Types of Skeletal Muscle Relaxers for Back Spasms

When you injure your neck or back, your muscles may seize up, making it difficult to get through your day, your exercises, and/or your physical therapy session. When this happens, your healthcare provider may prescribe skeletal muscle relaxers to help reduce pain.

Drugs in the skeletal muscle relaxer class are not available over the counter; they must be prescribed by your healthcare provider.

In this article, we'll discuss three types of skeletal muscle relaxers. Certain similarities are shared by all, regardless of which you take. We'll go over those so you can get a complete picture of this class of drugs, but in the meantime, the most important thing to remember about skeletal muscle relaxers is that they'll probably make you drowsy. This means that driving, operating heavy machinery and or engaging in other risky activities are a no-no when you are under the influence of this skeletal muscle relaxers.

Skeletal muscle relaxers are not recommended for people age 65 or older because there are effective alternatives that are safer. As well, if you are pregnant or breastfeeding there is a concern that these drugs may be passed on to the fetus or baby. Discuss these issues with your healthcare provider.


Soma, Rela, or Vanadom (Carisoprodol)

A man experiencing back pain at work. Safe lifting and ergonomics topic.
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Carisoprodol is available generically and as a brand; brand names are Soma and Vanadom.

It is thought that carisoprodol works by suppressing nerve impulses located in the brain and spinal cord (the two components of the central nervous system).

Many healthcare providers prescribe this medication, as well as other types of drugs in the skeletal muscle relaxer class, as an adjunct to physical therapy for the healing and managing of musculoskeletal injuries and/or pain.

By adjunct, we mean you may be able to take carisoprodol (or another skeletal muscle relaxer) to reduce your pain and/or release any muscle spasm you may have long enough to give you a fair chance to engage with your activity based care.

And taking this medication may help you adhere to the exercise program you'll inevitably encounter in your physical therapy sessions.

The idea of using carisoprodol is to give you a fair chance to get started so that you can reap the results in the long term. It's not about needing or continue taking the drug in order to feel better. Think of it more as a kickstart, after which you take the ball and run with it (by sticking with the home program your therapists gives you).

Back muscle spasm is a perfect example of the kind of condition that may benefit from carisoprodol in the short term.

The Drugs.com website says that carisoprodol can be habit-forming. Based on that, a few warnings are in order:

  • Only the person to whom it was prescribed should use it.
  • Never give carisoprodol to someone with a history of drug abuse or addiction.
  • If you've taken carisoprodol for a long time and stop, you may experience withdrawal symptoms. Be sure to talk to your healthcare provider before suddenly going off this medication; you may need to taper, and she can help you get this right.
  • Carisoprodol can cause side effects that may impair your thinking or reactions. As alluded to in the intro in this article, be careful if you drive or do anything that requires you to be awake and alert. Also, avoid drinking alcohol when you take carisoprodol; alcohol may increase the drowsiness and dizziness that is often caused by carisoprodol.

Be sure to communicate with your healthcare provider before taking carisoprodol if you have any drug allergies, kidney disease or liver disease, or if you get seizures.

If you're allergic to carisoprodol, obviously you shouldn't take it. And you shouldn't take it if you are allergic meprobamate (Equanil, Miltown). Another reason to avoid carisoprodol is if you have porphyria.

Soma (carisoprodol) has the potential for abuse, and non-medical use has risen significantly in recent years. Overdose of this drug can result in stupor, coma, and death.


Flexeril (Cyclobenzaprine)

Cyclobenzaprine is available as Flexeril, Amrix, and in generic form. Like other types of muscle relaxers, cyclobenzaprine may cause dizziness or drowsiness, so you shouldn't drive, lift heavy objects, or do vigorous exercise while under its influence.

In fact, the sedation effects of cyclobenzaprine may be the way in which it works its magic on your painful, tension-filled muscles.

As with carisoprodol and other skeletal muscle relaxers, cyclobenzaprine is used together with rest and physical therapy to treat skeletal muscle-related conditions and/or injuries, especially when pain or spasm is involved. So when you use cyclobenzaprine in conjunction with your physical therapy, you may find you're making speedier progress, especially if you take your home exercise program seriously.

Cyclobenzaprine is chemically related to tricyclic antidepressants. Although it is considered a derivative of the tricyclic antidepressant class, it does not pose the same risk to your liver health. Experts do not currently know the reason for this difference between the two substances.

According to the National Institutes of Health, reasons not to take this medication include, among other things, if you have a thyroid disorder, heart block, congestive heart failure, a heart rhythm disorder, or you have recently had a heart attack.

As with Skelaxin and carisoprodol, your healthcare provider's recommendation that you go with Flexeril (instead of another drug in this class) may be based on a comparison of anticipated side effects, your personal preferences and/or potential drug interactions.


Skelaxin (Metaxalone)

Skelaxin is the brand name for metaxalone. While the FDA has approved the generic form of this medication. As with the other muscle relaxers described on this page, metaxalone used as an adjunct for physical therapy and rest when your muscles get too tight; it works by suppressing nerve impulses in the brain and spinal cord.

In addition to older people and pregnant women, metaxalone is usually not prescribed for people with kidney disease, liver disease, seizures, or blood disorders.

Its possible metaxalone may skew the results of certain medical tests. So if you're scheduled for one, be sure to tell (or remind) your healthcare provider that you're taking this drug. You should not use Skelaxin if you're allergic to it.

2 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.
  1. 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;39(6):427-35.

  2. Zacny JP, Paice JA, Coalson DW. Subjective and psychomotor effects of carisoprodol in combination with oxycodone in healthy volunteers. Drug Alcohol Depend. 2012;120(1-3):229-32. doi:10.1016/j.drugalcdep.2011.07.006

Additional Reading
  • Carisoprodol. Drugs.com website. Revision Date: April 2009.
  • Cyclobenzaprine. Drugs.com website. Revision Date: Dec 2015.
  • Cyclobenzaprine. Liver Tox. United States National Library of Medicine. Last updated: Jan. 2017.
  • Skelaxin. Drugs.com website. Revision Date: Dec 2015.

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.