Fact Checked

What Do Muscle Relaxers Do?

If you’ve ever struggled with lower back pain, had certain types of surgery, or are affected by certain chronic muscular conditions like multiple sclerosis, you are unfortunately familiar with the pain associated with muscle spasms and tightness. When you’re in pain and you’ve tried over the counter pain relief medications like Tylenol (acetaminophen) and Advil (ibuprofen) with no relief, it can be frustrating to feel like there’s nothing that can be done. In situations involving muscular injuries, muscle relaxants may be able to offer relief to patients in specific circumstances. So, what do muscle relaxers do and how do they work?

What Do Muscle Relaxers Do?

Muscle relaxers help to relieve spasms that may be occurring in your muscles as a result of injury or certain medical conditions. When experience spasticity, they begin to contract, twitch, cramp, and tighten out of your control, which can be extremely painful. Doctors use muscle relaxers as treatment options to help reduce the discomfort associated with muscle spasms. Although they are primarily used to treat chronic pain and spasm associated with chronic conditions like cerebral palsy, fibromyalgia, spinal cord injury, or multiple sclerosis, muscle relaxers have a general relaxing effect on the body that makes them useful in other situations as well. Muscle relaxers are sometimes used to treat anxiety or difficulty sleeping (insomnia), and some doctors give muscle relaxers to their patients prior to surgery to help reduce discomfort and anxiety. Muscle relaxants like diazepam or Valium can also be used to treat seizures. 

How Do Muscle Relaxers Work?

While we often refer to muscle relaxers as one class of medications, the medications work in many different ways. However, all of them cause the muscles to relax and reduce tightness and stiffness, which helps to alleviate pain and discomfort. Several muscle relaxers, including baclofen, cyclobenzaprine, carisoprodol, metaxalone (Skelaxin), diazepam, orphenadrine (Norflex), tizanidine (Zanaflex), and methocarbamol (Robaxin) take action on the central nervous system, including the brain and spinal cord. These antispasmodic muscle relaxers are also effective in treating anxiety and insomnia in addition to muscle spasms and pain, as they have a relaxing effect on the entire body. Other muscle relaxers, including dantrolene, work directly on the muscle. Dantrolene is associated with fewer side effects than other muscle relaxants because it works on the muscles themselves rather than the central nervous system. Therefore, it is more appropriate for patients who need to take muscle relaxers for an extended period of time due to the nature of their condition. 

Why Do People Take Muscle Relaxers?

There are many different reasons why patients take muscle relaxants, but the most common reasons are to treat muscle spasms resulting from injury or a medical condition affecting the central nervous system, including:

  • Injuries to the head or back causing neck pain and low back pain that cannot be treated with over the counter medications like nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Whiplash
  • Multiple sclerosis
  • Cerebral palsy
  • Motor neuron disease

There are also several conditions that are not related to muscle spasms or tightening that may cause people to take muscle relaxers. Each of these conditions is impacted by the central nervous system, so muscle relaxers that work on the central nervous system can help alleviate their symptoms. Other conditions for which people take muscle relaxers include:

  • Anxiety
  • Insomnia
  • Seizures
  • Pre-surgery anxiety or discomfort

Are There Any Side Effects Associated With Muscle Relaxers?

Like many medications, there are side effects associated with the use of muscle relaxers. Regardless of how they work, the majority of muscle relaxers list muscle weakness as a possible side effect. While each medication will have its own individual list of side effects, some side effects that are common with most muscle relaxers include:

  • Muscle weakness
  • Drowsiness
  • Agitation
  • Headache
  • Dry mouth
  • Dizziness
  • Irritability
  • Nervousness
  • Decreased blood pressure

Not all patients will experience side effects while taking muscle relaxers, and your doctor will consider your age, condition, and medical history when providing your prescription in order to minimize your risk of side effects. Patients with heart, liver, or kidney problems should avoid taking muscle relaxers if possible.

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Are There Any Warnings Associated With Muscle Relaxers?

Unfortunately, skeletal muscle relaxants do have FDA warnings associated with their use due to the potential for abuse and addiction. The medications produce a relaxed feeling that some patients become dependent on over time; long-term use of muscle relaxers is associated with increased risk of physical dependence and increased tolerance. Muscle relaxers and other prescription medications can be abused by patients who take them without a medical need or who take them in combination with alcohol or illicit drugs to amplify their effects. Therefore, muscle relaxers are generally only prescribed at a low dose for a period of two to three weeks and are not meant to be taken long term. Soma, one of the most commonly prescribed brand name muscle relaxers, is also one of the most commonly diverted drugs in the United States, meaning it is redistributed for illicit use. Flexeril is another commonly abused muscle relaxer. Even though muscle relaxers are prescription drugs, their abuse is dangerous and can lead to overdose, which includes the following symptoms:

  • Stupor
  • Seizures
  • Respiratory depression
  • Coma
  • Hallucinations
  • Shock
  • Cardiac arrest
  • Death

Muscle relaxers also should not be mixed with alcohol, as the combination can amplify the effects on the central nervous system. Common side effects associated with the combination of alcohol and muscle relaxers include:

  • Blurred vision
  • Extreme lightheadedness
  • Low blood pressure
  • Memory problems
  • Increased risk of overdose
  • Urine retention
  • Extreme tiredness
  • Fainting
  • Liver damage

Patients who find themselves addicted to muscle relaxers may experience withdrawal symptoms when trying to wean themselves off of the medication. Withdrawal symptoms associated with muscle relaxers vary depending on the specific medication abused, but often include symptoms like nausea, drowsiness, headache, malaise, and discomfort. Withdrawal symptoms range from mild to severe depending on the type of medication abused, with Flexeril generally causing less severe symptoms and Soma causing more severe symptoms, including seizures and hallucinations. Patients attempting to wean off of Soma should do so at an inpatient detox program and should not attempt to do so at home, while Flexeril can often be detoxed from at home as long as no other drugs or alcohol are involved. The best way to prevent abuse of muscle relaxers is to take them only as a second or third line of treatment for muscle pain after treatments like physical therapy and to take them only when truly needed. 

Published July 17th, 2020 by Bridget Reed
Fact Checked by Chris Riley

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