Muscle Cramps/Spasticity

Spasticity causes pain, reduced mobility, muscles spasms and contracture.


Stretching, massage, heat, neutral splinting and aids to mobility


Baclofen 5-10mg po t.i.d., titrate very slowly to 80mg p.o. daily in divided doses. Do not stop suddenly – severe withdrawal symptoms. Adjust dose for eGFR <30

Tizanidine 2mg once daily at bedtime and increase as tolerated to 2-8mg t.i.d. and max dose of 24mg p.o. daily. Adjust dose for severe renal impairment. Do not stop suddenly – severe withdrawal

Gabapentin 100-300mg tid. Start low in older adults. Adjust for severe renal dysfunction

Botulinum toxin for local cramp/spasticity/contracture