Muscle relaxants are widely utilized in the treatment of both acute, self-limited conditions and chronic diseases in order to help alleviate pain from muscle spasms and help return a patient to his previous level of activity. They are prescribed for a wide range of conditions, including the treatment of low back and neck pain, temporomandibular joint (TMJ) disorder, tension headaches and fibromyalgia. Multiple sclerosis, cerebral palsy, spinal cord injuries and post-stroke patients can also benefit from muscle relaxers.
Acute Muscle Spasm
According to American Family Physician, the most commonly prescribed muscle relaxant in the United States is cyclobenazeprine (Flexeril). Medications such as cyclobenazeprine, methocarbamol (Robaxin) and metaxalone (Skelaxin) are often prescribed for the treatment of acute lower back and neck pain.
TMJ disorder, a painful and common condition affecting the jaw joint and surrounding muscles, responds favorably to treatment with muscle relaxers when conservative therapy (rest, heat/ice and non-steroidal anti-inflammatory drugs like ibuprofen) fails. Muscle relaxers also show some benefit in the treatment of both migraine and tension headaches, although they are not among the first-line treatment options.
Chronic Conditions
Patients with diseases such as multiple sclerosis and cerebral palsy, or conditions such as stroke and spinal cord injury, can suffer from painful muscle spasticity. Muscle relaxants such as baclofen (Lioresal), dantrolene (Dantrium) and tizanidine (Zanaflex) are often prescribed for the long-term management of muscle spasticity.
Fibromyalgia and myofascial pain syndrome are chronic conditions associated with generalized musculoskeletal pain that often require a multi-treatment approach. Cyclobenazeprine has been shown to reduce pain and improve sleep in some of these patients.
Side Effects
All muscle relaxants share the common side effects of sedation, fatigue and dizziness. Use of these medications in the elderly has been shown to increase the risk of falls, confusion and sleep disturbances (including hallucination).
Two commonly prescribed muscle relaxants, diazepam (Valium) and carisoprodol (Soma) have significant risks of physical dependence and abuse. Cyclobenazeprine adversely interacts with many other medications and must be used with caution.
References
- American Family Physician: Choosing a Skeletal Muscle Relaxant
- "The Pharmacological Basis of Therapeutics"; Goodman and Gilman; 2006
- American Family Physician: Temporomandibular Disorders
