title: Update on tizanidine for muscle spasticity and emerging indications.
abstract: BACKGROUND
  Tizanidine hydrochloride, an alpha(2)-adrenergic receptor agonist, is a widely used medication for the treatment of muscle spasticity. Clinical studies have supported its use in the management of spasticity caused by multiple sclerosis (MS), acquired brain injury or spinal cord injury. It has also been shown to be clinically effective in the management of pain syndromes, such as: myofascial pain, lower back pain and trigeminal neuralgia. This review summarizes the recent findings on the clinical application of tizanidine.
  
  
  OBJECTIVE
  Our objective was to review and summarize the medical literature regarding the evidence for the usefulness of tizanidine in the management of spasticity and in pain syndromes such as myofascial pain.
  
  
  METHODS
  We reviewed the current medical and pharmacology literature through various internet literature searches. This information was then synthesized and presented in paragraph and table form.
  
  
  CONCLUSIONS
  Tizanidine hydrochloride is a very useful medication in patients suffering from spasticity caused by MS, acquired brain injury or spinal cord injury. It can also be helpful in patients suffering from chronic neck and/or lower back pain who have a myofascial component to their pain. Doses should be started at low dose and gradually titrated to effect.
authors.affiliation: Clinical Professor, Physical Medicine and Rehabilitation, Director Overlook Pain Center, Associates in Rehabilitation Medicine, 11 Overlook Road, MAC II, Suite B110, Summit, NJ 07091, USA. gmalangamd@hotmail.com
authors.forename: Gerard
authors.initials: G
authors.lastname: Malanga
authors.forename: Raymond D
authors.initials: RD
authors.lastname: Reiter
authors.forename: Edward
authors.initials: E
authors.lastname: Garay
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists; D003000:Clonidine / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D006801:Humans; D017116:Low Back Pain / Q000150:complications / Q000188:drug therapy; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy; D009120:Muscle Cramp / Q000150:complications / Q000188:drug therapy; D009125:Muscle Relaxants, Central / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D019547:Neck Pain / Q000150:complications / Q000188:drug therapy; D013119:Spinal Cord Injuries / Q000150:complications / Q000188:drug therapy
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D009125:Muscle Relaxants, Central; C023754:tizanidine; D003000:Clonidine