Muscle Relaxers Prescribed for Arthritis

Understanding the Types, Appropriate Use, and Possible Risks

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Muscle relaxers are a group of drugs used to treat musculoskeletal pain, meaning pain involving muscles, bones, joints, and connective tissues like ligaments and tendons. Muscle relaxers are sometimes prescribed to people with osteoarthritis ("wear-and-tear" arthritis) as well as those with lower back pain, neck pain, and other musculoskeletal pain.

This article explains how muscle relaxers work, when they are used, and which types are available for people with osteoarthritis and other types of musculoskeletal pain. It also describes the possible risks and side effects of muscle relaxers, including when they should not be used.

A doctor giving a prescription bottle to her patient
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How Muscle Relaxers Works

Muscle relaxers, also known as muscle relaxants, are a group of drugs with sedative properties. While people tend to think of sedatives as "sleeping pills," the types used as muscle relaxers prevent nerve signals or pain impulses from reaching the brain. This action helps relieve muscle spasms and tension that contribute to musculoskeletal pain.

Muscle relaxers are not a class of drugs. While they all have similar mechanisms of action (in that directly act on the central nervous system), they have different chemical structures and indications for use. Some have stronger sedative effects than others, while others are used to treat specific medical conditions (for example, injuries or diseases of the spinal cord).

Muscle relaxers can be broadly categorized as follows:

  • Benzodiazepines: These are central nervous system depressants typically prescribed to treat anxiety, insomnia, and seizures. The types used for pain are short-acting.
  • Skeletal muscle relaxants: These are a group of drugs that block pain impulses to the brain (neuromuscular blockers) and/or relieve muscle spasms (spasmolytics).

There is limited research as to which muscle relaxer works "better" than others. Finding the right one often involves a process of trial and error. In the end, the choice is largely based on personal preference, possible side effects, and the potential for abuse and drug dependence.

When Muscle Relaxers Are Used

As a general rule, muscle relaxers are used for the short-term treatment of musculoskeletal pain. They can be used "on-demand" when acute pain strikes but are generally not the drugs of choice for chronic musculoskeletal pain.

Furthermore, muscle relaxers are usually not used for the primary treatment of pain. More often, they are prescribed when other more conservative treatments, like over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs), fail to provide relief.

Muscle relaxers may be prescribed for people with the following conditions:

Some muscle relaxants cause greater drowsiness than others, especially certain benzodiazepines. This can be useful if the pain is interfering with your sleep.

Type of Muscle Relaxers

Muscle relaxers are available by prescription. There are no OTC muscle relaxers. Many are prescribed in tablet, capsule, or liquid form, but there are also injectable forms used for rapid relief of acute pain.

Some of the more commonly prescribed muscle relaxants (by class) include:

Drug Drug Class Formulations
Amrix (cyclobenzaprine) Skeletal muscle relaxant Tablet, extended-release capsule
Ativan (lorazepam) Benzodiazepine Tablet, suspension, injection
Dantrium (dantrolene) Skeletal muscle relaxant Capsule, injection
Flexeril (cyclobenzaprine) Skeletal muscle relaxant Tablet, extended-release capsule
Lorzone (chlorzoxazone) Skeletal muscle relaxant Tablet
Norflex (orphenadrine) Skeletal muscle relaxant Extended-release tablet
Restoril (temazepam) Benzodiazepine Capsule, suspension
Robaxin (methocarbamol) Skeletal muscle relaxant Tablet, injection
Skelaxin (metaxalone) Skeletal muscle relaxant Tablet, injection
Soma (carisoprodol) Skeletal muscle relaxant Tablet
Valium (diazepam) Benzodiazepine Tablet, suspension, injection
Zanaflex (tizanidine) Skeletal muscle relaxant Tablet, capsule

Possible Side Effects and Risks

As with all drugs, muscle relaxers can cause side effects. The one side effect common to all muscle relaxers is dizziness and drowsiness, although some cause greater drowsiness than others.

Common side effects of muscle relaxants (by drug class) include:

Benzodiazepines
  • Drowsiness

  • Dizziness or lightheadedness

  • Restlessness

  • Nausea or vomiting

  • Headache

  • Slurred speech

  • Muscle weakness

  • Tremors

  • Loss of coordination

  • Blurred vision

  • Constipation

  • Confusion

  • Reduced sex drive

Skeletal Muscle Relaxants
  • Headache

  • Dry mouth

  • Dizziness

  • Drowsiness

  • Stomach upset

  • Fatigue

  • Loss of appetite

  • Muscle weakness

  • Diarrhea

  • Constipation

  • Blurred vision

Certain muscle relaxants pose a major risk of drug dependence. Among those known to be habit-forming are Amrix, Ativan, Restoril, Soma, and Valium. It is for this reason that these drugs are generally not prescribed for longer than four weeks when used for acute musculoskeletal pain.

The risk of dependence is increased when benzodiazepines are prescribed alongside opioid drugs like fentanyl.

Meanwhile, skeletal muscle relaxants like Dantrium, Flexeril, Lorzone, Robaxin, Skelaxin, Soma, and Zanaflex may need to be used with caution in people with preexisting liver or kidney disease. In some cases, the drugs may need to be avoided entirely.

Benzodiazepines are avoided during pregnancy.

Drinking alcohol can be especially dangerous when taking muscle relaxers. The sedative effects of the drugs are amplified with alcohol, and, in some cases, can lead to severe respiratory depression and death.

Summary

Muscle relaxers are sometimes prescribed for people with osteoarthritis pain and other types of musculoskeletal pain. They are available by prescription only and intended for short-term use only.

There are two broad categories of muscle relaxants (benzodiazepines and skeletal muscle relaxants), each of which acts on the nervous system in different ways. The drugs are usually not prescribed as the primary treatment of musculoskeletal pain but are rather reserved for when conservative treatments fail to provide relief.

A Word From Verywell

Muscle relaxers can be very effective for the treatment of severe muscle, joint, back, or neck pain. With that said, they are not intended for long-term use and should only be taken as prescribed.

If pain persists despite the appropriate use of muscle relaxants, speak with your healthcare provider. Other treatments may be available, like nerve blocks or radiofrequency ablation, that may not only be safer over the long term but provide more effective, sustained relief.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Witenko C, Moorman-Li R, Motycka C, et al. Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low back pain. P T. 2014 Jun;39(6):427-35.

  4. Park TW, Saitz R, Nelson KP, Xuan Z, Liebschutz JM, Lasser KE. The association between benzodiazepine prescription and aberrant drug-related behaviors in primary care patients receiving opioids for chronic pain. Subst Abus. 2016 Oct-Dec;37(4):516–20. doi:10.1080/08897077.2016.1179242

By Carol Eustice
Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis.