Do I Need a Muscle Relaxer?

A muscle relaxer or muscle relaxant is a type of medication that is used to treat muscle spasms or spasticity. There are two types of muscle relaxers: 

• Antispasmodic drugs or spasmolytics are used to relieve, prevent, and decrease the incidence of muscle spasms. They inhibit the transmission of nerve impulses in the central nervous system, or act directly on smooth muscles. Some examples are cyclobenzaprine (Flexeril®) and tizanidine (Zanaflex®).
• Antispastic drugs are used in the treatment of muscle spasticity. They relieve muscle stiffness by acting directly on the skeletal muscles, or interfering with nerve transmission on the spinal cord. Examples include baclofen (Lioresal®) and clonidine (Catapres®).

Some muscle relaxers like Tizanidine (Zanaflex®) and Dantrolone (Dantrium®) have both antispasmodic and antispastic effects.

When You Might Need a Muscle Relaxer

Muscle relaxers are prescribed if you have spasms or spastic episodes that affect daily function, such as eating or walking. Doctors also provide them as alternative treatment options for muscle pain.

Muscle Spasms

Muscle spasms are the sudden and involuntary contraction of muscles. These spasms or “muscle cramps” occur when:

• Muscles are overstretched or held in the same position for too long
• Muscle cells run out of energy and/or fluid, or they become excitable

They can affect a part of the muscle, the entire muscle, or a group of muscles. Although painful, muscle spasms are short-lived. They produce pain that ranges from mild to severe and last anywhere between a few seconds and several minutes.

Muscle relaxants with antispasmodic effects are often used in the treatment of muscle spasms caused by spinal cord injuries, multiple sclerosis, and other conditions.

Muscle Spasticity

Muscle spasticity is a chronic disorder that causes persistent stiffness or tightness of the muscles. People with this condition have recurring muscle spasms which limit their ability to function. They can also develop contractures or permanent contractions as a result of severe muscle spasms and stiffness. 

Signs of muscle spasticity include:

• Hyperactive reflexes
• Musculoskeletal pain
• Delayed motor development in infants and young children
• Impaired function (e.g., reduced ability to care for oneself)
• Abnormal posture
• Contractures
• Bone and joint deformities

Muscle relaxants with antispastic properties are prescribed for spasticity.

Muscle Pain and Other Uses

Muscle relaxers are no more effective than painkillers in treating problems like neck and lower back pain. However, doctors may prescribe these drugs in the following situations:  

• If you have acute muscular pain, but cannot tolerate painkillers such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen
• If you experience muscle spasms that interfere with sleep (e.g., nocturnal leg cramps and restless legs syndrome)
• If you have spasms that impair your ability to perform basic daily functions, like eating and bathing (e.g., gastroesophageal reflux disease)
• If you are not responsive to over-the-counter painkillers    

Before you consider muscle relaxants, it is best to talk with a doctor for medical advice. They can help you determine whether prescription drugs or over-the-counter (OTC) medications are more suitable. 

Using a muscle relaxer for chronic pain has not been proven to be effective. It also poses long-term health risks, namely drug addiction and abuse. 

Is it Bad to Take Muscle Relaxers Every Day?

Your doctor’s prescription will determine how long you can take a muscle relaxant. In general, it should be no more than 2 to 3 weeks. 

Evidence suggests that muscle relaxers aren’t safe for long-term use. 

For instance, the Drug Enforcement Administration (DEA) now considers carisoprodol (Soma®) as a Schedule IV controlled substance. This means it has a low potential for abuse. Cyclobenzaprine (Flexeril®) isn’t classified as a control substance by the DEA. However, research shows that Flexeril addiction is possible if you misuse it.

Also, researchers from the University of Florida College of Pharmacy published interesting findings. They found that combining muscle relaxers and low-dose opioids for short-term pain management did not pose any more health risks than using opioids alone. However, when people took both drugs for several weeks, the risk of overdose increased. 

Research further suggests that muscle relaxants aren’t as effective in long-term pain management. A very large study concluded that they helped with acute but not chronic lower back pain. 

Prior studies have shown that 10% to 30% of individuals who take opioids also take a muscle relaxer. 

Are Muscle Relaxers Addictive?

Not all muscle relaxers have a potential for abuse. However, some muscle relaxers like Flexeril and diazepam pose risks for dependence and withdrawal symptoms. 

It is best to get medical advice before taking any muscle relaxer. Healthcare professionals can help you better understand the possible side effects and health risks associated with these drugs. 

Types of Addictive Muscle Relaxers

Different addictive muscle relaxers have the potential for abuse and physical dependence. Here is a list of the main ones:

Diazepam (Valium®)

This prescription drug belongs to the group of medications called benzodiazepines. Other examples of benzodiazepines include clonazepam (Klonopin®) and alprazolam (Xanax®). 

Diazepam reduces excessive and abnormal brain activity, but it carries an increased risk of serious problems. When used with other medications or alcohol, it can cause sedation. 

Long-term or excessive use of diazepam can lead to physical tolerance. Meaning the drug could lose some effectiveness. Overall, diazepam is not often the first go-to treatment option for muscle spasms.

Carisoprodol (Soma®)

One study shows that the effects of carisoprodol are similar to other central nervous system (CNS) depressants like pentobarbital. The DEA recently released the Diversion Drug Trends (of controlled and non-controlled medications), stating that this drug is often misused in the United States. 

Cyclobenzaprine (Amrix® and former brand name Flexeril®)

Cyclobenzaprine has a similar chemical structure to tricyclic antidepressants. Because of this, it produces antidepressive effects that make some people more prone to Flexeril abuse. 

How Long Do Muscle Relaxers Remain in Your System?

Several factors influence how long muscle relaxers stay in your system.

These factors include:

• The type of muscle relaxer used
• How much of the muscle relaxant was used
• The type of test used to detect the muscle relaxer
• Biological factors, including age, overall health, and weight

A dose of cyclobenzaprine (Flexeril®) can take anywhere between 5.5 and 16.5 days to flush out of your system. A dose of carisoprodol (Soma) may take approximately 4 days to clear out of your system.

Signs You are Addicted to Muscle Relaxants 

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:

• Take a muscle relaxant when a prescription no longer indicates it 
• Require more of the drug to feel the same effects 
• Constantly think about a muscle relaxant, including how to obtain more, the effects it causes, and when to take it
• Fake symptoms for more prescription refills 
• Change physical appearance, hygiene, and behavior suddenly 
• Combine a muscle relaxant with other substances like alcohol to experience a more intense high or come down from stimulant drugs like cocaine.
• Overdose 

Do Muscle Relaxers Have Withdrawal Symptoms?

Yes. Many muscle relaxers can cause withdrawal symptoms, although it does not always mean an addiction has formed. 

For example, people who take cyclobenzaprine (Flexeril®) may experience withdrawal symptoms after they stop taking the drug. Flexeril withdrawal may cause nausea, headache, and malaise (or a general feeling of being unwell). 

Another muscle relaxer called tizanidine (Zanaflex®) may also produce withdrawal symptoms and rebound hypertension (high blood pressure). 

Doctors may slowly taper your dose over time to reduce the risk of withdrawal. 

Muscle Relaxer Withdrawal Timeline

How long withdrawal symptoms last will depend on the individual, the type of muscle relaxant taken, and whether there is addiction and abuse involved. The severity of withdrawal symptoms and detox will also vary.

Typically, those who abuse muscle relaxants or have become addicted to the drug may experience withdrawal symptoms within days after stopping use. These signs of withdrawal may continue for a few days or weeks, until the drug is no longer in your system.

If you have Flexeril addiction or have become addicted to other muscle relaxers, quitting cold turkey is not recommended. The safest way to become sober is to stop your abuse of muscle relaxers like Flexeril in a treatment facility. That way, you’ll be under the supervision of a medical practitioner as part of a muscle relaxer detox program.

Long-Term Side Effects of Muscle Relaxers

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:

• Falls
• Fractures or sprains
• Vehicle crashes
• Misuse and dependence
• Abuse and addiction
• Overdose

Because of these risks, the American Geriatrics Society does not recommend muscle relaxers in older individuals. 

What Are the Symptoms of a Muscle Relaxant Overdose?

Taking more muscle relaxants than what was prescribed can lead to a drug overdose. The signs of muscle relaxer overdose include:

• Drowsiness 
• Cardiovascular problems (e.g., fast or irregular heartbeats) 
• Agitation
• Confusion
• Difficulty speaking or moving 
• Dizziness 
• Nausea 
• Vomiting 
• Hallucinations 
• Tremors or seizures 
• Loss of consciousness
• Respiratory depression
• Stupor
• Shock
• Seizures
• Coma
• Death

If you believe you or a loved one is experiencing a muscle relaxant overdose, you must call 911 immediately.

Treatment for Muscle Relaxer Misuse & Addiction

Abuse of muscle relaxers can quickly result in physical dependence and addiction. It can cause severe medical issues, overdose, or death.

If you or a loved one have an addiction to muscle relaxers, there are many therapy options available, such as:

• Cognitive-behavioral therapy (CBT) — counseling sessions could help address the underlying causes of addiction and provide coping techniques. 
• Detox — a medical detox program is an excellent place to start if you want to recover from muscle relaxer addiction. Detox provides a safe and supportive environment and professional medical management for withdrawal symptoms so you can recover comfortably. Counseling is also provided, which can help you deal with some of the psychological symptoms of withdrawal and prepare you for participation in a rehab program if you decide to continue treatment.
• Outpatient or inpatient treatment programs — these clinics offer supervision and support groups through the detox period and help individuals maintain abstinence. 
• Sober living programs — many people recovering from muscle relaxer addiction also decide to continue treatment with sober living options and aftercare services. These treatment programs provide essential support and accountability to help newly sober patients prevent or deal with relapse and steadily adjust to society following rehab.

While recovery is difficult, it is also possible. Taking the first step of seeking help paves the path to a healthier life.