The Best Muscle Relaxants for Every Type of Pain
Various musculoskeletal conditions can lead to tense, cramping muscles or muscle spasms. Muscle spasticity occurs when skeletal muscles contract involuntarily and cannot relax. The symptoms can range from mild discomfort to intense, severe pain.
When muscle spasm symptoms are mild, over-the-counter medications like nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen) or Aleve (naproxen), in addition to stretching, and massage, can generally provide at-home relief, saving you time and money from a doctor’s appointment. However, depending on the severity, you may need to take medications called skeletal muscle relaxants to treat muscle spasms that are beyond at-home treatments.
This article will describe some of the commonly prescribed muscle relaxants. We will also discuss which muscle relaxant is best for different indications (types of muscle pain).
What are muscle relaxants?
As the name suggests, muscle relaxants (also called skeletal muscle relaxants) are medications that relax muscles or reduce tension in muscles which, in turn, alleviate the pain and discomfort caused by muscle spasms. Some of these medications work on the central nervous system (brain, brain stem, and spinal cord); typically, they inhibit activity between the nerve signals in the brain and the spinal cord. In other words, this type of muscle relaxant provides the muscle-relaxing effect by interfering with nerve activity, in turn, reducing the pain and discomfort caused by muscle spasms. Examples of centrally acting agents include baclofen, carisoprodol, methocarbamol, and tizanidine.
Other skeletal muscle relaxants act directly on the muscles; for example, oral dantrolene (Dantrium tablet). Botulinum toxin (Botox) is another skeletal muscle relaxant that acts directly on muscles.
Cannabis extract is believed to have dual muscle relaxant properties, i.e., both local and central effects.
What conditions do muscle relaxants treat?
Muscle relaxants are used to treat muscle spasticity (stiffness or rigidity). This can be caused by conditions such as cerebral palsy, multiple sclerosis, and stroke. The U.S. Food and Drug Administration (FDA) has approved three muscle relaxants—baclofen, tizanidine, and dantrolene—to treat muscle spasticity. Botulinum toxin is approved to treat a variety of medical conditions that affect how the body functions.
Muscle relaxants are also used to treat skeletal muscle spasms (tension, cramping, or involuntary contractions). For example, they are used to treat muscle spasms caused by conditions such as acute low back pain, tension headaches, and fibromyalgia. Some of the muscle relaxants used to reduce muscle spasms include cyclobenzaprine, methocarbamol, carisoprodol, metaxalone, chlorzoxazone, and orphenadrine. In general, doctors prescribe a locally or centrally-acting muscle relaxant to treat muscle spasms only after other treatments have failed.
Muscle relaxants are also used to treat seizure disorders, Parkinson’s disease, or alcohol withdrawal.
What is the most popular muscle relaxant?
Some of the popular and commonly prescribed muscle relaxants are briefly described below. These are prescription drugs and are typically only used when other medications like non-steroidal anti-inflammatory drugs (NSAIDs), have not provided sufficient pain relief from muscle spasms.
Baclofen
Brand names: Lioresal, Lioresal Double Strength.
Best for: Muscle spasms and tightness caused by spinal cord injuries and multiple sclerosis.
Dosage forms: Tablet, solution, suspension, packet.
Common side effects: Drowsiness, headache, nausea, vomiting, confusion, and muscle weakness.
Carisoprodol
Brand names: Soma, Vanadom.
Best for: Painful muscle and bone conditions like acute low back pain or neck pain.
Dosage forms: Tablet.
Common side effects: Drowsiness, dizziness, headache.
Note: Carisoprodol (Soma) tablet is a Schedule IV controlled substance with abuse potential (it can be habit-forming).
Methocarbamol
Brand names: Robaxin, Robaxin-750.
Best for: Painful muscle and bone conditions like back pain.
Dosage forms: Tablet, injection.
Common side effects: Dizziness, headache, blurred vision, flushing, nausea.
Tizanidine
Brand names: Zanaflex, Comfort Pac with Tizanidine.
Best for: Muscle cramping and tightness caused by multiple sclerosis and spinal cord injury.
Dosage forms: Tablet, capsule.
Common side effects: Fatigue, dizziness, dry mouth, constipation.
Chlorzoxazone
Brand names: Lorzone, Remular-S, Parafon Forte DSC.
Best for: Painful musculoskeletal conditions.
Dosage forms: Tablet.
Common side effects: Dizziness, drowsiness, nausea.
Cyclobenzaprine
Brand names: Flexeril, Amrix, Fexmid, FusePaq Tabradol.
Best for: Muscle spasms, pain, stiffness, and discomfort caused by strains and sprains.
Dosage forms: Tablet, extended-release capsule, suspension.
Common side effects: Dizziness, drowsiness, dry mouth, blurred vision.
Metaxalone
Brand names: Skelaxin.
Best for: Painful bone and muscle conditions like sprains, strains, and muscle injuries.
Dosage forms: Tablet, injection.
Common side effects: Dizziness, drowsiness, nausea, vomiting.
Orphenadrine
Brand names: Norflex.
Best for: Pain, discomfort, stiffness (increased muscle tone) caused by strains, sprains, and muscle injuries, shaking or trembling in Parkinson’s disease.
Dosage forms: Extended-release tablet.
Common side effects: Dry mouth, dizziness, heartburn, nausea, vomiting, difficulty urinating.
Dantrolene
Brand names: Dantrium.
Best for: Muscle cramps and tightness associated with conditions like multiple sclerosis, cerebral palsy, stroke, and spinal cord injuries.
Dosage forms: Capsule, injection.
Common side effects: Drowsiness, light sensitivity.
Which muscle relaxants are best for neck and back pain?
Skeletal muscle relaxants like cyclobenzaprine (Flexeril), methocarbamol (Robaxin), and carisoprodol (Soma) work well to relieve back and neck pain.
However, other drugs may work better for neck and back pain than muscle relaxants. The first line of treatment for muscle spasms and muscle pain is over-the-counter medications like Tylenol (acetaminophen) and nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen). Muscle relaxants do carry side effects just like any other medications. Dizziness is one of the common side effects caused by muscle relaxants. Some people find that taking an OTC pain reliever and muscle relaxant together provides maximum benefit, especially at night, to help with sleep problems and reduce daytime drowsiness.
Which is the best muscle relaxant medicine?
There is insufficient evidence to suggest that one skeletal muscle relaxant is better than the others. The choice of which medication to use for muscle spasms, or whether to use muscle relaxers at all, depends on various factors, such as your underlying condition, your preferences, your response to a medication, the potential for abuse, possible drug interactions, and adverse effects.
For example, if you have insomnia (trouble sleeping) due to muscle spasms, your doctor may prescribe sedating muscle relaxants like cyclobenzaprine or tizanidine. On the other hand, if you prefer a muscle relaxant with a less sedative effect, your healthcare provider may choose methocarbamol or metaxalone.
Muscle relaxants should always be used at the recommended dosage and for the prescribed time frame. Some muscle relaxants have abuse potential, especially with prolonged use. Many have a sedative effect and cause drowsiness and dizziness, so you should not drive or operate machinery until you know how the medicine affects you.
It is worth noting that muscle relaxant medications are intended for short-term relief. Muscle relaxants should be used with non-pharmacological approaches. You should work with your healthcare providers to develop a comprehensive recovery plan that includes rest, stretching, physical therapy, and exercise.
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