Key Takeaways
- Muscle relaxers treat muscle spasms (sudden, involuntary contractions) and muscle spasticity (continuous stiffness from brain or spinal cord injury). Prescription options include antispasmodics like cyclobenzaprine and antispastics like baclofen.
- Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen are recommended as first-line treatment for muscle spasms caused by acute lower back pain or tension headaches.
- Some muscle relaxants, such as carisoprodol and diazepam, can be habit-forming and may cause withdrawal symptoms. Talk with a healthcare professional if spasticity worsens, spasms become severe, or you experience side effects from your medication.
Muscle relaxers, or muscle relaxants, are medications used to treat muscle spasms or muscle spasticity.
Muscle spasms or cramps are sudden, involuntary contractions of a muscle or group of muscles. They can be caused by too much muscle strain and lead to pain. They’re
Muscle spasticity, on the other hand, is a continuous muscle spasm that causes stiffness, rigidity, or tightness that can interfere with walking, talking, or movement.
Muscle spasticity is caused by injury to parts of the brain or spinal cord involved with movement. Conditions that
Prescription drugs can help relieve pain and discomfort caused by muscle spasms or spasticity. In addition, certain over-the-counter medications may be used to treat aches and pains associated with muscle spasms.
Prescription medications are divided into two groups: antispasmodics and antispastics.
Antispasmodics are used to treat muscle spasms, and antispastics are used to treat muscle spasticity.
Some antispasmodics, such as tizanidine, can be used to treat muscle spasticity. However, antispastics should not be used to treat muscle spasms.
Antispasmodics: Centrally acting skeletal muscle relaxants (SMRs)
Centrally acting SMRs are used in addition to rest and physical therapy to help relieve muscle spasms. They’re thought to work by causing a sedative effect or by preventing your nerves from sending pain signals to your brain.
You should use these muscle relaxants for only
While antispasmodics can be used to treat muscle spasms, they have not been shown to work better than nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen. In addition, they have more side effects than NSAIDs or acetaminophen.
The more common side effects of centrally acting SMRs include:
- drowsiness
- dizziness
- headache
- nervousness
- lowered blood pressure upon standing
You should talk with your doctor about the benefits and risks of these medications for the treatment of your muscle spasms.
List of centrally acting SMRs
| Generic name | Brand name | Form | Generic available |
|---|---|---|---|
| carisoprodol | Soma | tablet | yes |
| carisoprodol/aspirin | not available | tablet | yes |
| carisoprodol/aspirin/codeine | not available | tablet | yes |
| chlorzoxazone | Parafon Forte, Lorzone | tablet | yes |
| cyclobenzaprine | Fexmid, Flexeril, Amrix | tablet, extended-release capsule | tablet only |
| metaxalone | Skelaxin, Metaxall | tablet | yes |
| methocarbamol | Robaxin | tablet | yes |
| orphenadrine | Norflex | extended-release tablet | yes |
| tizanidine | Zanaflex | tablet, capsule | yes |
Antispastics
Antispastics are used to treat muscle spasticity. They should not be used to treat muscle spasms. These drugs include the following:
Baclofen
Baclofen (Lioresal) is a skeletal muscle relaxer used to relieve spasticity caused by MS. Its mechanism of action is not fully understood. Still, it seems to block nerve signals from the spinal cord that cause muscle spasms. Side effects can include drowsiness, dizziness, weakness, and fatigue.
Dantrolene
Dantrolene (Dantrium) is a skeletal muscle relaxer used to treat muscle spasms caused by spinal cord injury, stroke, cerebral palsy, or MS. It works by acting directly on skeletal muscle to relax the muscle. Side effects can include drowsiness, dizziness, lightheadedness, and fatigue.
Diazepam
Diazepam (Valium) is a benzodiazepine used to relieve muscle spasms caused by inflammation, trauma, or muscle spasticity.
It works by increasing the activity of a specific neurotransmitter to reduce the frequency of muscle spasms. Diazepam is a sedative. Side effects can include drowsiness, fatigue, and muscle weakness.
List of antispastics
| Generic name | Brand name | Form | Generic available |
|---|---|---|---|
| baclofen | Lioresal, Gablofen, Lioresal | tablet, injection | yes |
| dantrolene | Dantrium | tablet | yes |
| diazepam | Valium | oral suspension, tablet, injection | yes |
Muscle relaxants such as carisoprodol and diazepam can be habit-forming. Be sure to take your medication exactly as prescribed by your doctor.
Muscle relaxants
Also, muscle relaxants depress your central nervous system (CNS), making it hard to pay attention or stay awake. While taking a muscle relaxant, avoid activities that require mental alertness or coordination, such as driving or using heavy machinery.
Did you know? You should not take muscle relaxants with:
- herbal supplements such as St. John’s wort
- alcohol
- CNS depressant drugs, such as opioids or psychotropics
- sleeping medications
Talk with your doctor about how you can safely use muscle relaxants if you:
- are older than 65 years
- have a mental health problem or brain disorder
- have liver problems
Doctors can use certain medications to treat spasticity even when the drugs are not approved for that purpose by the U.S. Food and Drug Association (FDA). This is called off-label drug use.
The following drugs are not actually muscle relaxants, but they can still help relieve symptoms of spasticity.
Benzodiazepines
Benzodiazepines are sedatives that can help relax muscles. They work by
Examples of benzodiazepines include:
- clonazepam (Klonopin)
- lorazepam (Ativan)
- alprazolam (Xanax)
Caution: Side effects of benzodiazepines can include drowsiness and problems with balance and memory. These drugs can also be habit-forming.
Gabapentin
Gabapentin (Neurontin) is an anticonvulsant drug
OTC treatment is recommended as first-line therapy for muscle spasms caused by conditions such as acute lower back pain or tension headache. This means you should try OTC treatments before prescription medications.
OTC treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or a combination of both. Your doctor or pharmacist can help you choose an OTC treatment.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs
NSAIDs come as oral tablets, capsules, or suspensions. They also come as chewable tablets for children. Side effects of these drugs can include upset stomach and dizziness.
Examples of NSAIDs include:
Acetaminophen
Acetaminophen (Tylenol) is thought to work by
The more common side effects of acetaminophen can include nausea and upset stomach.
Studies
However, research on the medicinal properties of cannabis is limited, as its cultivation, supply, and possession are still prohibited in many areas.
Therefore, more research is needed to understand whether cannabis or the compounds it contains could help ease muscle spasms or muscle spasticity.
When to call a doctor
You can often manage your muscle spasm or spasticity symptoms on your own, but in some cases, you may need medical advice or care. Be sure to call your doctor if you:
- have increasing discomfort or pain
- have spasticity for the first time and don’t know the cause
- notice the spasticity is getting more severe, happening more often, or making tasks difficult
- have severe and frequent muscle spasms
- notice deformity of the parts of your body affected by muscle spasms
- have side effects from your muscle relaxant
- have a “frozen joint” due to contracture that decreases your range of motion or causes pressure sores
What are the top 5 muscle relaxers?
The options will depend on your needs and other factors, but five commonly prescribed drugs are:
- baclofen (Lioresal)
- dantrolene (Dantrium)
- carisoprodol (Soma)
- clorzoxazone (Lorzon)
- methocarbamol (Robaxin)
Is there an over-the-counter muscle relaxer?
There are currently no over-the-counter muscle relaxers in the United States, but acetaminophen and NSAIDs, such as ibuprofen, can help manage sore muscles.
Are muscle relaxants safe to take?
This will depend on your individual needs, as some types can form a dependence. Some may also interact with alcohol and other drugs. Always discuss the benefits and risks of a muscle relaxer with your prescribing doctor, and follow any instructions carefully.
It’s important to treat both spasticity and muscle spasms. Severe, long-term spasticity can lead to muscle contracture, which can decrease your range of motion or leave the affected joints permanently bent.
Muscle spasms can be not only uncomfortable but also a sign of an underlying medical problem.
Your muscle spasms or spasticity are likely treatable with rest, physical therapy, medications, or any combination of these. Work with your doctor to put together a care plan that can ease your pain and get you moving comfortably again.
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