Muscle spasms are when a muscle tightens and contracts involuntarily,
causing pain and potentially serious joint mobility issues. Studies have
shown marijuana effectively reduces the frequency and intensity of spasms,
including in patients diagnosed with multiple sclerosis.
Overview of Spasms
Spasms are when your muscles are stiff and experience involuntary
contractions. Spasms, or cramps, are most commonly caused by long periods of
physical labor or dehydration, but they can also be associated with serious
conditions, like multiple sclerosis. Their intensity can range from somewhat
uncomfortable tightness to extremely painful and uncontrollable
contractions. Spasticity can occur throughout all limbs, but is most common
in the legs.
For those with multiple sclerosis, spasms can be stimulated by sudden
movements, temperature changes, humidity and from wearing tight clothing.
Muscle spasms will interfere with regular motor function and can cause
distressing symptoms. If left untreated, spasms can lead to soft tissue
shortening, which in turn can cause frozen or disabling contractures in the
hip, knee, ankle, shoulder and elbow joints.
Spasms are most commonly treated with medications and physical and
Findings: Effects of Cannabis on Spasms
Along with pain, muscle spasm is the most common reason that medical
cannabis is recommended and prescribed by medical professionals (Borgelt,
Franson, Nussbaum & Wang, 2013). Studies have demonstrated that medical
cannabis offers significant improvements in muscle spasticity, both in mice
trials and in human subjects (Borgelt, Franson, Nussbaum & Wang, 2013)
(Baker, et al., 2000.
The two major cannabinoids found in cannabis, tetrahydrocannabinol (THC) and
cannabidiol (CBD), are responsible for cannabis’ effectiveness at muscle
spasm relief. There’s strong evidence that suggests that cannabinoid-induced
reductions in muscle tremors and spasticity are due to the activation of the
cannabinoid receptors, CB1 and CB2, of the endocannabinoid system (Pertwee,
2002). THC and CBD have demonstrated that they both activate the CB1 and CB2
receptors and their actions on the two receptors regulates the excitatory
and inhibitory neurotransmitters necessary to curtail spasms (Syed, McKeage
& Scott, 2014) (Smith, 2002).
For those whose spasms and spasms are related to multiple sclerosis,
cannabis has demonstrated it can offer relief (Thaera, et al., 2009). In
what was the largest multinational clinical trial of its kind, multiple
sclerosis patients suffering from spasms were treated with cannabis
containing THC and CBD. After 12 weeks, the patients experienced
significantly reduced spasticity severity compared with patients receiving
the placebo. While the trial lasted 12 weeks, patients reported significant
improvements in spasticity after just four weeks (Syed, McKeage & Scott,
2014). The same patients also reported significant improvement in
quality-of-life measures over the 16 weeks (Vermersch, 2011). In another
study, approximately two-thirds of patients reported improvements in
spasticity after 50 weeks of treatment with cannabis containing THC and CBD
Cannabis has even shown to be effectively lower the frequency and intensity
of spasms in multiple sclerosis patients whose spasms had been previously
unrelieved by traditional anti-spasticity therapy. After 15 weeks of
treatment, patients saw a significant reduction in spasticity. Improvements
were seen within the first four weeks (Collin, et al., 2010).
States That Have Approved Medical Marijuana for Spasms
Currently, 17 states have approved medical marijuana for the treatment of
spasms. These states include: Arizona, Arkansas, California, Colorado, Delaware, Florida, Hawaii, Louisiana, Maryland, Michigan, Minnesota, Montana, Nevada, New
Hampshire, Oregon, Rhode
Island and Washington.
If muscle spasms are caused by multiple sclerosis, Alaska, Connecticut, Florida, Georgia, Illinois, Louisiana, Maine, Massachusetts, New
York, Ohio, Pennsylvania and Vermont have
approved medical marijuana for treatment purposes.
A number of other states will consider allowing medical marijuana to be used
for the treatment of spasms not related to multiple sclerosis with
recommendation by a physician. These states include: Connecticut (other
medical conditions may be approved by the Department of Consumer Protection)
and Massachusetts (other
conditions as determined in writing by a qualifying patient’s physician).
D.C., any condition can be approved for medical marijuana as long as a
DC-licensed physician recommends the treatment.
Recent Studies on Cannabis’ effect on Spasms
Multiple sclerosis patients achieved a 30% reduction in spasticity
severity after 4 weeks of being treated with cannabis that contained THC
Delta-9-tetrahydrocannabinol-cannabidiol (Sativex): a review of its use
in patients with moderate to severe spasticity due to multiple
Spasms that had previously proven to be untreatable by traditional
efforts were significantly reduced after four weeks of cannabis
A double-blind, randomized, placebo-controlled, parallel-group study of
Sativex, in subjects with symptoms of spasticity due to multiple
Baker, D., Pryce, G., Croxford, J.L., Brown, P., Pertwee, R.G., Huffman,
J.W., and Layward, L. (2000, March 2). Cannabinoids control spasticity and
tremor in a multiple sclerosis model. Nature,
Borgelt, L.M., Franson, K.L., Nussbaum, A.M., and Wang, G.S. (2013,
February). The pharmacologic and clinical effects of medical cannabis. Pharmacotherapy,
Collin, C., Ehler, E., Waberzinek, G., Alsindi, Z., Davies, P., Powell, K.,
Notcutt, W., O’Leary, C., Ratcliffe, S., Novakova, I., Zapletalova, O.,
Pikova, J., and Ambler, Z. (2010, June). A double-blind, randomized,
placebo-controlled, parallel-group study of Sativex, in subjects with
symptoms of spasticity due to multiple sclerosis. Neurological
Fernandez, O. (2014). Advanced in the management of multiple sclerosis
spasticity: recent clinical trials. European
72. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25278117.
Pertwee, R.G. (2002, August). Cannabinoids and multiple sclerosis. Pharmacology
Smith, P.F., (2002, June). Cannabinoids in the treatment of pain and
spasticity in multiple sclerosis. Current
Opinion in Investigational Drugs,
Spasticity. (n.d.). National
Multiple Sclerosis Society.
Retrieved from http://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Spasticity.
Syed, Y.Y., McKeage, K., and Scott, L.J. (2014, April).
Delta-9-tetrahydrocannabinol-cannabidiol (Sativex): a review of its use in
patients with moderate to severe spasticity due to multiple sclerosis. Drugs,
Thaera, G.M., Welik, K.E., Carter, J.L., Demaerschalk, B.M., and Wingerchuk,
D.M. (2009, November). Do cannabinoids reduce multiple sclerosis-related
Vermersch, P. (2011, April). Sativex (tetrahydrocannabinol + cannabidiol),
an endocannabinoid system modulator: basic features and main clinical data. Expert
Review of Neurotherapeutics,
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