With opioid prescribing being scaled back, muscle relaxers are gaining popularity. However, they come with their own side effects and risks.
Skeletal muscle spasticity medications are prescribed to reduce tightness and improve new or flare-ups of pain. There are two major drug classes: antispastics and antispasmodics.
A provider on Sesame can write a prescription for you during an online or in-person visit if they believe it’s necessary.
Muscle Relaxers – NSAIDs
Many people treat muscle pain by using over-the-counter remedies like acetaminophen or anti-inflammatories, which can help relieve some pain and discomfort. But if you’re dealing with severe spasticity or muscle pain that doesn’t respond to over-the-counter solutions, your doctor may prescribe muscle relaxants to help ease the discomfort. These prescription medications are available in various dosages and can be very effective in reducing the severity of your symptoms, but there is always a chance they could have negative side effects that you should be aware of.
Skeletal muscle relaxants like cyclobenzaprine (Flexeril) and methocarbamol (Robaxin) are excellent choices for easing back and neck pain caused by sprains or strains. These prescriptions work to reduce the amount of pain and tension you feel by inhibiting the nerve signals that send the spasm-pain message to your brain. This can also reduce the strength of your spasms. Common side effects include drowsiness, dry mouth, and dizziness.
Another type of prescription muscle relaxant is benzodiazepines, which are effective for treating spasticity associated with spinal cord injury, stroke, cerebral palsy, and multiple sclerosis. The two most commonly prescribed benzodiazepines are carisoprodol (Soma) and diazepam. These are controlled substances with addictive potential, so they should only be taken as prescribed. Taking more than your prescribed dose can lead to dependence, withdrawal, and other negative side effects.
A recent study that included eight trials with 724 patients found that muscle relaxants are more effective than placebo in relieving acute low back pain and shortening the duration of discomfort and recovery. However, muscle relaxants are associated with more central nervous system and gastrointestinal adverse effects than placebo, with a relative risk of 1.52 (95% CI 1.14 to 2.18).
Muscle Relaxers – Acetaminophen
If you are experiencing severe pain or spasms, your doctor may need to prescribe a stronger medication than over-the-counter medications (OTC) like acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. These medicines help relieve the pain by blocking the enzymes in your body that cause inflammation and swelling.
Skeletal Muscle Relaxers, such as cyclobenzaprine (Flexeril) and methocarbamol (Robaxin), work well to treat painful musculoskeletal spasms and back pain. They work by slowing down the muscles and nerves, as well as causing drowsiness. They typically need to be taken for short periods of time and are used in combination with other pain relief methods. Common side effects of this class of drug include drowsiness, dry mouth, dizziness, and blurred vision.
Centrally acting SMRs, such as carisoprodol (Soma), are prescribed for more serious skeletal muscle spasms, such as back and neck pain, to relieve pressure on the spinal cord. These medicines have been shown to reduce pain and spasms by reducing the brain’s ability to send pain signals to the muscles. However, they are not as effective as NSAIDs or acetaminophen and have more serious side effects.
Prescription Muscle Relaxers can be taken orally, via injection, or in creams and ointments. They should never be paired with alcohol or other medications that can cause drowsiness, such as antihistamines and sedatives. Additionally, people with kidney or liver problems should check with their medical provider before taking these medications.
Over-the-counter medications are the first line of defense for most people, but if you are experiencing severe pain or spasms, it’s important to seek medical care. If you are in need of a physician, a Sesame healthcare provider can write a prescription during a virtual or in-person visit.
Whether you are in need of an OTC medication or prescription, there are many treatments that can alleviate your symptoms and improve your quality of life, including physical therapy, home exercises, posture training, and weight loss. If you are struggling to manage your back or neck pain, a Sesame healthcare provider is available to speak with you.
Baclofen – Muscle Relaxers
Baclofen, also known as Lioresal, is an antispastic medication used to treat spasticity (continuous muscle tightness or stiffness) caused by multiple sclerosis or spinal cord injury. It works by blocking nerve signals from the spinal cord to muscles that cause them to spasm. Like all Muscle Relaxers, it has a strong sedative effect and can cause drowsiness. It may be taken orally as tablets or granules, or it can be administered directly into the spinal canal through an implanted pump (intrathecal baclofen).
It’s important to remember that muscle relaxants are not cures for pain. They’re most effective when used short-term for the relief of specific symptoms, and they should not be taken unless prescribed by your doctor. Muscle relaxants can have serious side effects, especially if they’re taken in large doses or for extended periods of time. They may interfere with certain medical conditions, including seizures, heart rhythm disturbances, and breathing difficulties.
People with MS should use NSAIDs to relieve their pain and inflammation before considering a muscle relaxant, as an alternative. NSAIDs can also help with the spasticity, weakness, and mobility issues that are often caused by MS.
If you’re taking a muscle relaxant, be sure to tell your doctor about all the other medications (including OTC medicines and vitamins) you’re taking. This will help your doctor determine if the drug could interact with other drugs or supplements you’re taking to cause dangerous side effects.
Although it’s not clear exactly how skeletal muscle relaxants work, it is believed that they act directly on the muscles to reduce spasticity and pain. It’s possible that they may increase the effectiveness of some NSAIDs, but this combination is not generally recommended. Other types of drugs that can interact with muscle relaxants include antianxiety medications such as Valium (diazepam) or Xanax (alprazolam) and some narcotic pain medicines such as OxyContin (oxycodone), Ultram (tramadol), or Vicodin (hydrocodone/acetaminophen). It is not recommended to take both skeletal muscle relaxants and narcotics together, as this can lead to an uncontrolled and dangerous combination of depressant and sedative effects. This is called serotonin syndrome and can be very dangerous for people with MS.
Orphenadrine – Muscle Relaxers
Orphenadrine is a type of Muscle relaxer, and it works by changing the way your body senses muscle pain. It is usually used along with rest, physical therapy, and other treatments to help relieve the discomfort caused by sprains, strains, or other muscle injuries. It is available as an oral extended-release tablet and an intravenous injection that must be given by a healthcare professional.
Orphenadrine has a centrally-mediated muscle relaxant effect, and it also has antihistaminic and local anesthetic properties. It has a favorable effect on the rigidity and tremor of Parkinson’s disease by maintaining the physiological balance between cholinergic and dopaminergic neurotransmission in the basal ganglia. It also has a mild antidepressant action.
This medication may cause dizziness or lightheadedness, so it is important to avoid driving or operating machinery until you know how it affects you. In addition, this medication may decrease blood pressure and can cause drowsiness or confusion. Therefore, it is important to tell your doctor about all other medications you are taking, including vitamins and herbs.
To ensure that you get the best possible results, it is important to follow your doctor’s instructions exactly. Do not take this medicine in larger or smaller amounts or for longer than prescribed by your doctor. Also, tell your doctor if you are pregnant or breastfeeding, or if you have glaucoma; myasthenia gravis; ulcers; an enlarged prostate; or liver, kidney, or heart disease.
In a study, 30 patients with hepatitis C who complained of frequent muscle cramps were randomized to receive orphenadrine 100 mg twice daily or calcium carbonate 500 mg twice daily as a control for one month. The number, severity, and duration of the muscle cramps were recorded before and after treatment. The results showed a significant difference between the groups, with orphenadrine significantly decreasing the number of muscle cramps. This result was maintained after two weeks of washout for both groups.
This medication should not be taken with other drugs that make you sleepy or slow your breathing, such as sedatives (including benzodiazepines), alcohol, or narcotic pain medicines. This drug can cause a dangerous drop in blood pressure and fainting, especially when combined with these other drugs.