Drugs used to treat muscle and joint disease

There are a wide range of joint and muscle diseases. The main joint diseases covered in this article are osteoarthritis and gout. The former is treated with symptomatic pain relief and the latter with strategies to reduce uric acid deposition in the joint, especially allopurinol. Myasthenia gravis is an autoimmune disease targeted to muscle type nicotinic receptors. Treatment is based on improving neuromuscular function by (i) increasing acetylcholine concentrations with neostigmine and pyridostigmine, (ii) immunosuppression, (iii) thymectomy and (iv) plasmapheresis. General muscle spasticity can be caused by a wide range of conditions including multiple sclerosis, cerebral palsy, Parkinson’s disease and secondary to stroke. This can be treated centrally with baclofen, tizanidine and benzodiazepines or peripherally with dantrolene. Botulinum toxin inhibits the exocytosis of acetylcholine-containing vesicles and can be used for cervical dystonia, strabismus, blepharospasm, severe axillary hyperhidrosis and cosmetic procedures.