Muscle relaxants are not really a class of drugs, but rather a group of different drugs that each has an overall sedative effect on the body. These drugs do not act directly on the muscles, rather they act centrally (in the brain) and are more of a total body relaxant.
Typically, muscle relaxants are prescribed early in a course of back pain, on a short-term basis, to relieve low back pain associated with muscle spasms. There are several types of muscle relaxant medications that are commonly used to treat low back pain:
- Robaxin, and Skelexin are older muslce relaxants that can be helpful for acute painful muscle pain. Robaxin dose is usually 750mg 3-4 times per day. Skelexin dose is either 400 or 800mg 3-4 times per day.
- Zanaflex tablets or capsules are prescribed for more severe spasms. The dose can be increased to achieve the desired results. The dose for Zanaflex starts from 2mg up to 8mg and is often given in intervals of every 4-8 hours.
- Carisoprodol (Soma). This drugs dosage is either 250mg or 350mg every eight hours as needed for muscle spasm. Soma is typically prescribed on a short-term basis and may be habit-forming, especially if used in conjunction with alcohol or other drugs that act on the mind.
- Cyclobenzaprine (Flexeril). This medication can be used on a longer-term basis and actually has a chemical structure related to some antidepressant medications, although it is not an antidepressant. Usually it is prescribed as 10mg every six hours as needed to relieve low back pain associated with muscle spasm, or it can also be prescribed as 10mg at night as needed to help with difficulty sleeping. Flexeril can impair mental and physical function, and may lead to urinary retention in males with large prostates.
- Diazepam (Valium). Valium is usually limited to one to two weeks of use, and the typical dosage is 5-10mg every six hours as needed to relieve low back pain associated with muscle spasm. Because of its habit-forming potential, and because it changes sleep cycles and makes it very difficult to sleep after stopping the drug, Valium should not be used long term. Valium should not be used concurrently with Opioid pain medications. Patients should also note that Valium is a depressant and can worsen depression associated with chronic pain.
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