Quick answer
Quick answer
Yes, in many places. 32 state programs name severe muscle spasms & spasticity on the official list, and 7 more let the certifying provider decide. Either way, a provider licensed in your state has to evaluate you and agree that cannabis is appropriate.
Understanding severe muscle spasms & spasticity
Spasticity can cause pain, stiff joints, poor sleep and trouble walking, dressing or transferring. Treatment often includes stretching and physical therapy, oral medicines such as baclofen or tizanidine, botulinum toxin injections and, for severe cases, a baclofen pump.
Symptoms patients hope to ease
- Stiff, tight muscles in the legs or arms
- Painful sudden spasms
- Spasms that wake you at night
- Trouble walking or moving because of stiffness
- Muscle pain and aching after spasms
Does severe muscle spasms & spasticity qualify in your state?
- AL AlabamaListed as “Spasticity associated with a motor neuron disea…”
- AK AlaskaListed as “Chronic or debilitating disease (or its treatme…”
- AZ ArizonaListed as “Chronic or debilitating disease (or its treatme…”
- AR ArkansasListed as “Severe and persistent muscle spasms, including …”
- CA CaliforniaListed as “Persistent muscle spasms (e.g., those associate…”
- CO ColoradoListed as “Persistent muscle spasms”
- CT ConnecticutListed as “Damage to the nervous tissue of the spinal cord…”
- DE DelawareDoctor's discretion
- FL FloridaDoctor's discretion
- HI HawaiiListed as “Chronic or debilitating disease or its treatmen…”
- IL IllinoisListed as “Spinal cord injury with intractable spasticity”
- IA IowaListed as “Multiple sclerosis with severe and persistent m…”
- KY KentuckyListed as “Multiple sclerosis, muscle spasms or spasticity”
- LA LouisianaListed as “Spasticity”
- ME MaineDoctor's discretion
- MD MarylandListed as “Severe or persistent muscle spasms”
- MA MassachusettsNot listed by name
- MI MichiganListed as “A chronic or debilitating disease, or its treat…”
- MN MinnesotaListed as “Severe and persistent muscle spasms, including …”
- MS MississippiListed as “Spastic quadriplegia”
- MO MissouriListed as “A chronic condition causing severe, persistent …”
- MT MontanaListed as “A central nervous system disorder causing chron…”
- NV NevadaListed as “Muscle spasms, including spasms caused by multi…”
- NH New HampshireListed as “Qualifying symptoms (needed with a diagnosis ab…”
- NJ New JerseyListed as “Intractable skeletal muscular spasticity”
- NM New MexicoListed as “Damage to the nervous tissue of the spinal cord…”
- NY New YorkDoctor's discretion
- ND North DakotaListed as “Spinal stenosis or chronic back pain, including…”
- OH OhioListed as “Spasticity”
- OK OklahomaDoctor's discretion
- OR OregonListed as “A condition or its treatment that produces pers…”
- PA PennsylvaniaListed as “Damage to the nervous tissue of the central ner…”
- RI Rhode IslandListed as “Severe and persistent muscle spasms, including …”
- SD South DakotaListed as “Severe and persistent muscle spasms”
- TX TexasListed as “Spasticity”
- UT UtahListed as “Multiple sclerosis or persistent and debilitati…”
- VT VermontNot listed by name
- VA VirginiaDoctor's discretion
- WA WashingtonListed as “Spasticity disorders”
- DC Washington, D.C.Doctor's discretion
- WV West VirginiaListed as “Damage to the nervous tissue of the spinal cord…”
What the research says
Stronger evidence. There's substantial evidence that oral cannabinoids reduce patient-reported spasticity in MS.
- The 2017 National Academies review found substantial evidence that oral cannabinoids improve patient-reported spasticity in people with multiple sclerosis.
- Improvements measured by clinicians in exam-based scores have been smaller and less consistent than what patients report.
- Nabiximols, a THC and CBD mouth spray, is approved for MS spasticity in many countries outside the US, though not by the FDA.
- Research in spasticity from other causes, such as spinal cord injury, is smaller but points in a similar direction.
Sources: National Academies of Sciences, Engineering, and Medicine, The Health Effects of Cannabis and Cannabinoids (2017); FDA approvals; published trials. General information, not medical advice.
How doctors approach severe muscle spasms & spasticity
Doctors often consider oral sprays, tinctures or capsules, which match the forms used in most spasticity trials.
Products with a balance of THC and CBD are commonly discussed, reflecting the research on MS spasticity.
Evening use is a common starting point when spasms disrupt sleep.
Starting low and going slow, then judging the effect after a few weeks, is the usual approach.
Risks and precautions
- Cannabis can add to the drowsiness and weakness caused by baclofen, tizanidine, benzodiazepines and gabapentin.
- Some people rely on a bit of leg stiffness to stand or transfer, so reducing spasticity too much can affect mobility.
- Dizziness and slowed reactions can raise the risk of falls.
- THC can affect memory and thinking, which may matter for people with MS who already have cognitive changes.
- Cannabis is not recommended during pregnancy or breastfeeding, and you should not drive while impaired.
- Not recommended during pregnancy or breastfeeding, and never drive while impaired.
What to bring to your evaluation
A diagnosis letter confirming the underlying condition, such as MS, spinal cord injury, stroke or cerebral palsy.
Neurologist or rehabilitation notes describing your spasticity.
A list of spasticity treatments you take or have tried, including baclofen, tizanidine and injections.
A spasm diary showing how often spasms occur and how they affect sleep and movement.
A government photo ID and proof that you live in your state.
Don't have records handy? Many patients are evaluated on their history alone.
Start my free checkHow to get certified for severe muscle spasms & spasticity
Answer a few questions
Pick your state, tell us your symptoms and what you've already tried. Review your answers and contact you to schedule your video visit.Meet your doctor by video
Join from your phone or laptop. Have a photo ID ready. The doctor reviews your history and decides whether cannabis is right for you.Get certified and registered
Pay the evaluation fee, then submit your state registry form. The doctor files your certification. We walk you through the state form line by line.
Severe muscle spasms & spasticity: 9 common questions
Does severe muscle spasms & spasticity qualify for a medical marijuana card?
Yes, in many places. 32 state programs name severe muscle spasms & spasticity on the official list, and 7 more let the certifying provider decide. Either way, a provider licensed in your state has to evaluate you and agree that cannabis is appropriate.
Which states list severe muscle spasms & spasticity as a qualifying condition?
As of our latest check of each state's official list: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Hawaii, Illinois, Iowa, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Texas, Utah, Washington and West Virginia. Providers can also certify it in Delaware, Florida, Maine, New York, Oklahoma, Virginia and Washington, D.C., which don't use a fixed list. Lists change, so confirm on your state's page before you apply.
Can I get certified for severe muscle spasms & spasticity online?
Yes, in 25 of those states — including Arizona, Arkansas, California, Connecticut, Hawaii and 20 more — your first evaluation can happen by video with a provider licensed there. In 12 others, such as Alabama, Alaska, Colorado and 9 more, the first visit must be in person, and renewals can usually be done online.
Does cannabis help MS spasticity?
Yes, this is one of the best-supported uses of cannabis. The National Academies found substantial evidence that oral cannabinoids improve how people with MS rate their own spasticity. Benefits are usually modest, and not everyone responds.
Does CBD or THC work better for muscle spasms?
Most spasticity research used products containing both THC and CBD. THC appears to play an important role, while CBD may soften some THC side effects. Many doctors start with a balanced product.
Can I take cannabis with baclofen or tizanidine?
Many people do, but the combination can increase drowsiness, dizziness and weakness. Tizanidine can also lower blood pressure, which THC may add to. Start with a small amount and tell your prescriber so doses can be adjusted if needed.
How long does cannabis take to help spasticity?
Inhaled forms act within minutes, while oral forms take 30 minutes to two hours. In trials, people often judged the benefit over several weeks. Keep a spasm diary for a few weeks before deciding whether it helps.
Can cannabis make my legs too weak?
Some people rely on a certain amount of stiffness to stand, walk or transfer. Relaxing the muscles too much, or adding sedation, can make these tasks harder. If you notice new weakness or falls, talk with your doctor.
Can cannabis help night-time spasms and sleep?
Many people with spasticity report better sleep when spasms ease at night, and some trials found improved sleep too. An oral product taken in the evening is a common approach. Watch for next-morning grogginess before driving or other tasks.