Muscle relaxers: Think twice before popping prescription drugs for muscle pain


Last Updated June 24th, 2019

What are muscle relaxers?

These are drugs used to treat muscle spasm as well as muscle spasticity.  Sudden involuntary contractions of a muscle or group of muscles can lead to muscle spasms or cramps.  Excessive muscle strain is considered to be one of the causes of muscle spasm.  The symptoms may include lower back pain, neck pain, as well as fibromyalgia.  A continuous muscle spasm is called muscle spasticity.  Muscle spasticity causes stiffness, rigidity as well as tightness in the muscles. 

This may affect the way you walk, talk, or move.  An injury caused to the parts of the brain or spinal cord can lead to muscle spasticity.  Some of the medical conditions associated with muscle spasticity include multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), and cerebral palsy.  Muscle relaxers are referred to two main categories of therapeutics namely spasmolytics and neuromuscular blockers.  Spasmolytics are used to treat spasms and reduce spasticity whereas neuromuscular blockers are used during surgical procedures to cause temporary paralysis.

Muscle relaxant drugs are in use since early times as early as the 16th century.  The natives of South America used poison-tipped arrows to cause death by skeletal muscle paralysis.

Prescription medications

There are two types of prescription medications available as muscle relaxers and are called antispasmodics and antispastics.  Muscle spasms are treated with the help of antispasmodics whereas muscle spasticity is treated with the use of antispastics.

Antispasmodics:  This drug works by causing a sedative effect and preventing the nerves from sending pain signals to the brain.  These drugs are used to treat spasms, but a better choice would be NSAIDs.  They also have numerous side effects associated with them namely drowsiness, headache, dizziness, nervousness, orange urine, as well as a reduction in blood pressure upon standing.

Antispastics:  This drug is used to treat muscle spasticity.  Some of the widely used antispastics are discussed below:

  • Baclofen:  It is used to relieve spasticity due to multiple sclerosis.  It seems to block nerve signals from the spinal cord that cause muscle spasm.
  • Dantrolene:  Spinal cord injury, stroke, as well as cerebral palsy related muscle spasms can be treated with this drug.  It is known to directly act on skeletal muscle to relax the muscle spasm.
  • Diazepam:  Inflammation, trauma, or muscle spasticity related muscle spasms are treated with this drug.  It increases the activity of a neurotransmitter that decreases muscle spasms.

When are they prescribed?

For muscle spasms:  This occurs when muscles become tight and cramp up suddenly.  It is generally associated with severe pain.  Lifting heavy object or twisting the body may cause back or neck spasm.  It is prescribed with a combination of pain relievers to ease the spasm.

Emergency room care:  It is common for people to come to the emergency room with a complaint of back pain.  Initially, it is first determined if the problem is related to a serious underlying issue such as a fracture.  Once it is determined that it is not associated with any serious issues, then muscle relaxers can be prescribed on a short-term basis.  It can be taken with a combination of painkillers for a short period if the pain is excruciating so as to take the edge off, but should not be continued on a long-term basis.

Following spine surgery:  Following surgery, it is quite common for a person to have muscle spasms.  Muscle spasms may occur in parts of the body well away from the surgery.  The patient is initially treated with muscle relaxants in the hospital followed by a prescription which needs to be followed at home.  It is very important to follow the instructions from the doctor as each pill is accounted for.  It is advised to discuss with your doctor about the schedule of taking medications.  It is advised to take muscle relaxers and pain medications at a different time to provide better pain management as compared to taking it at the same time.  This is helpful when one medication fades off the other will kick in to provide pain relief.

During physical therapy:  When you are beginning a new physical therapy program, you may be prescribed with muscle relaxants to avoid soreness associated with physical therapy.  Physical therapy may involve bending and stretching that can flare up the pain level.  Taking muscle relaxers helps in reducing this and enables you to perform better with physical therapy.

Potential side-effects of pharmaceutical muscle relaxers

May cause dependence:  These drugs are prescribed early in a course of back pain but on a short-term basis.  This is done keeping in mind the potential for dependence or abuse.  The prescriptions provided to a patient should be accounted for as it is illegal to share these types of drugs.

Interacts with antihistamines:  Studies have indicated that it is quite dangerous to combine muscle relaxants and antihistamines.  One of the important side effects is associated with drowsiness.  Studies have indicated that the combination of these two medications to be linked to an increase in emergency room visits.

Interacts with alcohol:  It is considered dangerous to consume alcohol when taking muscle relaxants. It is believed that alcohol can increase the sedative effect when it is combined with muscle relaxant and this is considered dangerous.

May cause allergic reactions:  A person may experience swelling in the throat, difficulty breathing, rashes, as well as chest tightness that are considered to be an allergic reaction to medications.  It is highly advised that this type of medication should never be taken even if the reaction was mild initially.

It limits the daily activities:  Muscle relaxers promote relaxation to the whole body and are known to induce sleepiness and loss of balance.  Due to this reason, it is not safe to operate machinery or drive.  A long-acting muscle relaxant is advised to be taken during the evening as it induces sedative effect up to 12 hours.  There are short-acting drugs available, which provide a milder effect and are suitable for morning dose.

Withdrawal:  Studies have indicated that stopping these types of drugs abruptly can lead to withdrawal.  It is highly recommended to take advice from your doctor to know how it can be stopped.  Generally, the dose is tapered down gradually over a period of time and then finally stopped.

People may also experience symptoms such as breathing problems, blurred vision, light-headedness or fainting, confusion, etc.  It is recommended to notify the doctor immediately when these side effects occur.

Natural muscle relaxers

Cherry juice:  They have a high concentration of antioxidants and anti-inflammatory compounds.  Studies have indicated that drinking cherry juice can reduce pain and muscle damage associated with exercise.  It is advised to use a concentrated form of cherry juice to obtain the benefits rather than the diluted form.

Blueberries:  They have a high concentration of antioxidants and polyphenols, which provide anti-inflammatory effects.  Exercise performance can be increased with the use of blueberries.  They also aid in decreasing inflammatory markers.  Due to this property, it helps the muscle to relax and recover after a workout.

Protein:  Proteins help reduce muscle inflammation.  Studies have indicated that exercise induces muscle damage can be recovered with the use of whey and casein, which are two types of protein.  It also indicates that people consuming protein and carbohydrate foods before a marathon experience lesser soreness as compared to others.

Magnesium:  Muscle contraction is highly dependent on magnesium.  It plays an important role in various bodily functions.  Almonds, cashews, spinach, black beans, edamame are rich sources of magnesium.  They are also available in supplement form, which can be consumed on a daily basis when prescribed by the doctor.

Turmeric:  It contains an important ingredient called curcumin.  It is known for anti-inflammatory properties. Studies have indicated that curcumin can decrease inflammatory markers after exercise.  Consuming any food containing curcumin can help relax muscles.

Pomegranate juice:  They have a high concentration of polyphenols.  It is believed that the antioxidant property of pomegranate is three times higher than green tea.  Studies have also indicated that pomegranate juice speeds up muscle recovery.

Arnica:  It is an ingredient used in creams and oils to reduce bruising.  It is generally used topically since high doses of arnica can be life-threatening.  Many use this as a muscle relaxant remedy.  Researchers are yet to prove their effectiveness.  According to a few people, it is helpful in reducing the soreness associated with marathon runners.

Capsaicin:  This ingredient is found in chili peppers.  Studies have indicated that they are helpful in providing relief to people suffering from fibromyalgia.  It is available as a cream, which can be applied to sore areas to get relief from muscle soreness.  Studies have indicated that it is more beneficial in providing treatment to nerve pain as compared to inflammatory muscle pain.  This is accomplished when capsaicin reduces the density of nerve fibers underneath the skin.

Lemongrass:  Lemongrass oil and tea have been used for a very long time to treat arthritic joint pain and inflammation.  Studies have indicated that they are effective in treating inflammation and nerve pain.

Peppermint oil:  It is considered to be the home remedy for various muscle pains.  Topical use is also associated to relieve sprains and provides a cooling effect to the area.  It also provides muscular relaxation.  Caution is advised to people suffering from liver or gallbladder problems, as peppermint oil is not suitable to them.

Important advice for pharmaceutical muscle relaxer users

People who are 65 years and older are recommended not to take muscle relaxants.  The sedating effects of muscle relaxants are intense and there is a high probability that they may have a fall and can lead to other complications.

Secondly, older people generally take medication on a regular basis for diabetes or hypertension.  Muscle relaxants are known to interact with other medications and hence this may cause some serious side effects.  It is advised that pregnant woman should avoid muscle relaxants during pregnancy as well as during breastfeeding.

People suffering from psychological disorders such as stress and depression should avoid muscle relaxers.

There are several other natural foods available to promote the effect of muscle relaxation.  It is advised to try these first before choosing for a prescribed muscle relaxant.

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