A muscle spasm means one or more of your muscles contract, and the cramp is out of your control. It can occur for many different reasons and can sometimes be very painful. You may reach a point with chronic back pain when stretching, ice, and rest usually don't cut it.
Although these alternative methods are tried and work well, your spine specialist may also recommend pain medication daily or as needed. It's no wonder that pain medication has become more prevalent.
According to the Centers for Disease Control and Prevention, about one in five U.S.adults struggle with chronic pain. These pain medications can either be over-the-counter or, if you need something more robust, can be prescribed by your doctor. Over-the-counter medications include acetaminophen or paracetamol. While these drugs usually work for most people, sometimes they're not enough.
Next come NSAIDs like naproxen sodium and ibuprofen. But these aren't for continued use because of the risks involved. After these pain medications, the doctor may prescribe a muscle relaxant instead. Often, these are given to patients with acute pain. There are two classes of muscle relaxants- Antispasmodics and Antispastics. Continue reading the blog for further details.
Muscle relaxers (or skeletal muscle relaxants) are medications that relax muscles or reduce muscle tension, alleviating the pain and discomfort caused by muscle spasms.
Some muscle relaxant (Antispasmodics) provides the muscle-relaxing effect by interfering with nerve activity, reducing the pain and discomfort caused by muscle spasms. Examples of centrally acting agents include Baclofen, Carisoprodol, Methocarbamol, and Tizanidine.
Other skeletal muscle relaxants (Antispastics) act directly on the muscles; for example, oral dantrolene (Dantrium tablet). Botulinum toxin (Botox) is another skeletal muscle relaxant that works now on muscles.
Cannabis extract is believed to have dual muscle relaxant properties, i.e., both local and central effects. Muscle relaxers are effective short-term treatments and should be used to treat acute pain or injury caused by muscle spasms rather than chronic pain.
Individuals should not take muscle relaxers for more than two or three weeks unless directed by the concerned medical practitioner. Because of the risk of dependence and abuse, these medicines are not recommended for people over 65.
Muscle relaxers relieve tense muscles, contractions, and tissue stiffness by different methods. Most muscle relaxers act as CNS depressants and cause sedation or prevent your nerves from sending pain signals to your brain. There are two categories of muscle relaxants.
Muscle relaxants directly affect the skeletal muscles or spinal cord, improving muscle tightness (hypertonicity) and involuntary spasms. These are recommended for chronic pain involving CNS or spinal cord dysfunction. These drugs are frequently prescribed for multiple sclerosis and spinal cord injuries.
It blocks the transmission of specific neurons in the brain. They decrease spasticity and muscle spasms by directly affecting the central nervous system. These are most recommended for acute back pain.
While both drugs can relax muscles and ease pain caused by spasms or tight muscles, they are used for different purposes and have other side effects.
Muscle relaxers are medications patients use to treat acute and chronic pain conditions. These relieve tense muscles, contractions, and tissue stiffness by different methods. Usually, OTC muscle relaxants are used for short-term pain, and prescription muscle relaxers are used for long-term pain.
A medical practitioner might prescribe muscle relaxants for people with muscle pain and spasms. These medicines help alleviate muscle pain and tightness by reducing muscle contraction. While these medications are beneficial for short-term use, they may not be appropriate for everyone because of the associated adverse effects. The muscle relaxers are available in two classes- Antispasmodics and Antispastics.
Antispasmodic muscle relaxants decrease muscle spasms by altering conduction in the CNS. Antispasmodics can be benzodiazepines (block certain chemicals in the brain) and non-benzodiazepines (act on the spinal cord and brain). Potential side effects of antispasmodics typically involve drowsiness, dizziness, and headaches.
Some Muscle relaxers can be addictive, so using them for the short term is advisable. Apart from this, people who take drugs that affect serotonin should not take antispasmodics because of the risk of serotonin syndrome.
|
Antispasmodic drug |
Definition |
Age limit |
Dosage |
Miscellaneous |
|---|---|---|---|---|
|
Non-benzodiazepine drug for the relief of acute, painful muscle conditions. |
Ideal for the age group 17 65 years |
Recommended dosage is 250-300 mg thrice daily at bedtime Prescribed for max. 3 weeks |
There is a risk of developing a dependency on Carisoprodol. |
|
|
Chlorzoxazone (Lorzone) |
Non-benzodiazepine drug for the relief of acute, painful muscle conditions. |
Above 18 years old |
Recommended dosage is 5 - 7.5 mg thrice daily Max. the dose is 30 mg daily |
Chlorzoxazone has the potential for addiction |
|
Cyclobenzaprine (Flexeril, Amrix) |
Non-benzodiazepine drugs given in combination with physical therapy, and other non-drug treatment strategies for painful muscle conditions |
Above 12 year old |
Recommended dose is 800 mg three to four times daily |
Cyclobenzaprine has the potential for addiction |
|
Metaxalone (Skelaxin) |
Non-benzodiazepine drugs indicated for acute, painful musculoskeletal conditions |
Above 12 year old |
800 mg thrice to four times daily as per requirement |
It is not a controlled substance and cannot cause dependence when taken within prescribed limits |
|
Methocarbamol (Robaxin) |
Relieves short-term acute pain and stiffness caused by injury. This includes sprains, strains, and fractures. |
Above 16 year old |
recommended dosage for muscle stiffness is- Three 500 mg four times or two 750 mg tablets four times daily |
It isn't addictive when used within prescribed limits. At higher doses, it has an increased potential for abuse |
|
Norflex (Norgesic) |
Indicated for the relief of discomfort, muscle spasms, and acute painful musculoskeletal conditions |
Above 12 year old |
Recommended dose is 100 mg twice daily |
Norflex has the potential for addiction |
Antispastic muscle relaxants act on the muscle cells and spinal cord to improve muscle tightness and relieve spasms. They inhibit the transmission of neurons in the brain. These drugs include Baclofen and Tizanidine, prescribed for conditions that cause muscle spasms, such as cerebral palsy or multiple sclerosis (M.S.). General side effects of antispastics include drowsiness and muscle weakness.
|
Antispastic drug |
Definition |
Age limit |
Dosage |
Miscellaneous |
|---|---|---|---|---|
|
Baclofen (Lioresal) |
It is a skeletal muscle relaxant for managing M.S., flexor spasms, and spinal cord injuries |
Above 12 year old |
Initial dose- 5 mg or 50 mcg, adjusted after 24 hours if needed Can be taken for long-term |
There is a risk of getting addicted to Baclofen |
|
Tizanidine (Zanaflex) |
Is a skeletal muscle relaxant that has both antispastic and antispasmodic effects Helpful in M.S. and spinal cord injuries |
Above 18 years old |
Recommended dosage is 2 to 4 mg tablets every 6 to 8 hours |
Tizanidine is not addictive like opioids or benzodiazepines are, but it can lead to tolerance and physical dependence |
A person may use OTC pain relievers for mild to moderate muscle pain. These can include NSAIDs that help treat or relieve pain by reducing inflammation. Examples of OTC NSAIDs include- Aspirin, Ibuprofen, Naproxen, and Tylenol.
These medications reduce the production of prostaglandins, which the body produces after injury or illness. They also block an enzyme called cyclooxygenase (COX), which helps to create prostaglandins. Potential side effects of OTC NSAIDs include dizziness, headache, drowsiness, and gastrointestinal problems.
|
OTC drugs |
Definition |
Age limit |
Dosage |
Miscellaneous |
|---|---|---|---|---|
|
Aspirin |
An NSAID to treat headache, period pain, toothache, or other pain relief. |
Above 16 years |
The recommended dose is one or two 300mg tablets, taken every 4 to 6 hours.
|
For short-lived pain, take Aspirin for 1 or 2 days or as recommended by your doctor |
|
Ibuprofen (Brufen) |
An NSAID to treat headache, period pain, toothache, or other pain relief such as sprains and strains. |
Above 17 years |
A usual adult dose is one or two 200mg tablets thrice daily. Or the doctor might prescribe a higher dose as per requirement. |
Is non-addictive |
|
Naproxen (Anaprox DS) |
An NSAID to treat period pain, O.A., gout, R.A., swelling, and pain in joints and muscles. |
Above 15 years |
Joint pain- 500mg to 1000 mg daily Muscle pain- 500mg every 6 to 8 hours initially |
Is non-addictive |
|
Tylenol (Acetaminophen) |
It is a non-aspirin painkiller that helps to reduce pain symptoms and fever |
Suitable for all ages, but the dosage may vary |
For adults and children over 12 years: take 2 caplets every 4 6 hrs For children 6 to 11 years: take 1 caplet every 4 6 hrs |
Is non-addictive |
In some cases, doctors may prescribe Anxiety medication as muscle relaxers for anxiety. But that does not primarily treat muscle pain but may help relieve pain or spasms. These treatments can include the use of benzodiazepines which help manage the following:
A doctor may prescribe them off-label to relieve muscle pain. These medications do not relieve pain but may help alleviate muscle spasms if a person takes them for a short period. They enhance the effect of GABA neurotransmitters that can have soothing properties.
Examples of benzodiazepines include:
Common side effects of benzodiazepine include confusion, drowsiness, and breathing difficulties. These drugs can also be habit-forming.
Gabapentin is an anticonvulsant drug to treat seizures, relieve nerve pain, and treat restless leg syndrome. It works by changing electrical activity in the brain and influencing neurotransmitters, which can alter how the body senses pain. Common side effects of gabapentin include fatigue, dizziness, and headaches.
Clonidine is an anti-hypertensive drug, but it has also been used for drug detoxification, pain relief, and sedation. It works by changing some of the nerve impulses in the brain. This results in the relaxing of the blood vessels, and blood passes through them more easily. Common side effects of Clonidine include anxiety, confusion, and discomfort.
Muscle relaxers can help alleviate back pain, but people should know their potential side effects and risks. Some muscle relaxers, however, can have potentially severe side effects, like liver damage.
Contact your doctor if you experience these side effects, and they are severe or bothersome. Your pharmacist/ doctor will work with you to find the best-suited medicine and advise you on managing side effects effectively.
|
Common Side Effects |
Severe Side Effects |
|
Dizziness |
Confusion |
|
Drowsiness |
Urinary retention |
|
Fatigue |
Light-headedness or fainting |
|
Constipation |
Reduced blood pressure |
|
Tiredness |
Blurred vision |
Avoid drinking alcohol while taking muscle relaxers, as it interferes with the body's functioning and can increase your risk of an accident.
Before you start taking any muscle relaxant, inform your doctor of any allergies or medical conditions you have suffered or are suffering, any medicine you are taking, and other significant facts about your health or whether you are pregnant or breastfeeding.
Drug interactions may be classified into drug-drug interactions, drug-food interactions, and drug-condition interactions. Muscle relaxants interact with an extensive range of other drugs and diseases. Some medicines that interact with these muscle relaxers include antidepressants, painkillers, benzodiazepines, alcohol, anesthetic agents, cocaine, and weed.
Further, other interactions include-
Other drug classes interacting with muscle relaxants include anticonvulsants, antiarrhythmics, and inhaled anesthetics.
Taking medicines correctly at the right time and in the right way as your doctor prescribes can help keep you healthy and control medical issues. Muscle relaxers help relieve muscle pain and spasms but can cause side effects.
The best option depends on the injury or underlying condition and factors such as the person's age and current medications. There are risks involved in taking prescription or OTC muscle relaxers. Consult a doctor or pharmacist first and follow the instructions closely.
