Muscle relaxers, or muscle relaxants, 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:
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:
Millions of Americans currently use muscle relaxants. Middle-aged adults are the most frequent users.
NHANES III
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:
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.”
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.
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. They may also get prescribed when back or neck pain causes insomnia — due to their sedative effects.
Muscle relaxers can also help treat restless leg syndrome and sore muscles.
Muscle relaxants may be used to treat a variety of other conditions, including:
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:
OTC medications are typically the first type of muscle relaxants that doctors prescribe, and include:
Generic name | Brand name | Form | Used to treat |
---|---|---|---|
Acetaminophen | Tylenol, Paracetamol | Tablet/CapsuleLiquidInjectionSuppository | Minor aches and painFever |
Ibuprofen | Advil, Motrin | Tablet/CapsuleLiquidInjection | PainInflammationFever |
Naproxen | Aleve | TabletLiquidSuppository | Acute painInflammation |
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:
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 |
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 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:
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 |
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 |
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.
Discontinuing the use of some muscle relaxers after long-term use can result in withdrawal symptoms, such as hallucinations and seizures. Do not stop taking the medication without talking to your doctor first.
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:
Nearly 15,000 people die each year of overdoses involving prescription painkillers.
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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Prescription Painkiller Overdoses in the US. Centers for Disease Control and Prevention, 1 Nov. 2011, www.cdc.gov/vitalsigns/painkilleroverdoses/index.html.
Dillon, Charles & Paulose-Ram, Ryne & Hirsch, Rosemarie & Gu, Qiuping. (2004). 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/
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 (2014): 427-35., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103716/
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 (2019): 121-132. doi:10.1007/s40122-019-0112-6, https://pubmed.ncbi.nlm.nih.gov/30652262/
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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