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Updated on April 21, 2022

Muscle Relaxers/Relaxants

What is a Muscle Relaxer (Relaxant)?

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

  • Muscle spasms, commonly referred to as cramps, are quick and unexpected contractions of a muscle or group of muscles.
  • Muscle spasticity is a continuous spasm that causes muscle stiffness or tightness.
  • Muscle tone refers to the muscle’s resistance to stretch in a relaxed state.

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.

Causes of Muscle Spasms

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

  • Not stretching enough, including before exercise
  • Muscle overuse
  • Exercising in the heat
  • Dehydration
  • Depletion of important electrolytes, including potassium, magnesium, and calcium
  • Involuntary nerve discharges
  • Decrease in blood supply
  • Stress

Conditions that are 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)

Causes of Muscle Spasticity

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

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 movement limitation and the an inability of moving affected areas to severe pain during movement.

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

NHANES III

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 — 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 muscle spasticity is 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.”

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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.

Muscle Relaxers for Neck & Back Pain

Back pain is the number one ailment that calls for a muscle relaxant prescription. Neck pain, upper back pain, and lower back 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. 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 often helps a person rest.

Muscle relaxers can also help treat restless leg syndrome and sore muscles.

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)

Treatment Types for Muscle Spasms and Spasticity

There are many classes of medications that help with muscle spasms and spasticity. They can include non-steroidal anti-inflammatory drugs (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:

Generic name Brand name Form Used to treat
Acetaminophen Tylenol, Paracetamol Tablet, Capsule, Liquid, Injection, Suppository Minor aches and painFever
Ibuprofen Advil, Motrin Tablet, Capsule, Liquid, Injection Pain, Inflammation, Fever 
Naproxen Aleve Tablet, Liquid, Suppository Acute pain, Inflammation

Prescription Muscle Relaxants

Along with rest and physical therapy, doctors will use prescription muscle relaxants when pain is more severe, or if OTC medications are not tolerated due to side effects.

Antispasmodic prescription muscle relaxants, or centrally acting SMRs include:

Generic name Brand name Form Used to treat
Carisoprodol Soma Tablet Skeletal muscle
pain or injury
Chlorzoxazone Parafon Forte,
Lorzone
Tablet Muscle spasms,
muscle pain,
musculoskeletal
conditions
Cyclobenzaprine Fexmid, Flexeril,
Amrix
Tablet,
Extended-release
capsule
Skeletal muscle
pain or injury
Metaxalone Skelaxin,
Metaxall
Tablet Skeletal muscle
pain or injury
Methocarbamol Robaxin Tablet Skeletal muscle
pain or injury
Orphenadrine Norflex Extended-release
tablet
Skeletal muscle pain or
injury, Parkinson’s Disease
Tizanidine Zanaflex Tablet, Capsule Multiple Sclerosis, Spinal
cord injury

Antispastic Prescription Muscle Relaxers

Some types of antispastic prescription muscle relaxers include:

Generic name Brand name Form Used to treat
Baclofen Lioresal, Gablofen Tablet, Injection Multiple Sclerosis
Dantrolene Dantrium Tablet Multiple Sclerosis, Cerebral Palsy,
Strokes, Spinal cord injury
Diazepam Valium Oral suspension, Tablet,
Injection
Inflammation, Muscle trauma,
Muscle spasticity

Off-Label Medications for Spasticity

Doctors are able to prescribe certain medications for certain conditions, even when the 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 by doctors to relieve symptoms of spasticity, including:

Generic name Brand name Form Used to treat
Clonazepam Klonopin Tablet Seizures, Anxiety,
Muscle spasms
Lorazepam Ativan Tablet, Liquid Anxiety, IBS,
Substance withdrawal
Alprazolam Xanax Tablet, Liquid Anxiety, Panic attacks,
Muscle spasms
Clonidine Kapvay, Catapres,
Jenloga
Tablet High blood pressure, ADHD,
Muscle Spasms, Spasticity
Gabapentin Neurontin, Gralise, Horizant Tablet, Liquid Seizures, Nerve pain,
Restless leg syndrome

All Natural Muscle Relaxers

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:

Generic name Brand name Form Used to treat
Cannabidiol (CBD) - Tinctures and oil,
Topical, Capsule
Pain, Dystonia,
Insomnia
Cherries and blueberries - Fruit, Juice Muscle pain, Inflammation
Cayenne pepper - Food, Capsule,
Topical
Fibromyalgia
Rheumatoid arthritis
Chamomile - Tea, Oil Muscle spasms,
Sore muscles

Common Side Effects of Muscle Relaxers

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:

  • Tiredness and drowsiness
  • Weakness
  • Dizziness
  • Nausea
  • Agitation
  • Light-headedness
  • Headaches
  • Forgetfulness
  • Muscle weakness (side effect of Diazepam)
  • Confusion
  • Shakiness
  • Sweating
  • Anxiety
  • Blurred Vision
  • Appetite Changes
  • Decreased blood pressure
  • Constipation
  • Dry mouth

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.

Abruptly discontinuing the use of muscle relaxers after long-term use 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 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 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

Aside from its direct effects, muscle relaxants can depress your central nervous system (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 drive 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:

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.

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Resources

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  1. Prescription Painkiller Overdoses in the US. Centers for Disease Control and Prevention, 1 Nov. 2011, www.cdc.gov/vitalsigns/painkilleroverdoses/index.html.
  2. Dillon, Charles & Paulose-Ram, Ryne & Hirsch, Rosemarie & Gu, Qiuping. . Skeletal muscle relaxant use in the United States - Data from the Third National Health and Nutrition Examination Survey (NHANES III). Spine. 29. 892-6. 10.1097/00007632-200404150-00014., https://pubmed.ncbi.nlm.nih.gov/15082991/
  3. Witenko, Corey et al. “Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low back pain.” P & T : a Peer-reviewed Journal for Formulary Management vol. 39,6 : 427-35., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103716/
  4. Patel, Himanshu D et al. “Efficacy and Safety of Combination of NSAIDs and Muscle Relaxants in the Management of Acute Low Back Pain.” Pain and Therapy vol. 8,1 : 121-132. doi:10.1007/s40122-019-0112-6, https://pubmed.ncbi.nlm.nih.gov/30652262/
  5. Richards BL, Whittle SL, Buchbinder R. Muscle relaxants for pain management in rheumatoid arthritis. Cochrane Database of Systematic Reviews 2012, Issue 1. Art. No.: CD008922. DOI: 10.1002/14651858.CD008922.pub2., https://www.researchgate.net/publication/221760679_Muscle_relaxants_for_pain_management_in_rheumatoid_arthritis

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