Which Muscle Relaxers Are Best for Neck and Back Pain

Anut21ng/iStock via Getty Images

Stiffness and soreness in your neck and back can be difficult to deal with, especially when sleeping. Maybe you have a new injury, or you've aggravated an old one. Either way, if you feel this kind of pain at night, you may not sleep well. And then you may have more pain when you wake up.

In some cases, muscle relaxers can help relieve this pain and get you through these tough days. With so many muscle relaxers to choose from, you may be wondering which one works best. Let's take a closer look at a list of commonly used muscle relaxers and the ones that you should consider when facing neck and back pain.

What do muscle relaxers do?

Muscle relaxers do exactly what their name says: relax muscles. Reducing muscle tightness may improve new neck and back pain, especially when used at night.

Muscle relaxers can work in different ways. They may act on your muscles, nerves, or central nervous system. There isn't enough evidence to suggest that one muscle relaxer is better than another. Let's look at eight popular muscle relaxants, including how well they work and their side effects.

1. Methocarbamol

Methocarbamol (Robaxin) is a well-studied medication that treats back pain. Compared to other options, it's inexpensive and less likely to make you sleepy (sedated).

Methocarbamol is generally a well-tolerated option for people who have new neck and back pain. But it may be less effective. In one study, almost 1 in 5 people taking it stopped because it wasn't helping their pain go away.

2. Cyclobenzaprine

Cyclobenzaprine is a reasonable first choice because it's a cheap generic medication. But it has more potential for side effects, like drowsiness. This limits how you can use it during the day. If this is an ongoing concern, it may be a good idea to consider a non-sedating option.

You may want to break your tablet in half to decrease this effect. Interestingly, one study found that a lower dose of cyclobenzaprine at 15 mg worked just as well as a higher dose of 30 mg.

Cyclobenzaprine may also cause dry mouth, especially in older adults.

3. Carisoprodol

Carisoprodol (Soma) is classified as a medication that has the potential for misuse. For this reason, you shouldn't use it if you have a history of substance use. If prescribed, you should only use it for short periods of 2 to 3 weeks. Scientists don't know how effective it is when taken for longer periods.

Carisoprodol may also cause drowsiness and dizziness. It's not a good choice for people over age 65. Because of the potential side effects, some experts believe that carisoprodol should be phased out as a muscle relaxant in favor of much better options.

4. Metaxalone

Metaxalone (Skelaxin) is a muscle relaxer that has the fewest reported side effects. It's also the least likely of the muscle relaxants to make you sleepy. It may work better for chronic lower back pain that is flaring up, rather than for pain that's new.

Metaxalone is a generic medication, but it still tends to cost more than most other muscle relaxers. Insurance companies often don't cover it because there are cheaper alternatives. But it works as well as cyclobenzaprine and carisoprodol, with fewer side effects and less sedation.

5. Tizanidine

Tizanidine (Zanaflex) is often used for spasticity in people with multiple sclerosis or cerebral palsy. Spasticity is where the muscles contract continuously, which leads to tightness and stiffness.

For multiple sclerosis or cerebral palsy, tizanidine tends to have fewer side effects than Baclofen - another commonly used medication. Tizanidine isn't a first-choice option for new neck or back muscle pain. It's only FDA-approved to treat spasticity.

6. Baclofen

Similar to tizanidine, Baclofen (Gablofen, Lioresal) is primarily used for spasticity in people who have multiple sclerosis or spinal cord injuries. Up to 1 in 5 people taking it have drowsiness, though. For many people, it's not a first-choice medication for neck and back muscle pain and isn't FDA-approved to treat these symptoms.

7. Oxazepam and diazepam

Benzodiazepine medications like oxazepam (Serax, Zaxopam) and diazepam (Valium) are anti-anxiety medications. They're sometimes prescribed as muscle relaxants. But these really aren't recommended because they don't work well, are sedating, and can be habit-forming.

Plus, the FDA hasn't approved benzodiazepines for neck or back pain. It's a good idea to avoid these medications for neck and back muscle pain, since there are much better options.

8. Chlorzoxazone

Chlorzoxazone (Lorzone) isn't well studied for new low back and neck pain in adults. And it wasn't found to be effective for pain after spine surgery. Chlorzoxazone has also been reported as a rare cause of acute liver toxicity. A healthcare professional may consider this medication once you've exhausted all other options.

What are some risks and side effects of muscle relaxers?

Muscle relaxers can cause some side effects and sometimes interact with other medications and substances. That's why it's important to let your healthcare professional know about your medical history and which medications and supplements you're taking.

Common medications that can interact with muscle relaxers include sedatives, antidepressants, and antihistamines.

Sedatives

Many muscle relaxers have a sedative effect - slowing brain activity. If you're taking other medications that also affect your brain, you could have severe side effects.

Sedative medications that may also interact with muscle relaxers are:

• Sleep medications, like Zolpidem (Ambien)

• Gabapentin (Neurontin)

• Pregabalin (Lyrica)

• Opioid pain medications (like oxycodone, hydrocodone)

Antidepressants

Some muscle relaxers can also affect serotonin levels in the brain - a hormone that affects mood. If you're already taking medications for your mood, muscle relaxers could cause serotonin levels to become too high.

Some antidepressants that can cause an interaction with muscle relaxers are:

• Amitriptyline (Elavil)

• Venlafaxine (Effexor)

• SSRIs, like sertraline (Zoloft) and fluoxetine (Prozac)

• Selegiline (Zelapar)

Anticholinergics

Anticholinergic medications are commonly used to treat lots of conditions ranging from overactive bladder to digestive conditions and movement disorders like Parkinson's disease. These medications can have side effects like trouble urinating, constipation, or dry mouth. Adding a muscle relaxer to these medications can make these side effects more severe.

Anticholinergics that may interact with muscle relaxers include:

• Diphenhydramine (Benadryl)

• Hyoscyamine (Levsin)

• Benztropine (Cogentin)

• Scopolamine

Frequently asked questions

Public link

Please use the above public link if you want to share this noodl on another website.