Muscle Relaxers/Relaxants

What is a Muscle Relaxer (Relaxant)?

Muscle spasms or cramps are quick, unexpected muscle contractions. On the other hand, muscle spasticity is a continuous spasm that causes muscle stiffness or tightness.

Muscle relaxers or relaxants are medications used to treat spasms and spasticity. They decrease the body’s muscle tone. Muscle tone refers to the muscle’s resistance to stretch in a relaxed state.

The most common type of cramp is a skeletal muscle spasm. These spasms are usually abrupt, painful, and short-lived.

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What Causes Muscle Spasms?

Most muscle spasms are idiopathic, meaning their causes are unknown. The following are often associated with muscle spasms:

• Not stretching enough, including before exercise
• Muscle overuse
• Muscle fatigue
• Exercising in the heat
• Dehydration
• Electrolyte depletion, including potassium, magnesium, and calcium
• Involuntary nerve discharges
• Decrease in blood supply
• Stress

What Conditions Cause Muscle Spasms?

Conditions often associated with, not a cause of, muscle spasms include:

• Back pain
• Neck pain
• Fibromyalgia
• Obesity
• Diabetes
• Anemia (low red blood cell count)
• Kidney disease
• Hormone issues (thyroid disorders)

What Causes Muscle Spasticity?

Muscle spasms often originate from damage to an area of the brain or spinal cord that regulates voluntary movement. Conditions that lead to muscle spasticity include:

• Cerebral Palsy (CP)
• Multiple sclerosis (MS)
• Spinal cord injuries
• Traumatic brain injuries
• Brain damage
• Stroke
• Encephalitis
• Meningitis
• Adrenoleukodystrophy (ALD)
• Amyotrophic lateral sclerosis (Lou Gehrig's disease or ALS)
• Phenylketonuria

Side Effects of Muscle Spasticity

Muscle spasticity has adverse effects on the joints and extremities, especially in growing children. It can also interfere with everyday activities such as walking, talking, or bending.

Symptoms range from:

• Mild movement limitations
• Inability to move affected areas
• Severe pain during movement

Millions of Americans currently use muscle relaxants. Middle-aged adults are the most frequent users.

NHANES III

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What Do Muscle Relaxers Do?

Muscle relaxants can help relieve pain and other symptoms caused by muscle spasms and spasticity. Muscle relaxers work at many levels. The most common ones exert their effects on the brain and skeletal muscles.

There are two categories of muscle relaxants:

• Antispasmodics: Centrally acting skeletal muscle relaxants (SMRs), used with rest and physical therapy to relieve muscle spasms
• Antispastics: Used to treat muscle spasticity and shouldn’t be used to treat spasms

Doctors believe muscle spasticity is caused by your nerves sending an excessive amount of signals to your brain. Muscle relaxants reduce the signals sent between your nerves and your brain. This creates a sedative effect.

Uses of Muscle Relaxants

Muscle relaxants treat certain disorders that produce muscle spasms or spasticity. They can also treat acute and, in some cases, chronic pain.

Acute pain is sudden and lasts for a short time. Chronic pain, however can last up to 6 months or longer.

Other uses for muscle relaxants include treating restless leg syndrome and sore muscles.

Muscle Relaxers for Neck & Back Pain

Back pain is the number one ailment requiring a muscle relaxant prescription. Tense or spasming muscles can cause or are caused by:

• Neck pain
• Upper back pain
• Lower back pain

Doctors always prescribe muscle relaxants in conjunction with rest and physical therapy. They may use muscle relaxants to reduce pain associated with muscle spasms.

Although muscle relaxers work no better than non-steroidal anti-inflammatory drugs (NSAIDs) in pain relief, doctors still prescribe them. This is due to their added sedative befits, which can often help you rest.

Treating Other Disorders

Muscle relaxants may be used to treat a variety of other conditions, including:

• Cerebral palsy
• Multiple sclerosis (MS)
• Motor neurone disease (MND)
• Head or spinal cord injuries
• Irritable bowel syndrome (IBS)

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Treatment Types for Muscle Spasms and Spasticity

Many classes of medications help with muscle spasms and spasticity. They can include NSAIDs, natural methods, and muscle relaxants.

The following is an overview of the most common medications that relieve muscle spasms:

Over-the-Counter (OTC) Treatments

OTC medications are typically prescribed first by a doctor. The following are classified as NSAIDs and include:

Prescription Muscle Relaxants

Along with rest and physical therapy, doctors will prescribe prescription muscle relaxants when pain is more severe. It can also be used if the person does not tolerate OTC medications due to side effects.

Antispasmodic prescription muscle relaxants, or centrally acting SMRs, include:

Antispastic Prescription Muscle Relaxers

Some types of antispastic prescription muscle relaxers include:

Off-Label Medications for Spasticity

Doctors can prescribe certain medications for certain conditions, even when the U.S. Food and Drug Administration (FDA) has not approved the drugs for that purpose. This is called off-label drug use.

Some off-label medications are not technically muscle relaxants but may be prescribed to relieve symptoms of spasticity, including:

All-Natural Muscle Relaxers

The FDA does not approve natural and holistic medicines. However, many people believe they are effective in pain relief.

There is little to no scientific evidence to support these claims, but they may be useful for some people:

Common Side Effects of Muscle Relaxers

Muscle relaxants and prescription drugs come with several possible side effects. They will vary depending on the type of drug. The most common muscle relaxant side effects include:

Do not use muscle relaxants with alcohol, central nervous system (CNS) depressants (opioids, benzodiazepines, barbiturates), or sleeping medications. Serious side effects, including death, may occur.

If you suddenly stop using muscle relaxers after long-term use, it can result in withdrawal symptoms. This includes hallucinations and seizures. Do not stop taking the medication without talking to your doctor first.

Muscle Relaxant Abuse and Addiction

People can safely use muscle relaxants for short-term treatments, specifically for 2 to 3 weeks. Long-term use safety is not yet confirmed. Further, muscle relaxants are not FDA-approved for long-term use because they are habit-forming.

If they are used for longer, a person will be at risk of misuse and abuse. Soma and Flexeril, the most commonly prescribed muscle relaxants, can lead to tolerance and dependence with prolonged use.

Muscle relaxants often get abused for their euphoric and dissociative effects. One in twenty people in the U.S. aged 12 and up have reported using muscle relaxants recreationally. This can lead to addiction or overdose.

Symptoms of Muscle Relaxant Overdose

Muscle relaxant overdose symptoms include:

• Stupor
• Hallucinations
• Shock
• Seizures
• Hyperventilation
• Cardiac arrest
• Coma
• Death

Aside from their direct effects, muscle relaxants can depress your CNS. This makes it hard to pay attention or stay awake.

People who take muscle relaxants should avoid activities that require mental alertness or coordination. These include driving and using heavy machinery. Both can make injuries more likely.

Nearly 15,000 people die each year of overdoses involving prescription painkillers.

Muscle Relaxer Addiction Treatment

There are several treatment options for people suffering from muscle relaxant addiction.

The most commonly used treatment methods include:

• Outpatient treatment
• Partial hospitalization programs
• Inpatient treatment
• Self-Management and Recovery Training (SMART)

If you or someone you know suffers from a muscle relaxant addiction, reach out to a healthcare professional to review your treatment options.

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