensation for patients is much more painful than simple periodic muscle cramps. Hypotonia, characterized by reduced muscle tone, results in floppy or weak muscles, making movements less controlled and causing difficulties in activities such as sitting, walking, and maintaining posture.

Muscle spasticity, on the other hand, involves excessive muscle stiffness and involuntary contractions, leading to rigid and often painful movements. Both conditions can stem from various causes, including cerebral palsy, multiple sclerosis, spinal cord injuries, and genetic disorders.

The underlying mechanisms of these conditions involve disruptions in the communication between the brain, spinal cord, and muscles. In hypotonia, there is often a deficiency in the signals that stimulate muscle contraction, whereas spasticity results from overactive reflexes due to damaged nerve pathways, leading to continuous muscle contraction.

Medical cannabis has shown promise in alleviating symptoms of both hypotonia and spasticity. Cannabinoids, such as CBD and THC, interact with the endocannabinoid system in the body, which plays a role in regulating muscle tone and movement. By modulating this system, cannabis can help reduce muscle stiffness and involuntary spasms, improving mobility and comfort for patients.

What May Be Causing Muscle Spasms?

Chronic muscle spasms can be caused by a variety of health conditions. Patients who experience persistent involuntary muscle contractions may be diagnosed with one of the following health conditions:

1. Multiple Sclerosis (MS)

Multiple Sclerosis (MS) is a neurological condition in which the immune system attacks the protective myelin sheath covering nerve fibers. This disrupts communication between the brain and the body, leading to a range of symptoms, including muscle spasms. Spasms in MS commonly affect the legs and may occur sporadically or persistently.

The frequency and intensity of spasms can vary, often exacerbated by factors like fatigue or stress. Managing MS-related spasms involves a multifaceted approach, including physical therapy and medications.

2. Spinal Cord Injury

Spinal cord injuries (SCIs) can result in muscle spasms due to disrupted signals between the brain and the affected body parts. Depending on the location and severity of the injury, spasms can occur in muscles below the level of injury. These spasms may be triggered by movements or sensory stimuli, contributing to discomfort and mobility challenges.

Spasms following SCI can range from occasional to frequent, affecting daily activities and rehabilitation progress. Treatment often includes medications to relax muscles alongside therapies aimed at improving motor function and independence.

3. Stroke

Stroke, a sudden interruption in blood flow to the brain, can lead to muscle spasms as part of the recovery process. Depending on the location and extent of brain damage, individuals may experience spasms affecting muscles on one side of the body. These spasms often occur during the early stages of stroke recovery, gradually improving as rehabilitation progresses.

Physical therapy and medications are commonly used to manage stroke-related spasms, aiming to restore movement and function.

4. Parkinson’s Disease

Parkinson’s disease, a progressive nervous system disorder, causes tremors, stiffness, and muscle rigidity, often leading to spasms. Muscles in the limbs, face, or neck can experience involuntary contractions or “dystonic storms,” particularly in the advanced stages of the disease.

Patients with Parkinson’s disease experience spasms that may occur unpredictably and impact daily activities and mobility. Treatment focuses on medications to manage motor symptoms, including spasms, alongside therapies to enhance movement and quality of life.

5. Cerebral Palsy

Cerebral Palsy (CP) is a group of disorders affecting movement and muscle tone, often resulting in muscle spasms and stiffness. Spasms in CP typically affect muscles in the limbs, impairing coordination and motor skills. These spasms can be triggered by changes in position or emotional stress, varying in frequency and intensity depending on the individual’s condition.

Management of CP-related spasms involves a combination of therapies such as physical and occupational therapy, medications, and sometimes surgical interventions to alleviate muscle tightness. Patients living with cerebral palsy experience significant chronic pain caused by muscle cramps and continuous contraction of the muscles.

6. Injury Related Muscle Spasms

Injury-related muscle spasms occur when muscles involuntarily contract following trauma, often as a protective response to stabilize the affected area and prevent further damage. Sports injuries like muscle strains, ligament tears, and fractures can lead to chronic spasms due to ongoing inflammation and muscle guarding. For example, a torn hamstring or a sprained ankle often results in muscle spasms as the body attempts to immobilize the injured region to facilitate healing.

Traumatic injuries, such as whiplash from a car accident or a spinal cord injury, can also cause persistent muscle spasms. In whiplash, the sudden jolt to the neck muscles can lead to prolonged spasms, causing pain and restricted movement. Similarly, a spinal cord injury can disrupt nerve signals, leading to uncoordinated muscle contractions and chronic spasms.

These spasms can be debilitating, limiting mobility and causing significant discomfort. Addressing the underlying injury and utilizing treatments such as physical therapy, medication, and, in some cases, medical cannabis can help manage and reduce the severity of these chronic muscle spasms.

How Medical Cannabis Works to Manage Muscle Spasms

Epilepsy was the first qualifying medical condition that made patients eligible for a medical marijuana card. It is well understood that involuntary muscle contractions are not only painful but also debilitating and can impact every aspect of life, from work to leisure and activities of daily living or self-care.

The endocannabinoid system, present throughout the human body, plays a crucial role in regulating various physiological processes, including pain perception and muscle control. Cannabinoids found in cannabis plants, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), interact with cannabinoid receptors in the nervous system and muscles.

Tetrahydrocannabinol (THC) is well-known for its psychoactive effects and may help reduce muscle spasms by modulating nerve signaling and muscle tone. CBD, on the other hand, is non-intoxicating and has shown promise in alleviating muscle stiffness and spasticity through anti-inflammatory and neuroprotective mechanisms.

Clinical studies have explored the efficacy of medical cannabis in managing muscle spasms across different medical conditions. Research indicates that cannabinoids may offer relief for individuals with conditions like MS, SCI, and CP, where conventional treatments may be inadequate or associated with undesirable side effects.

While further research is needed to establish standardized dosing and long-term safety, medical cannabis represents a potential therapeutic option for improving quality of life and symptom management in patients experiencing muscle spasms.

Cannabis Strains Suggested For Chronic Muscle Spasms

There are over seven hundred (700) different strains of cannabis, including hybridized varieties. However, there are five strains that are highly rated by patients who seek relief from muscle spasms.

1. Harlequin

Harlequin is a popular cannabis strain known for its high CBD content and low THC levels, making it a favorite for patients seeking relief without intense psychoactive effects. Harlequin’s high CBD concentration helps reduce muscle spasms by interacting with the endocannabinoid system to promote muscle relaxation and reduce inflammation.

The Harlequin strain also contains significant amounts of the terpene myrcene, which is known for its muscle-relaxing properties. Patients often find that Harlequin’s balanced cannabinoid profile provides effective spasm relief while maintaining mental clarity.

2. ACDC

ACDC is another high-CBD strain renowned for its therapeutic benefits, particularly in alleviating muscle spasms and pain. With a CBD-to-THC ratio of 20:1, ACDC minimizes the psychoactive effects while maximizing the medicinal benefits of cannabidiol.

The ACDC cannabis strain is rich in the terpene caryophyllene, which has anti-inflammatory and analgesic properties, contributing to its effectiveness in managing muscle spasms. ACDC’s calming effects make it an excellent choice for patients looking for relief without the high associated with THC.

3. Cannatonic

Cannatonic is a hybrid strain with a roughly balanced ratio of CBD to THC, often around 1:1, offering both therapeutic and mild psychoactive effects. Its high CBD content makes it particularly effective for muscle spasms, as CBD interacts with cannabinoid receptors in the body to reduce spasticity and pain.

The Cannatonic cannabis strain also contains the terpenes pinene and myrcene, both of which have anti-inflammatory and muscle-relaxant properties. This strain is popular among patients seeking a balanced approach to managing muscle spasms and associated discomfort.

4. Charlotte’s Web

Charlotte’s Web is a renowned high-CBD strain named after a young epilepsy patient (Charlotte Figi) who experienced significant seizure reduction with its use. Her story changed the world and started an educational narrative about the potential benefits of cannabinoids for the treatment of moderate to severe epilepsy.

Its low THC content ensures minimal psychoactive effects, making it suitable for a wide range of patients. The pain-relieving properties patients have experienced using Charlotte’s Web are attributed to the powerful anti-inflammatory properties of cannabidiol (CBD), which can have a positive effect on the human central nervous system.

Charlotte’s Web is rich in CBD and also contains beneficial terpenes like linalool and limonene, which contribute to its calming and anti-inflammatory effects. This strain is particularly effective in reducing muscle spasms and providing overall muscle relaxation, making it a go-to option for many patients.

5. Sour Diesel

Sour Diesel, though typically higher in THC, is favored by some patients for its strong analgesic and muscle-relaxing properties. The strain’s energetic and uplifting effects can help counteract the fatigue and discomfort associated with chronic muscle spasms.

The Sour Diesel strain contains limonene, which has anti-inflammatory and mood-enhancing properties, and caryophyllene, which adds to its muscle-relaxant effects. Patients who tolerate THC well often find Sour Diesel effective for managing severe muscle spasms and pain while maintaining an active lifestyle.

Due to the fact that these five medical marijuana strains are recognized for their potential relief from muscle spasms or pain caused by muscle spasticity, many medical cannabis dispensaries carry them. However, if you cannot find specific strains locally, ask your local dispensary for suggestions on similar strains that may offer the same effects and help you find relief.

Medical Cannabis Can Help Patients Living With Moderate to Severe Spasms

Using medical marijuana to ease muscle spasms is not a new concept, but there have been many patient success stories supporting its use. You state’s medical marijuana program may accept a diagnosis of epilepsy, spasticity, or other common muscle spasms and disorders.

Muscle spasms are a common symptom across various health conditions, impacting mobility and daily life for many individuals. Understanding the underlying causes of spasms, such as MS, SCI, stroke, Parkinson’s disease, and cerebral palsy, is crucial for effective management and treatment.

Medical cannabis, with its ability to interact with the body’s endocannabinoid system and potentially alleviate muscle spasms, offers a promising alternative for those seeking relief. As research continues to evolve, integrating cannabis into comprehensive treatment plans under medical supervision may provide new avenues for improving patient outcomes and quality of life.

Dr. Jack Rothman

Dr. Rothman is a diplomate of the American Board of Obstetrics and Gynecology.  He has received multiple special awards and recognitions, including Physician of the Year, from the Pinellas County Medical Association (2014 – 2015) and the President’s Service Award from the Pinellas County Medical Society.

He attended medical school at State University of New York Upstate Medical Center in Syracuse, New York, where he also completed his Obstetrics and Gynecology residency. In addition to practicing medicine, Dr. Rothman’s professional career includes being an Assistant Professor at the University of South Florida and Clinical Instructor at the University of Tampa’s College of Nursing.

Dr. Rothman received his Florida Medical Marijuana Physicians Certification in 2016 and was one of the first recommending physicians through DocMJ in the state and is loved by many of those early patients today.