Spasticity and Muscle Control: Cannabinoids for MS and Similar Conditions

Living with a condition like multiple sclerosis often means navigating a changing landscape of physical sensations. For many, muscle stiffness, or spasticity, becomes a constant companion, affecting the simple rhythm of moving through the day. While traditional treatments help many, they can sometimes bring challenges of their own, leading people to explore supportive options like medicinal cannabis.

In New Zealand, multiple sclerosis was one of the first conditions for which cannabinoid therapy was formally recognised as a potential aid for symptom management. This guide explores how cannabinoids may support muscle control and the ways you can coordinate this path with your existing healthcare team.

Understanding spasticity and the body’s natural balance

To understand how cannabinoids work, it helps to look at the endocannabinoid system, a biological network that exists in all of us. This system acts as a gentle regulator, helping to maintain balance across our nerves and muscles.

Spasticity occurs when the electrical signals between your brain and muscles become disrupted. This disruption often leads to an increase in muscle tone, which feels like stiffness or involuntary spasms. Research suggests that cannabinoids may influence this process by interacting with specific receptors in the central nervous system. These receptors sit on nerve endings and help regulate how much signalling chemical is released, helping to dampen the overactivity that causes muscles to tighten and stay stiff.

The roles of THC and CBD in muscle control

Many people find that a balanced approach is most effective when managing muscle tone. Medicinal cannabis contains various compounds with delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD)  being the most studied.

THC is often noted for its direct relaxant effect on the muscles. By mimicking the body’s natural signalling molecules, it can help reduce the hyperexcitability of the nerves that cause spasms. Meanwhile, CBD is often valued for its anti-inflammatory properties and its ability to help people feel more settled. It may also help manage the discomfort that often goes hand in hand with muscle stiffness.

In New Zealand, some patients are prescribed a 1:1 ratio of these compounds. This balanced approach aims to provide relief while keeping the overall experience steady and manageable.

What the research tells us

When we look at the clinical evidence for cannabis and multiple sclerosis, there is an interesting distinction between physical tests and the lived experience of patients.

Standard clinical tests, like the Ashworth scale, measure muscle resistance during a physical examination. While these tests sometimes show modest changes, the results reported by patients themselves often tell a much more encouraging story. Many people have reported meaningful improvements in their muscle stiffness, the frequency of their spasms, and their overall ease of movement.

This suggests that even if the physical stiffness remains measurable, the relief from the discomfort and the improved ability to relax can significantly enhance a person’s quality of life.

A shared journey of care

Choosing to explore medicinal cannabis is a personal decision, but it is one that works best when shared with your regular medical team. Coordination between your GP, any specialists involved in your care and a specialised clinic ensures that your care remains consistent and safe.

Specialised clinics in New Zealand focus on a patient-centred approach. With your consent, these clinics share your treatment plan with your regular doctor, ensuring everyone is on the same page regarding your health goals and any other medications you may be taking.

You can learn more about how this coordination works or start a conversation with a clinician here.

Practical steps for the day-to-day

If you and your doctor decide to trial medicinal cannabis, the focus is usually on a slow, steady progression. This allows your body to find its own rhythm with the treatment.

• The Low and Slow Approach: Most people start with a very small dose, often taken in the evening. This allows you to monitor your response in a relaxed setting without any pressure to perform daily tasks.
• Monitoring Your Strength: Spasticity can sometimes provide a level of support that helps with standing or walking. As muscle tone reduces, it is important to monitor your balance and work closely with a physiotherapist to ensure your safety and stability.
• Pacing and Rest: Cannabinoid therapy is often most helpful when viewed as part of a wider wellness plan. Prioritising rest and gentle movement can help you make the most of the relief you may experience.

Finding the right balance takes time and patience. If you would like to explore whether this path is suitable for your needs, you can book a consultation.

Every person’s journey with a neurological condition is unique. While the goals may change from day to day, the focus remains on finding a sense of ease and maintaining a quality of life that feels sustainable for you.

References

1. An overview of medicinal cannabis for health practitioners – bpacnz. https://bpac.org.nz/2022/medicinal-cannabis.aspx
2. Navarro, C. E. (2022). Sistema endocannabinoide y el rol del cannabis medicinal en el tratamiento de la espasticidad: una revisión narrativa. IATREIA. https://doi.org/10.17533/udea.iatreia.207
3. Zajicek, J., Fox, P., Sanders, H., Wright, D., Vickery, J., Nunn, A., & Thompson, A. (2003). Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial. The Lancet, 362(9395), 1517–1526. https://doi.org/10.1016/s0140-6736(03)14738-1
4. Medsafe. (2023). Sativex Oromucosal Spray Data Sheet. https://www.medsafe.govt.nz/profs/datasheet/s/sativexspray.pdf
5. Ministry of Health NZ. (2020). Medicinal Cannabis Scheme Information for Health Professionals. https://www.health.govt.nz/our-work/regulation-health-and-disability-system/medicinal-cannabis-agency/medicinal-cannabis-agency-information-health-professionals
6. Cannabis Clinic. (2024). How to Prepare for Your Medicinal Cannabis Appointment. https://cannabisclinic.co.nz/how-to-prepare-for-your-medicinal-cannabis-appointment/
7. Filippini, G., Minozzi, S., Borrelli, F., Cinquini, M., & Dwan, K. (2022). Cannabis and cannabinoids for symptomatic treatment for people with multiple sclerosis. Cochrane Database of Systematic Reviews, 5, CD013444. https://doi.org/10.1002/14651858.cd013444.pub2
8. Ora Pharm. (2021). Cannabis and Multiple Sclerosis: Can medicinal cannabis help with MS symptoms? https://orapharm.co.nz/cannabis-and-multiple-sclerosis-can-medicinal-cannabis-help-with-ms-symptoms/