Muscle relaxants are widely prescribed for acute back pain, often in conjunction with an over-the-counter or prescription pain medication. They are generally prescribed for a short time to relieve pain in the lower back or neck caused by muscle spasms, also called muscle cramps.
The medication is generally used for a few days and up to two weeks, but is sometimes prescribed for chronic back pain or neck pain.
Muscle relaxers are a group of drugs that have a sedative effect on the body. They work through the brain, rather than directly on the muscles. Common side effects include drowsiness and constipation. While it is important to take drowsiness into account during the day, the sedation can be helpful at night, when pain might otherwise interfere with sound sleep.
If a medication seems to cause problems, it is important to notify the doctor. Each medication works a little differently, and the doctor may be able to prescribe another that fits the individual’s needs better.
Common Uses for Treating Back Pain
There is some evidence in the medical literature of effectiveness of muscle relaxants when used for acute back or neck pain on a short-term basis (e.g. up to one or two weeks). They can promote recovery by blocking the feeling of pain, so patients can get the rest they need to heal.
Common uses of muscle relaxants for back or neck pain include:
- For muscle spasms
Muscles spasms occur when a muscle—or muscles—tighten up or cramps suddenly. The pain can be severe. When this happens in the back or neck, it is often caused by lifting a heavy object or twisting the body, leading to a strained muscle. Muscle relaxants may be prescribed along with pain relievers to ease the spasms.
- Emergency room care
Checking to see if there is a serious problem is the initial focus of emergency room treatment for back pain. If the situation is not related to a serious underlying issue, such as an unstable fracture or a tumor, the patient may be prescribed muscle relaxers with painkillers for a short time to treat an intensely painful sprain or strain of muscles, ligaments, or tendons.
- Following spine surgery
Muscle spasms are common following surgery, even if the original pain has eased. In some cases, the muscle spasms occur in parts of the body well away from the surgery. Muscle relaxants are often given in the hospital and patients may receive a prescription during the initial days or weeks of recovery at home. The doctor’s directions, and directions on the pill bottle, should be followed closely. It is useful to discuss in advance whether the doctor wants the medication to be taken on a set schedule, to stay ahead of the pain, or to be used as needed. It may be helpful to stagger doses of pain medication and muscle relaxers, rather than take both at the same time, so there is always some medication in the body and the pain does not become too intense as the medication is wearing off.
- During physical therapy
Muscle relaxants may be prescribed while the patient is starting a new physical therapy program. The muscle relaxant may aid in range of motion during physical therapy, may help alleviating anxiety related to starting with physical therapy and exercise, and may aid in pain related to possible pain flare-ups related to muscle spasm.
Muscle relaxants can be helpful in temporarily alleviating symptoms in the lower back. Some research indicates that pairing analgesics with muscle relaxants enhances the effect of analgesics alone.
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Concern About Overuse
Despite widespread prescribing, the use of muscle relaxants is controversial in the medical community.
The growing use of these medications has drawn concern about overuse, adverse side effects, and limited evidence of their effectiveness—especially when used on an ongoing basis for a chronic condition.
Research is mixed on muscle relaxers. A number of research studies and analyses have found muscle relaxants to be more helpful than a placebo in easing symptoms of nonspecific acute low back pain in the short term.2,3
Other research, however, found that people visiting an emergency room for back pain received no additional benefit from taking muscle relaxers.4
- Witenko W, Moorman-Li R, Motycka C, Duane C, Hincapie-Castill J, Leonard P, and Valaer C. Considerations for the Appropriate Use of Skeletal Muscle Relaxants for the Management Of Acute Low Back Pain. P T. 2014 Jun; 39(6): 427435.
- Pareek A, Chandurkar N, Chandanwale AS, Ambade R, Gupta A, Bartakke G. Aceclofenac–tizanidine in the treatment of acute low back pain: a double-blind, double-dummy, randomized, multicentric, comparative study against aceclofenac alone. European Spine Journal. 2009;18(12):1836-1842. doi:10.1007/s00586-009-1019-4.
- Friedman BW, Dym AA, Davitt M, Holden, L, et al. Naproxen With Cyclobenzaprine, Oxycodone/Acetaminophen, or Placebo for Treating Acute Low Back Pain: : A Randomized Clinical Trial. JAMA. 2015;314(15):1572-1580. doi:10.1001/jama.2015.13043.