Various musculoskeletal conditions can cause skeletal muscles to contract involuntarily, leading to tense and cramping muscles or muscle spasms. The symptoms can range from mild discomfort to intense, severe pain. 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 for different types of muscle pain.

Which muscle relaxants are best for different types of pain?

Certain muscle relaxant properties make them especially useful in treating certain types of pain. The best muscle relaxers for specific kinds of pain are listed below.

Sciatica: Nerve pain medications such as gabapentin (Neurontin) and pregabalin (Lyrica).
Back and neck pain and muscle spasms: Tizanidine (Zanaflex) and baclofen (Lioresal).
TMJ: Cyclobenzaprine (Flexeril) and tizanidine (Zanaflex).
Tension headaches: Baclofen (Lioresal) and tizanidine (Zanaflex).
Fibromyalgia: Tizanidine (Zanaflex) and cyclobenzaprine (Flexeril).
Muscle spasticity from stroke: Baclofen (Lioresal), tizanidine (Zanaflex), and dantrolene (Dantrium).
Cerebral palsy: Diazepam, baclofen, gabapentin, dantrolene.
Multiple sclerosis: Centrally acting agents like baclofen (Lioresal), tizanidine (Zanaflex), oral dantrolene (Dantrium) tablet.
Parkinson’s disease: Orphenadrine, tizanidine.

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What conditions do muscle relaxants treat?

Muscle relaxants are used to treat muscle spasms caused by conditions like back pain, fibromyalgia, stroke, cerebral palsy, and multiple sclerosis. They are also used to treat epilepsy (seizure disorders), Parkinson’s disease, and alcohol withdrawal.

Prescription muscle relaxers are used when over-the-counter medications, stretching, massage, and physical therapy don't provide relief.

The U.S. Food and Drug Administration (FDA) has approved several skeletal muscle relaxants such as baclofen, tizanidine, cyclobenzaprine, and dantrolene to treat muscle spasticity. Botulinum toxin is also approved to reduce muscle spasticity and pain associated with several disorders.

Top prescription muscle relaxants

Baclofen (Brand names: Lioresal, Lioresal Double Strength)

Best for: Muscle spasms and muscle 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.

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.

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.

Orphenadrine (Brand names: Norflex)

Best for: Stiffness, pain, and discomfort caused by strains and sprains, trembling caused by Parkinson’s disease.
Dosage forms: Extended-release tablet.
Common side effects: Dry mouth, dizziness, drowsiness, blurred vision, nausea, vomiting, constipation.

Chlorzoxazone (Brand names: Lorzone, Parafon Forte DSC, Remular-S)

Best for: Acute muscle pain.
Dosage forms: Tablet.
Common side effects: Drowsiness, lightheadedness, headache, tiredness, upset stomach.

Metaxalone (Brand names: Skelaxin)

Best for: Short-term muscle pain and spasm.
Dosage forms: Tablet.
Common side effects: Drowsiness, dizziness, nausea, vomiting, upset stomach.

Strongest over-the-counter muscle relaxer

Non-pharmacological treatments and over-the-counter medications are usually tried before using prescription muscle relaxants as they can help to control pain from muscle tension. They also have anti-inflammatory and muscle-relaxing effects.

Naproxen (Aleve) is one of the strongest OTC medications for muscle pain, cramps, and spasms. Its effects last for 8-12 hours compared to ibuprofen, which typically lasts 4-6 hours.

Acetaminophen, aspirin, and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) and naproxen (Aleve) can be purchased without a doctor’s prescription.

Strongest prescription muscle relaxer

There is no clear evidence that one prescription muscle relaxant is stronger or better than the other prescription drugs. Certain medications work better for different indications.

Your doctor will choose the best muscle relaxant depending on your symptoms, such as pain, increased muscle tone, or muscle spasms.

Best painkiller and muscle relaxant combination

Some combination painkillers and muscle relaxants that can reduce muscle spasms and provide pain relief include:

Norgesic Forte (orphenadrine, aspirin, caffeine)
Soma Compound (carisoprodol, aspirin, codeine)

Non-drowsy or the least sedating muscle relaxants

Methocarbamol
Metaxalone

Best muscle relaxants for the elderly

Baclofen
Tizanidine

Muscle relaxants such as carisoprodol, cyclobenzaprine, chlorzoxazone, and orphenadrine are avoided in older adults due to the risk of sedation and falls.

What are the most popular muscle relaxants?

The most popular muscle relaxers include:

Flexeril or Amrix (cyclobenzaprine): often used short-term to treat muscle spasms and pain related to sprains and strains.
Soma (carisoprodol: used to treat muscle pain and discomfort.
Robaxin (methocarbamol): used to treat muscle spasms and pain.
Tizanidine (Zanaflex): used to relieve common complaints like back and neck pain.

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 medication for muscle spasms, or whether to use muscle relaxers at all, depends on various factors, such as your underlying condition, preferences, 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 a sedating muscle relaxant like cyclobenzaprine.

On the other hand, if you prefer a muscle relaxant with a less sedative effect, your healthcare provider may choose methocarbamol or metaxalone.

What precautions should I take on skeletal muscle relaxants?

Muscle relaxants carry side effects just like any other medication. 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.

Your doctor will prescribe muscle relaxers if the benefits outweigh the risks. Read the prescription label and package insert carefully. Always take a muscle relaxer at the recommended dosage and for the prescribed time frame.

Follow the dosing instructions carefully. Your doctor may start you on a low dose and gradually increase the initial dose based on your response. Some muscle relaxers have the potential for abuse, especially with prolonged use.

Many cause central nervous system (CNS) depression and have a sedative effect, causing drowsiness and dizziness. Do not drive or operate machinery until you know how the medicine affects you.

Remember that muscle relaxant medications are intended for short-term relief of muscle spasms and not chronic pain management.

Muscle relaxants should be used along 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 to treat muscle spasms.

What are muscle relaxants?

Muscle relaxants are medications used to treat musculoskeletal conditions such as skeletal muscle spasms, muscle spasticity, muscle pain, and muscle weakness. Spasms and spasticity occur when skeletal muscles contract involuntarily, and the muscle cells are unable to relax.

There are mainly two types of muscle relaxers. A centrally acting muscle relaxant acts on the central nervous system and reduces nerve signals, causing muscle tension. Other skeletal muscle relaxants act directly on the muscle cells themselves to treat muscle spasms.