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eLetters: Does muscle spasm exist and does it cause pain?
In response to: Benztropine for acute muscle spasm in the emergency department
Perry Rush
Email: prush@home.com
Affiliation: Department of Rehabilitation Medicine, University of Toronto
Posted on: February 5, 2001
This paper describes 8 patients with 'acute muscle spasm'. The diagnosis appears to be based on subjective demonstrated range of motion associated with pain symptoms or pain reported when touched. It is not stated how range of motion was measured or how tenderness was measured. There is no proof that pain symptoms or decreased range of motion, are directly the result of an abnormality or 'spasm' of muscles. There is no gold standard for a diagnosis of paralumbar spasm. There is no electrodiagnostic testing or other objective investigation proving that the muscles are abnormal. There is also no medical literature proving that muscle spasm, especially 'paralumbar spasm', can be diagnosed clinically with scientific validity or reliability. 'In spite of overwhelming evidence that skeletal muscle spasm is nonexistent, physicians are continually deluged with seductive ads to prescribe expensive muscle relaxants...' I agree that a randomized, blinded, placebo controlled trial is needed to corroborate the findings in this case series.
1. Johnson EW (editor): The myth of skeletal muscle spasm. Am J Phys Med Rehabil 1989;68:1.
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