What treatment options are available for muscle cramps?

Muscle cramps can be a distressing symptom of ALS. They result from a disrupted connection between motor neurons and the muscles. This unstable connection between the nerves and the muscles can lead to uncontrolled electrical discharges in the muscle tissue and involuntary muscle activity, which manifests as a painful “muscle cramp (crampus).”

The pain associated with muscle cramps can be distressing and may require treatment. Muscle cramps can occur spontaneously or in connection with certain movements. Treatment is indicated based on the severity or frequency of the painful muscle cramps. Pharmacological treatment of muscle cramps can be challenging. The most common medication is quinine (Limptar N), which is taken once a day in tablet form. If quinine is not sufficiently effective, other medications may be considered that are formally approved for the treatment of other conditions and symptoms but can also have a positive effect on muscle cramps (e.g., carbamazepine, gabapentin, baclofen, mexiletine). In some cases, treatment with cannabis-based medications (e.g., tetrahydrocannabinol combined with cannabidiol, THC:CBD) may also be helpful. THC:CBD is known to reduce muscle spasms. Medications containing cannabis are appropriate when other treatment methods have been unsuccessful.

In this case, an application for approval of this therapy must be submitted to the health insurance provider. With regard to the selection of the THC preparation, the dosage, and the criteria for use, supervision by a physician with experience in treating patients with medical cannabis is required.