Muscle Relaxants/Relaxers

What are Muscle Relaxants?

Muscle relaxants, or muscle relaxers, are medications that treat muscle spasms or muscle spasticity by decreasing the body’s muscle tone.

Skeletal muscle spasms are the most common type of cramp and come from overuse, muscle fatigue, dehydration, or electrolyte abnormalities. Spasms are usually abrupt, painful, and short-lived.

Conditions that lead to muscle spasms include:

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

Muscle spasticity may interfere with everyday activities such as walking, talking, or bending. It often originates from damage to an area of the brain or spinal cord that regulates voluntary movement. Muscle spasticity has adverse effects on the joints and muscles of extremities, especially in growing children. Symptoms range from mild tightness to severe pain.

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

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

NHANES III

What do Muscle Relaxants Do?

Muscle relaxants can help relieve pain and other symptoms caused by muscle spasms and spasticity. They are unique because scientists and doctors still don’t understand how many of them work.

There are two categories of muscle relaxants:

• Antispasmodics — also known as centrally acting skeletal muscle relaxants (SMRs) are used, along with rest and physical therapy, to relieve muscle spasms.
• Antispastics — are used to treat muscle spasticity, and shouldn’t be used to treat spasms.

Doctors believe that spasms are caused by your nerves sending an excessive amount of signals to your brain. Muscle relaxants reduce the number of signals sent between your nerves and your brains. This is commonly referred to as a “sedative effect.”

Uses of Muscle Relaxants

Muscle relaxants treat acute pain; however, in some cases, they can treat chronic pain. Acute pain lasts for a short amount of time, whereas chronic pain lasts for longer than six months.

They are also used to treat certain disorders and ailments that produce muscle spasms or spasticity.

Treating Back or Neck Pain

Back pain is the number one ailment that calls for a muscle relaxant prescription. Both back and neck pain can be caused by, or be the cause of, tense or spasming muscles.

Doctors always prescribe muscle relaxants in conjunction with rest and physical therapy. Doctors may use them early on to reduce pain associated with muscle spasms. They may also get prescribed when back or neck pain causes insomnia — due to their sedative effects.

Treating Other Disorders

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

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

List of Common Muscle Relaxants

Muscle relaxants encompass a large group of different types and classes of substances. They include natural, over-the-counter, and prescription medications.

The following is an overview of the most common types of muscle relaxants:

Over-the-Counter (OTC) Muscle Relaxants

OTC medications are typically the first type of muscle relaxants that doctors prescribe, and include:

Prescription Muscle Relaxants

Along with rest and physical therapy, doctors will use prescription muscle relaxants when pain is more severe, or if OTC medications do not have the desired effect.

Antispasmodic prescription muscle relaxants, or centrally acting SMRs include:

Antispastic prescription muscle relaxants include:

Off-Label Muscle Relaxants

Off-label drug use refers to when a doctor prescribes medication in a way that is not approved by the FDA. It may be that the drug is not FDA approved to treat a certain ailment, age group, or that the dosage or route of administration hasn’t been approved.

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

Natural Muscle Relaxants

The FDA does not approve natural and holistic medicines, but many people believe that 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:

Side Effects of Muscle Relaxants

Muscle relaxants, along with all prescription drugs, come with a number of possible side effects. They will vary depending on the type of drug, but the most common muscle relaxant side effects include:

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

Muscle Relaxant Abuse and Addiction

Muscle relaxants are intended for short term treatments, typically two to three weeks. If they are used for longer, a patient 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 20 people in the U.S. age 12 and up have reported using muscle relaxants recreationally. This can lead to addiction or overdose.

Muscle relaxant overdose symptoms include:

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

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

Muscle Relaxant 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
• SMART Recovery

If you or someone you know is suffering from a muscle relaxant addiction, reach out to a health care professional to review your treatment options.