A muscle relaxer or muscle relaxant is a type of medication that helps treat muscle spasms or muscle spasticity.
Muscle spasms or cramps occur unexpectedly and involuntarily. These spasms are contractions of either a muscle or group of muscles, often happening due to the following health conditions:
Muscle spasticity refers to a continuous muscle spasm that causes stiffness or tightness and affects motor skills like walking or talking. This can happen, because the brain or spinal cord has suffered some damage in the parts related to movement. For example, multiple sclerosis (MS) is a condition that can lead to muscle spasticity.
However, not all muscle relaxers will treat muscle spasms or vice versa.
Muscle relaxers comprise two categories:
While these drugs treat problems like low back pain, they are not more effective than painkillers like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs).
However, evidence supports muscle relaxants for short-term relief of acute low back pain when someone cannot tolerate NSAIDs or acetaminophen or find them ineffective.
Before taking muscle relaxants, it is best to talk with a doctor. They can help you determine if different prescription drugs or over-the-counter (OTC) medications are more suitable.
Using a muscle relaxer for chronic problems has not been proven to be effective in the long term. There is also an additional health risk of safety.
The prescription provided by a doctor will determine how long you should take a muscle relaxer.
In general, a doctor should limit the use of a muscle relaxer to no more than 2 to 3 weeks. This is because there is little evidence regarding the long-term effectiveness and safety of these medications.
The Drug Enforcement Administration (DEA) now considers the muscle relaxer carisoprodol (Soma®) as a Schedule IV controlled substance. This means it has a low potential for abuse. Chronic use of this drug could increase dependence.
Also, researchers from the University of Florida College of Pharmacy published interesting findings about muscle relaxers. In the short term, the combination of muscle relaxers and low-dose opioids did not pose any more significant health risk than opioids alone. However, when people took both drugs for several weeks, the risk of overdose increased.
Finally, a very large study concluded that muscle relaxers were effective for acute low back pain. However, the evidence to support these drugs for chronic low back pain was not as convincing.
Prior studies have shown that 10% to 30% of individuals who take opioids also take a muscle relaxer.
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Not all muscle relaxers have abuse potential and are habit-forming. However, some muscle relaxers function like antidepressants or other types of drugs. Because of this, withdrawal symptoms can arise.
It is best to speak with a healthcare professional before taking any muscle relaxer to understand all possible side effects and risks.
3.69 million people (12 years old and up) took carisoprodol (Soma®) for non-medical reasons in their lifetime. In 2011, the number of people who misused carisoprodol was 3.06 million.
- 2012 National Survey on Drug Use and Health
Different addictive muscle relaxers have the potential for abuse and physical dependence.
Here is a list of the main ones:
Addiction comes in many forms. However, some signs can indicate if someone has an addiction to muscle relaxants.
Some of these signs include people who:
Muscle relaxant overdose signs and symptoms include:
Yes. Many muscle relaxers can cause withdrawal symptoms, although it does not always mean an addiction has formed.
For example, like tricyclic antidepressants, cyclobenzaprine has effects on the body that can cause withdrawal symptoms after a person stops taking the drug. Stopping cyclobenzaprine suddenly after taking it for a long time could cause nausea, headache, and malaise (not feeling well).
Another muscle relaxer called tizanidine (Zanaflex®) may also produce withdrawal symptoms and rebound hypertension (high blood pressure).
Doctors may set up a tapering plan (to lower doses gradually over time) to minimize the risk of withdrawal.
Doctors should only prescribe muscle relaxers for no more than 2 to 3 weeks. There is little evidence to support such drug use for extended periods. Long-term use could have serious side effects, including:
Because of these risks, the American Geriatrics Society does not recommend muscle relaxers in older individuals.
Muscle relaxer use doubled from 2005 to 2016 in the general population. There was a disproportionately high use of muscle relaxers in older adults.
- JAMA Medical Journal Study
If you or a loved one have an addiction to muscle relaxers, there are many therapy options available, such as:
While recovery is difficult, it is also possible. Taking the first step of seeking help paves the path to a healthier life.
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CARISOPRODOL (Trade Name Soma), United States Department of Justice, Dec. 2019, www.deadiversion.usdoj.gov/drug_chem_info/carisoprodol/carisoprodol.pdf.
FLEXERIL® (CYCLOBENZAPRINE HCL) TABLETS , US Food and Drug Administration, www.accessdata.fda.gov/drugsatfda_docs/label/2013/017821s051lbl.pdf.
See, Sharon, and Regina Ginsburg. “Skeletal Muscle Relaxants.” Pharmacotherapy, U.S. National Library of Medicine, 28 Feb. 2008, pubmed.ncbi.nlm.nih.gov/18225966/.
See, Sharon, and Regina Ginzburg. “Choosing a Skeletal Muscle Relaxant.” American Family Physician, 1 Aug. 2008, www.aafp.org/afp/2008/0801/p365.html.
Soprano , Samantha E, et al. “Assessment of Physician Prescribing of Muscle Relaxants in the United States, 2005-2016.” JAMA Network Open, JAMA Network, 24 June 2020, jamanetwork.com/journals/jamanetworkopen/fullarticle/2767591.
“UF Study Finds Some Combinations of Opioids and Muscle Relaxants Are Safe, Others Raise Overdose Risk " College of Pharmacy " University of Florida.” UF Monogram, University of Florida College of Pharmacy, 6 July 2020, pharmacy.ufl.edu/2020/07/06/uf-study-finds-some-combinations-of-opioids-and-muscle-relaxants-are-safe-others-raise-overdose-risk/.
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