Spasticity comes as a result of the dysfunction of an upper motor neuron in controlling impulses and neurochemistry. This symptom is not necessarily negative, as it can be helpful in transferring techniques and may be present without any significant weakness. 

When spasticity is causing discomfort, aggressive treatment is both appropriate and necessary. In spasticity management, removal of the noxious stimuli comes first. Following the removal of the noxious stimuli is exercise. Medication comes next.

One of the first utilized medication is baclofen (Lioresal). This is highly effective at both low and high doses, the exact dose being determined by the patient’s response.  Side effects may include weakness, sedation and cognitive problems.

When baclofen doesn’t work on it’s own, tizanidine ( Zanaflex) can be added for in the mix for its synergistic potential. Both these medicines can be addictive.

Also common in MS are spasms which occur usually during the night or just before sleep. Both baclofen and tizandine are helpful for spasm, but clonazapam ( Klonopin) and diazepam ( Valium) are also appropriate, the latter having a strong antispasticity and sedative potential. Other anti-convulsant medication that can help in spasm management are gabapentin (Neurontin) and topiamate( Topomax).

There is a strong controversy around the use of canniboids in the treatment of spasticity because of the legal issues surrounding canniboid’s (compounds present in Cannabis) use and trial. There are clinicians that believe that the relaxing qualities of canniboid administration will help relieve spasticity; however, the damage to the lungs and the addictive potential point to a cautious approach when it comes to the use of canniboids.

Very helpful in managing intractable spasticity not managed by other approaches proved to be the baclofen pump. The programmable pump allowed for relief of severe spasticity with minimal side effects. The downside of this device is the fact that it involves a surgical procedure and it requires an experienced physician to implant it and control the dosage of the medication.