Which Muscle Relaxants Are Best for Neck and Back Pain?

Whether from a new injury or an aggravated old injury, stiffness and soreness in the neck and back at night may lead to disrupted sleep and more pain in the morning. Muscle relaxants have been shown to help relieve this pain and get you through these tough days. Used at night, these medications may improve acute neck and back pain.

Your first-line treatment will still be over-the-counter pain relievers like acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve). They work better for neck and back pain than muscle relaxants, but there may be a benefit to taking them together, especially at night. Research shows that a muscle relaxant added to acetaminophen or an NSAID works better than either alone.

Now, let’s compare 9 popular muscle relaxants. How well do they work and what are their side effects? Oh, and are they affordable?

1) Methocarbamol

Methocarbamol (Robaxin) is a well-studied medication that treats back pain. It’s also inexpensive and relatively less sedating than other options. In recent studies where it was used for up to 8 days, 44% of folks that took methocarbamol had complete pain relief (compared to 18% who took nothing) — and that was without any serious side effects.

Taken as needed, 1500 mg every 6 to 8 hours is a cheap and well-tolerated option for sufferers of acute neck and back pain. Think of trying this first, as it is less sedating than other options, like cyclobenzaprine and carisoprodol.

2) Cyclobenzaprine

At the standard dose of 10 mg to 30 mg a day, cyclobenzaprine (Flexeril) will make you sleepy. If you use it during the day, you’ll want to break your 10 mg tab in half and take 5 mg to lessen the drowsiness. Interestingly, 5 mg three times a day has been shown in studies to work as well as 10 mg taken 3 times a day.

Cyclobenzaprine is a reasonable first choice because it’s a cheap generic, but the sedation side effect limits its use during the day. It may also cause more dry mouth, especially in older folks. If this is a concern, consider a better non-sedating option.

3) Carisoprodol

Carisoprodol (Soma) is a Schedule IV drug (similar to benzodiazepines Ativan, Valium, and Xanax) and has the potential for being abused. For this reason, you should not use it if you have a history of substance abuse.

Many believe that carisoprodol should be phased out as a muscle relaxant in favor of much better options. If prescribed, you should only use it for short periods of 2 to 3 weeks due to lack of evidence for effectiveness with longer use. It may cause drowsiness and dizziness, and it should not be used in folks over 65.

4) Metaxalone

Taken as 800 mg tablets 3 to 4 times a day, metaxalone (Skelaxin) has the fewest reported side effects and lowest sedation potential of the muscle relaxants based on clinical studies. Simply put, it is the best-tolerated of the muscle relaxants.

Metaxolone is a generic alternative for the brand drug Skelaxin, but it is still pricey. Insurance companies don’t like to cover it because there are cheaper alternatives. Having said that, it works as well as cyclobenzaprine and carisoprodol with fewer side effects and less sedation—so paying cash may be worth it.

5) Tizanidine

Tizanidine (Zanaflex) is often used for spasticity in patients with multiple sclerosis or cerebral palsy. Spasticity is where the muscles undergo continuous contraction, which leads to tightness and stiffness. In head-to-head studies with Baclofen for those conditions, tizanidine tends to have fewer side effects — but they both work just as well. This is not a first-line choice for acute neck or back muscle pain, though.

6) Baclofen

Similar to tizanidine, Baclofen is primarily used for spasticity in spinal cord injury patients or those with multiple sclerosis. Up to 20% of folks taking it have drowsiness, and there are better options for neck and back muscle pain. Also not a first choice.

7) Oxazepam and diazepam

Benzodiazepine medications like oxazepam and diazepam (Valium) are sometimes prescribed as muscle relaxants. However, these really aren’t recommended because they don’t work well, are sedating, and can be habit-forming. Avoid benzodiazepines for neck and back muscle pain because there are much better options.

8) Chlorzoxazone

Chlorzoxazone (Lorzone) is not well-studied for acute low back and neck pain in adults. And when investigated for pain after spine surgery, it wasn’t found to be effective. Chlorzoxazone has also been reported as a rare cause of acute liver toxicity. Don’t choose this until you’ve exhausted all other options.

9) Orphenadrine

For neck and back pain in adults, the first 4 medications on this list work better than orphenadrine (Norflex), so save this as another last resort in the event the others don’t work. It just hasn’t been well studied for this purpose.

What is the difference between Baclofen and Cyclobenzaprine for Muscle Spasms ?

Many people experience muscle cramps (spasms) every now and then. Muscle spasms typically occur when we overuse or injure our muscles. While these cramps can be painful, they usually last for only a few seconds or minutes.

But for some people, muscle spasms are frequent and intensely painful. The spasms can also last for long periods of time. When a spasm hits, severe symptoms can negatively impact your quality of life.

Fortunately, medications are available that can help relieve your symptoms. Two common muscle relaxer medications are baclofen and cyclobenzaprine (Flexeril). They’re routinely filled at pharmacies across the country with a similar treatment goal in mind, but they’re given for different reasons.

Here, we’ll compare baclofen and cyclobenzaprine — what they are, how effective they are, and what side effects to expect.

What is baclofen?

Baclofen is a prescription medication that’s usually taken by mouth. It can also be given as a spinal injection (Gablofen).

Baclofen is considered to be an antispastic muscle relaxant or a spasmolytic, which is used to treat muscle spasms due to brain injury or nerve damage.

What is baclofen approved to treat?

Antispastic muscle relaxants — like baclofen — are used for muscle spasticity conditions. For these conditions, people have unusually tight, stiff, and rigid muscles that repeatedly spasm because of brain injury or nerve damage.

In fact, the FDA approved baclofen to treat muscle spasticity symptoms caused by spinal injuries or spine-related medical conditions. The FDA also approved baclofen to relieve similar symptoms in people with multiple sclerosis (MS), a type of autoimmune disorder.

How does baclofen work for muscle spasms?

Baclofen is thought to work by affecting the spinal nerves. It lessens the number and severity of muscle spasms. It also relieves pain, loosens rigid muscles, and helps with muscle movement.

What is cyclobenzaprine?

Like baclofen, cyclobenzaprine is a prescription medication that’s taken by mouth. But unlike baclofen, cyclobenzaprine is an antispasmodic muscle relaxant. This means it’s used to treat muscle spasms due to muscle and bone problems.

What is cyclobenzaprine approved to treat?

Cyclobenzaprine is routinely used to treat muscle spasms caused by musculoskeletal conditions. These are muscle spasms related to problems from the muscles and bones — not the brain or spine.

These types of muscle spasms can also be painful. But the pain is usually acute (short-term), not chronic. So, the FDA only approved cyclobenzaprine use for 2 to 3 weeks at a time to relieve painful muscle spasms from these musculoskeletal conditions. Cyclobenzaprine should also be used in combination with rest and physical therapy when possible.

How does cyclobenzaprine work for muscle spasms?

Cyclobenzaprine is thought to relax muscles by mainly working in the brain. To a lesser extent, it also exerts its effects on the spine. It doesn’t work by affecting muscles directly.

How are baclofen and cyclobenzaprine dosed and given?

The following table contains information on how baclofen and cyclobenzaprine oral tablets are dosed and given.

Baclofen Cyclobenzaprine
Tablet strengths 5 mg
10 mg
20 mg
5 mg
7.5 mg
10 mg
Typical starting dose 5 mg by mouth 3 times daily 5 mg by mouth 3 times daily
Usual maximum daily dose 20 mg by mouth 4 times daily 10 mg by mouth 3 times daily
Duration of Use 1-2 months, or until you and your healthcare provider decide to slowly stop the medication 2-3 weeks
Kidney or liver function affects dosing Yes, kidney Yes, liver

As a reminder, baclofen is also given as an injection into the back. It’s also available as an oral (by mouth) liquid. Cyclobenzaprine is also available as an oral capsule. If you have any questions about how these other dosage forms are used, talk with your pharmacist or healthcare provider.

How effective are baclofen and cyclobenzaprine for treating muscle spasms?

For muscle spasticity conditions — especially spinal injuries — experts consider baclofen as a possible first-choice option. Clinical trials showed that baclofen improved muscle tone in up to 72% of study participants.

For muscle spasms caused by muscle and bone issues, cyclobenzaprine is considered moderately effective. Studies have suggested that people taking cyclobenzaprine are 5 times more likely than placebo (a pill with no medication in it) to experience improvement in pain-related muscle symptoms.

What are the known side effects of baclofen and cyclobenzaprine?

Like all medications, both baclofen and cyclobenzaprine have a number of side effects. Some are common to both medications, and some are more unique to just one. Side effects can also vary by dose and dosage form (pill, injection, etc).

The following are some common side effects for common doses of baclofen and cyclobenzaprine:

Side effect Baclofen Cyclobenzaprine
Drowsiness 10-63% 29%
Dry mouth Rare 21%
Dizziness 5-15% 1-3%
Weakness 5-15% Less than 1%
Headache 4-8% 5%

What are the serious side effects of baclofen?

A number of rare but serious side effects are also possible. If you experience serious side effects with baclofen, such as the ones below, get medical help right away.

Sudden discontinuation (withdrawal) symptoms

Abruptly stopping baclofen can cause severe withdrawal symptoms, which can include seizures, unusual behavior, and more.

If you would like to stop using baclofen, talk with your healthcare provider first. They can help you slowly stop the medication to prevent withdrawal side effects.

Withdrawal symptoms in newborn babies

If you’re taking baclofen throughout your pregnancy, your healthcare provider may want to slowly stop this medication before your delivery date to limit withdrawal side effects in your baby. This is because within hours to days after delivery, newborn babies can experience withdrawal symptoms, such as rigid muscles, tremors, and seizures.


In people with epilepsy, baclofen can raise the odds of having seizures. Your healthcare provider may want to closely monitor your brain waves over time to keep your seizure risk in check.

What are the serious side effects of cyclobenzaprine?

For cyclobenzaprine, seek immediate medical attention if you have symptoms like serotonin syndrome, heart-related side effects, or other similar symptoms.

Serotonin syndrome

Serotonin syndrome is a rare but potentially life-threatening condition. Symptoms of serotonin syndrome may include confusion, sweating, seizures, and tremors. Risk of serotonin syndrome is higher when you take cyclobenzaprine with other medications that raise serotonin levels. Serotonin is a naturally-occurring chemical in the body.

Heart-related side effects

Cyclobenzaprine might raise your risk for heart-related side effects, including a fast heartbeat and abnormal heart rhythm.

What interactions do baclofen and cyclobenzaprine have?

In general, don’t take baclofen or cyclobenzaprine with alcohol, opioid medications, or benzodiazepines. These can worsen side effects of your medication, like drowsiness or sleepiness.

You should also avoid taking cyclobenzaprine within 14 days of taking a monoamine oxidase inhibitor (MAOI). Combining cyclobenzaprine and MAOIs drastically raises your risk of serotonin syndrome. Examples of MAOIs include linezolid (Zyvox) and selegiline (Emsam).

Additionally, when taking cyclobenzaprine, use caution with tramadol (Ultram). Combining these two medications can worsen your seizure risk.

This is not a complete list of drug interactions for baclofen and cyclobenzaprine. For more detailed information about medication interactions for each muscle relaxant, talk with your pharmacist or healthcare provider.

6 Baclofen Interactions You Should Watch Out for

Like most medications, baclofen has drug interactions to be aware of. Interactions can occur with other medications and substances that have similar effects on the body. This includes sleepiness, dizziness, and weakness. In rare instances, this can lead to severe side effects like difficulty breathing.

Below we’ll discuss a few medications and substances that can interact with baclofen. But this isn’t a complete list. Talk to your healthcare provider and pharmacist before starting baclofen. Provide them with an updated list of all your medications. They can help you check for possible baclofen interactions.

1. Alcohol

Muscle relaxers, like baclofen, may interact with alcohol. Drinking alcohol while taking baclofen can cause weakness, dizziness, and confusion.

Baclofen and alcohol impact the central nervous system (CNS). The CNS consists of your brain and spinal cord. Medications and substances that lower the activity of the CNS can cause symptoms:

  • Lowered concentration
  • Confusion
  • Headache
  • Dizziness
  • Slowed speech
  • Problems with coordination
  • Worsening memory
  • Lower blood pressure
  • Slowed breathing

When alcohol and baclofen are combined, these side effects are more likely. If you drink alcohol, talk with your healthcare provider before starting baclofen. They can provide guidance on how much alcohol, if any, is safe to drink with your medication.

2. Opioids

Opioids are a class of medications that are usually used to treat moderate to severe pain. Examples of opioids include oxycodone (Oxycontin, Roxicodone), morphine (MS Contin, Kadian), and tramadol (Ultram).

Individually, opioids and baclofen can both cause your brain to slow down. In 2016, the FDA warned about the risk of combining opioids with other medications that affect the brain. This includes baclofen. They warned that a combination of these medications can cause serious side effects. Slowed and ineffective breathing is possible, and can lead to death in severe cases.

If you take opioids, it’s a good idea to have Narcan (naloxone) on hand at all times. This is especially important if you’re taking opioids with a medication that amplifies opioid effects. You can get Narcan without a prescription at your local pharmacy in every state. And in some states, you can get Narcan for free.

Before starting baclofen, make sure to tell your healthcare provider if you’re taking opioids. They may recommend you slowly lower your opioid dose if baclofen is needed. Or they may recommend another medication besides baclofen. It’s important to note that the prescribing information for intrathecal baclofen has a specific warning about epidural morphine. Epidural morphine is administered into the spine. Combining these two products can cause difficulty breathing and low blood pressure.

3. Benzodiazepines

Benzodiazepines (BZDs) are a group of medications that treat many health conditions, including anxiety, panic disorder, and more. A few examples of medications in this class include alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan).

Like opioids, BZDs can slow down your brain, and cause similar side effects as those caused by baclofen. This can lead to more serious symptoms such as slow and shallow breathing, and even death.

If you take BZDs, talk with your healthcare provider before starting baclofen. They may recommend stopping your BZD or adjusting the dose. Or they may recommend avoiding baclofen. But, don’t make any changes to your medications without talking to your healthcare provider. Stopping medications like BZDs abruptly can be dangerous.

4. Sleep medications

Sleep medications — like zolpidem (Ambien) and doxylamine (Unisom Sleep Tabs) — can cause excessive sleepiness when taken with baclofen. Medications that aren’t approved for sleep (but cause sleepiness as a side effect) can also interact with baclofen. This includes trazodone, diphenhydramine (Benadryl), and gabapentin (Neurontin).

Excessive sleepiness can lead to trouble with coordination. It can also impact your ability to complete daily tasks. If you take sleep medication, let your healthcare provider know before starting baclofen. They may recommend you avoid one of these medications entirely.

If you need baclofen and a sleep medication, avoid activities that require you to be alert until you know how the combination affects you. That includes driving and operating heavy machinery.

5. Barbiturates

Barbiturates are a group of medications that treat seizures and sleep problems. Examples include phenobarbital and pentobarbital. Pentobarbital is only used in hospitals because it’s given through a vein.

Barbiturates slow down brain activity and can cause drowsiness on their own (which is what they’re often used for). When combined with baclofen, the risk for severe drowsiness is higher.

If you need a barbiturate, your healthcare provider may recommend stopping baclofen slowly. Or, they may ask you to monitor closely for side effects. These include extreme sleepiness, confusion, or trouble breathing.

6. Other muscle relaxers

There are multiple other muscle relaxers available besides Baclofen. Examples include methocarbamol, cyclobenzaprine (Fexmid, Amrix), and tizanidine (Zanaflex). While these medications don’t all necessarily work just like baclofen, they have a similar effect of muscle relaxation. They can also cause dizziness and drowsiness. When combined with baclofen, these effects can be amplified.

In general, it’s best to avoid taking multiple muscle relaxers at once. If you’re taking baclofen and not feeling relief, talk to your healthcare provider. They may recommend an alternative option.

What are the risks and warnings for baclofen?

Baclofen can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options

Withdrawal symptoms

  • Risk factors: Taking baclofen for a long time | Stopping baclofen suddenly | Newborns whose mothers took baclofen during pregnancy

If you’ve taken baclofen for a long period of time and you suddenly stop taking it, you can experience serious problems including hallucinations (seeing or hearing things that aren’t there), muscle stiffness, or seizures. Talk to your healthcare provider if you’d like to stop taking baclofen. They can help you lower your dose safely.

Similar withdrawal symptoms can also happen to newborn babies right after birth if you took baclofen consistently (e.g., every day) during your pregnancy. If you become pregnant while taking baclofen, let your provider know right away. There might be a safer alternative for you.

Effect on driving and concentration

  • Risk factors: Taking with alcohol or illicit drugs | Taking other medications that cause drowsiness | People over 65

Taking baclofen can make you feel sleepy and affect your concentration and focus. Don’t drink alcohol while taking this medication because it can make these side effects worse. Avoid activities that require you to be alert, like driving or operating machinery, until you know how the medication affects you.

Higher risk of side effects if you have kidney problems

  • Risk factors: History of kidney problems

If you have kidney problems, be careful using baclofen. Baclofen is processed by the kidneys, and if they aren’t working properly, the medication can build up in your body. This buildup can raise your risk of side effects, like drowsiness and dizziness, or make them more intense. To prevent these issues, you’ll most likely need to take lower doses of baclofen.

Poor response or tolerability to baclofen if you’ve had a stroke

  • Risk factors: History of a stroke

If you’ve had a stroke in the past, baclofen might not work well and be more likely to cause side effects. Let your provider know if you’ve ever had a stroke before starting baclofen. They can discuss if the medication is right for you or if there are other options that might be safer.

Worsening of other health conditions

Speak to your provider before taking baclofen if you have any health conditions because this medication might make certain conditions worse. Baclofen can worsen conditions like mental health problems, high blood pressure (autonomic dysreflexia), and seizures.

What are Skeletal muscle relaxants?

Muscle relaxers, or muscle relaxants, are medications used to treat muscle spasms or muscle spasticity.

skeletal Muscle Relaxants-classification
skeletal Muscle Relaxants-classification

Skeletal muscle relaxants are drugs that are used to relax and reduce tension in muscles. They are more simply referred to as muscle relaxants.

Some work in the brain or spinal cord to block or dampen down excessively stimulated nerve pathways. These are called centrally acting muscle relaxants and examples include baclofen, methocarbamol, and tizanidine.

skeletal Muscle Relaxants
skeletal Muscle Relaxants

Others act directly on muscle fibers and are classified as peripherally acting muscle relaxants. Examples include dantrolene and the different types of botulinum toxin. Although dantrolene acts directly on the muscle itself, it also appears to indirectly act on the central nervous system and can cause drowsiness.

Cannabis extract also has muscle relaxing properties and is thought to act both centrally and peripherally.

Muscle spasms or cramps are sudden, involuntary contractions of a muscle or group of muscles. They can be caused by too much muscle strain and lead to pain. They’re associated with conditions such as lower back pain, neck pain, and fibromyalgia.

Muscle spasticity, on the other hand, is a continuous muscle spasm that causes stiffness, rigidity, or tightness that can interfere with normal walking, talking, or movement. Muscle spasticity is caused by injury to parts of the brain or spinal cord involved with movement. Conditions that can cause muscle spasticity include multiple sclerosis (MS), cerebral palsy, and amyotrophic lateral sclerosis (ALS).

Prescription drugs can help relieve the pain and discomfort from muscle spasms or spasticity. In addition, certain over-the-counter medications may be used to treat aches and pains associated with muscle spasms.

What are skeletal muscle relaxants used for?

Skeletal muscle relaxants are mainly used to treat:

  • spasticity, which is another term for stiff and rigid muscles caused by conditions such as cerebral palsy, multiple sclerosis, or stroke
  • muscle spasms which are temporary muscular contractions that are often associated conditions such as tension headache, low back pain, or fibromyalgia
  • cervical dystonia – a painful condition where the neck muscles involuntarily contract, causing your head to uncontrollably tilt forward or backward.

Which Prescriptions are  skeletal muscle relaxants?

Skeletal muscle relaxants differ in the way they work (centrally or peripherally as discussed above), their side effects, and their effectiveness for certain conditions.

Note that several other medicines, notably diazepam, may also be used as a muscle relaxant and are not listed below.

Note that several other medicines, notably diazepam, may also be used as a muscle relaxant and are not listed below.

Generic name Brand name FDA approval (spasm-related)
abobotulinumtoxinA Dysport Cervical dystonia, Muscle spasms
baclofen Gablofen, Lioresal General spasticity
carisoprodol Soma, Vanadom Muscle spasms
chlorzoxazone Lorzone Muscle spasms
cyclobenzaprine Amrix, Flexeril, Fexmid Muscle spasms
dantrolene Dantrium General spasticity
onabotulinumtoxinA Botox Cervical dystonia, Muscle spasms
orphenadrine Norflex Muscle spasms
metaxalone Skelaxin Muscle spasms
methocarbamol Robaxin Muscle spasms
rimabotulinumtoxinB Mybloc Cervical dystonia
tizanidine Zanaflex General spasticity

Are skeletal muscle relaxants safe?

Evidence supporting the effectiveness of skeletal muscle relaxants for muscle spasm is sparse; most trials are old and not of good quality.

Skeletal muscle relaxants consist of a varied range of medicines and some may not be suitable for people with certain medical conditions such as an enlarged prostate, epilepsy, glaucoma, intestinal problems, liver or kidney disease, or myasthenia gravis. Many also interact with other medications.

Some, like dantrolene, can adversely affect the liver and blood samples should be taken before treatment to check for any pre-existing liver disease or to establish how well the liver is functioning before treatment, and what effect the drug subsequently has.

Muscle relaxants can affect overall muscle tone and may be dangerous if muscle tone is needed for safe balance or movement. Alcohol can enhance these effects. Many muscle relaxants need to be tapered off slowly, rather than abruptly stopped.

List of Common Muscle Relaxers

Muscle relaxers are used in addition to rest, physical therapy, and other measures to relieve discomfort. They are typically prescribed for short-term use to treat acute, painful musculoskeletal conditions. Muscle relaxers are occasionally prescribed for chronic pain (pain lasting longer than 3 months).

Muscle Relaxant List
Muscle Relaxant List

Muscle relaxers are not a class of drugs—meaning they do not all have the same chemical structure or work the same way in the brain. Rather, the term muscle relaxer is used to describe a group of drugs that act as central nervous system depressants and have sedative and musculoskeletal relaxant properties.

Muscle relaxers may be prescribed to treat back pain:

  • Early in the course of back pain, on a short-term basis, to relieve pain associated with muscle spasms
  • When back pain causes insomnia (for their sedative effect)

Muscle relaxers are also prescribed for other conditions such as fibromyalgia, multiple sclerosis, and seizure disorders.

There are several types of muscle relaxer medications commonly used to treat back pain.

Common Muscle Relaxants

Muscle relaxers are usually prescribed to treat back pain in conjunction with rest and physical therapy. Common muscle relaxants include:

  • Baclofen. Muscle tightness and muscle spasms, including those related to spine injuries, may be eased with baclofen. The medication may be helpful in treating multiple sclerosis and stabbing nerve pain. It is available as a tablet and can be taken by children as young as 12 years old. Some common side effects could include nausea and vomiting, confusion, drowsiness, headache, or muscle weakness. Baclofen is rated C in the FDA’s A through X pregnancy safety ranking for medications, with A being the safest. The C category means that the medication should only be used if the benefits outweigh the risks.
  • Benzodiazepines. In addition to treating anxiety, alcohol withdrawal, and seizure disorders, such as epilepsy, benzodiazepines can also treat muscle spasms and skeletal pain. Benzodiazepines, such as diazepam (Valium), lorazepam (Ativan), and temazepam (Restoril), are typically only intended for short-term use. This limitation is due to their habit-forming potential and because they alter sleep cycles, leading to sleep difficulties once the drug is stopped. Benzodiazepines are sold as tablets, liquid, injections, and rectal gels. People who have myasthenia gravis, severe liver disease, serious breathing troubles, or some forms of glaucoma, should avoid taking diazepam. All benzodiazepines are rated D by the FDA for safety during pregnancy and are not recommended for women who are pregnant.
  • Carisoprodol (Soma). Carisoprodol relaxes muscles and eases pain and stiffness caused by acute bone and muscle problems, often caused by an injury. It is taken by mouth in tablet form and is also available in combination with aspirin or aspirin and codeine. Carisoprodol can be habit-forming, particularly if used in conjunction with alcohol or other drugs that have a sedative effect, including opioids (such as codeine). Common side effects include drowsiness, dizziness, and headache. People with a history of blood disorders, kidney or liver disease, and seizures may need to avoid Carisoprodol. It is rated C in the FDA’s pregnancy safety ranking for medications.
  • Chlorzoxazone (Lorzone). Chlorzoxazone is used for the relief of discomfort from acute, painful, musculoskeletal conditions. Chlorzoxazone is available as a tablet. Common side effects include drowsiness, dizziness, and nausea. Chlorzoxazone is not recommended for people with liver disease. It has not been rated by the FDA for safety during pregnancy.
  • Cyclobenzaprine (Amrix, Fexmid, FlexePax Kit, FusePaq Tabradol). Cyclobenzaprine eases stiffness and pain from muscle cramps, also called muscle spasms. It is available as a tablet and extended-release capsule. Cyclobenzaprine itself is not intended for long-term use (more than 2 to 3 weeks). Cyclobenzaprine ( Generic Flexeril )
  • Common side effects include blurred vision, dizziness or drowsiness, and dry mouth. It is not advised for those with an overactive thyroid, heart problems, or liver disease. Cyclobenzaprine is rated B by the FDA for safety during pregnancy, making it the safest muscle relaxant to use while pregnant.
  • Dantrolene (Dantrium). Dantrolene helps control chronic spasticity related to spinal injuries. It is also used for conditions such as stroke, multiple sclerosis, and cerebral palsy. Dantrolene is taken as a capsule or intravenous powder for injection. Drowsiness and sensitivity to light are common side effects. It can cause severe liver problems, and should not be taken by people with active liver disease. The FDA has given dantrolene a C rating for safety in pregnancy.
  • Metaxalone (Skelaxin, Metaxall, and Metaxall CP, Lorvatus PharmaPak). Metaxalone targets pain and muscle spasms from sprains, strains, and muscle injuries. It is available as a tablet or injection. Common side effects include drowsiness, dizziness, nausea, and vomiting. Metaxalone is generally not recommended for people with a known tendency to become anemic, and who have kidney or liver disease. Metaxalone may affect blood sugar tests for people with diabetes. The FDA has not rated metaxalone for safety during pregnancy.
  • Methocarbamol (Robaxin, Robaxin-750). Methocarbamol eases acute muscle and bone pain. It can be taken as a tablet or by injection.Methocarbamol (Generic Robaxin) Common side effects include dizziness, headache, nausea, flushing, and blurred vision. Methocarbamol is generally not recommended to people with renal disease or failure, or a history of allergic reaction to the medication. The FDA has given methocarbamol a C rating for safety during pregnancy.
  • Orphenadrine. Orphenadrine is a medication used to relieve pain and stiffness caused by muscle injuries. It is available as an extended-release tablet. Common side effects include dry mouth, lightheadedness, difficult urination, heartburn, nausea and vomiting. It is generally not recommended to people with previous sensitivities to the ingredients, myasthenia gravis, those with glaucoma or certain types of ulcers. The FDA has given orphenadrine a C rating for safety during pregnancy.
  • Tizanidine (Comfort Pac with Tizanidine, Zanaflex). Tizanidine is used to treat muscle spasms caused by spinal cord injuries and other conditions such as multiple sclerosis. Tizanidine is available in tablet and capsule form and absorbs differently depending on whether it is taken on an empty stomach or with food. Zanaflex (Generic Tizanidine)Common side effects include dry mouth, dizziness, constipation and tiredness. It should not be used by people taking fluvoxamine or ciprofloxacin or those who have liver disease. Tizanidine is rated in the C category for safety during pregnancy.

Sometimes the first muscle relaxers a doctor prescribes does not work as well as expected. It may be necessary to try an alternative if the initial prescription is not effective. Many drugs interact with muscle relaxers and a person should keep their health care provider informed of all prescription and non-prescription medications he or she is taking.

There is very little research regarding which muscle relaxers are most effective, so the choice of which medication—or whether to use one at all—is based on factors such as a person’s reaction to the medication and personal preferences, potential for abuse, possible drug interactions, and adverse side effects.

Medication is just one part of pain relief. These medications are intended to be one element, usually on a short-term basis, of an overall recovery strategy that includes rest, stretching, physical therapy, and other exercise.

About Soma ( Carisoprodol )

Carisoprodol, sold under the brand name Soma among others, is a medication used for musculoskeletal pain.  Use is only approved for up to three weeks.  Effects generally begin within half an hour and last for up to six hours. It is taken by mouth.

Common side effects include headache, dizziness, and sleepiness. Serious side effect may include addiction, allergic reactions, and seizures. In people with a sulfa allergy certain formulations may result in problems. Safety during pregnancy and breastfeeding is not clear. How it works is not clear. Some of its effects are believed to occur following being converted into meprobamate.

Carisoprodol is meant to be used along with rest, physical therapy and other measure to relax muscles after strains, sprains and muscle injuries. It comes in tablet format and is taken by the mouth three times a day and before bed.

Carisoprodol was approved for medical use in the United States in 1959. Its approval in Europe was withdrawn in 2008.  It is available as a generic medication. In the United States the wholesale cost is less than US$0.10 per dose.  In 2017, it was the 255th most commonly prescribed medication in the United States, with more than one million prescriptions. In the United States, it is a Schedule IV controlled substance.

Soma ( Carisoprodol ) is a controlled prescription and we can not sell it online. It is also illegal for you to buy Soma ( Carisoprodol ) online.


Side Effects Associated with Muscle Relaxers

Side effects of muscle relaxers include:

  • Sleepiness or grogginess
  • Fatigue
  • Dry mouth
  • Constipation
  • Nausea

More serious side effects include:

  • Light-headedness or fainting
  • Blurred vision
  • Confusion
  • Urinary retention

Any serious side effects should be reported to a doctor immediately.

Warnings for prescription muscle relaxants

Muscle relaxants such as carisoprodol and diazepam can be habit forming. Be sure to take your medication exactly as prescribed by your doctor.

Muscle relaxants can also cause withdrawal symptoms, such as seizures or hallucinations (sensing things that aren’t real). Do not suddenly stop taking your medication, especially if you’ve been taking it for a long time.

Also, muscle relaxants depress your central nervous system (CNS), making it hard to pay attention or stay awake. While taking a muscle relaxant, avoid activities that require mental alertness or coordination, such as driving or using heavy machinery.

You should not take muscle relaxants with:

  • alcohol
  • CNS depressant drugs, such as opioids or psychotropics
  • sleeping medications
  • herbal supplements such as St. John’s wort

Talk to your doctor about how you can safely use muscle relaxants if you:

  • are older than 65 years
  • have a mental health problem or brain disorder
  • have liver problems

Off-label medications for spasticity

Doctors can use certain medications to treat spasticity even when the drugs are not approved for that purpose by the U.S. Food and Drug Association (FDA). This is called off-label drug use. The following drugs are not actually muscle relaxants, but they can still help relieve symptoms of spasticity.


Benzodiazepines are sedatives that can help relax muscles. They work by increasing the effects of certain neurotransmitters, which are chemicals that relay messages between your brain cells.

Examples of benzodiazepines include:

  • clonazepam (Klonopin)
  • lorazepam (Ativan)
  • alprazolam (Xanax)

Side effects of benzodiazepines can include drowsiness and problems with balance and memory. These drugs can also be habit forming.


Clonidine (Kapvay) is thought to work by preventing your nerves from sending pain signals to your brain or by causing a sedative effect.

Clonidine should not be used with other muscle relaxants. Taking it with similar drugs increases your risk of side effects. For instance, taking clonidine with tizanidine can cause very low blood pressure.

Clonidine is available in brand-name and generic versions.


Gabapentin (Neurontin) is an anticonvulsant drug typically used to relieve seizures. It’s not fully known how gabapentin works to relieve muscle spasticity.  Gabapentin is available in brand-name and generic versions.

Over-the-counter options for muscle spasms

OTC treatment is recommended as first-line therapy for muscle spasms caused by conditions such as acute lower back pain or tension headache. This means you should try OTC treatments before prescription medications.

OTC treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or a combination of both. Your doctor or pharmacist can help you choose an OTC treatment.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs work by blocking your body from making certain substances that cause inflammation and pain. NSAIDs are available in generic and brand-name versions. They’re typically sold over the counter. Stronger versions are available by prescription.

NSAIDs come as oral tablets, capsules, or suspensions. They also come as chewable tablets for children. Side effects of these drugs can include upset stomach and dizziness.

Examples of NSAIDs include:

  • ibuprofen (Advil, Motrin)
  • naproxen (Aleve)


Acetaminophen (Tylenol) is thought to work by blocking your body from making certain substances that cause pain. Acetaminophen is available in generic and brand-name versions. It comes as immediate-release and extended release oral tablets and capsules, orally disintegrating tablets, chewable tablets, and oral solutions.

The more common side effects of acetaminophen can include nausea and upset stomach.

Can cannabis be used to treat muscle spasticity or spasm?

Yes, in some cases.

Cannabis, more commonly known as marijuana, is legal in certain states for medicinal uses. Muscle spasm is one of the health conditions that cannabis is used to treat. It helps relieve muscle spasms by reducing pain and inflammation.

Cannabis has also been used to treat muscle spasticity due to multiple sclerosis (MS). In many research trialsTrusted Source, cannabis has been shown to be effective alone and in combination with other treatments for reducing muscle spasticity symptoms.   However, there’s limited information available on the use of cannabis for muscle spasticity that’s not associated with MS.

If you’re being treated for MS and still have muscle spasms or spasticity, adding cannabis may help. Talk to your doctor about whether it’s a good option for you.

You should keep certain factors in mind. The more common side effects of cannabis include dizziness, vomiting, urinary tract infections, and a relapse of MS. Also, limited information is available about drug interactions and other usage warnings.

Risks Associated with Muscle Relaxers

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. Muscle relaxants are generally used for a few days and up to 3 weeks, but are sometimes prescribed for chronic back pain or neck pain.

To minimize risk, the doctor should be informed of any history of seizures, liver disease, and any other medical conditions or concerns. Women should inform their doctors if they are pregnant, plan to become pregnant, or are breast-feeding.

  • Sleepiness. Because muscle relaxers are total body relaxants, they typically induce grogginess or sleepiness. As a result, it is not safe to drive or make important decisions while taking muscle relaxers. Muscle relaxers are often suggested for evening use due to their sedative effect.
  • Interactions with alcohol. Drinking alcohol can be especially dangerous when taking muscle relaxers. The sedative effect of the medication is intensified with alcohol use, and combining the two can be fatal.See Alcohol Avoidance
  • Allergic reactions. No medication should be taken if the person has had an allergic reaction to it in the past, even if the reaction seemed mild. Symptoms of an allergic reaction include swelling in the throat or extremities, trouble breathing, hives, and chest tightness.
  • Potential for abuse. Muscle relaxers have a risk of misuse and abuse. Some muscle relaxers, such as cyclobenzaprine, can be habit-forming on their own. Others may be taken in conjunction with other drugs, such as opioids, to create a high, and are therefore more likely to be abused.See Opioids for Back Pain: Potential for Abuse, Assessment Tools, and Addiction Treatment
  • Tapering off. Stopping a muscle relaxer abruptly can be harmful. Instead, the doctor will prescribe a gradual reduction in dosage.

Concern About Overuse of Muscle Relaxants

The use of muscle relaxers 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.1,2 Other research, however, found that people visiting an emergency room for back pain received no additional benefit from taking muscle relaxers.3

What is the best muscle relaxer?

It’s difficult to declare one muscle relaxant better than all others because each type has its own advantages and uses. In general, pain relief treatments fall into one of three categories: over-the-counter (OTC), prescription, and natural. Determining the best muscle relaxer depends entirely on your specific condition and pain level. When in doubt, consult your healthcare provider.

Over-the-counter remedies: OTC pain relievers are often the first line of defense against pain, inflammation, and tension. They can work wonders for milder conditions like neck and lower back pain. Typically, your doctor might start you out on an OTC medication, and if that doesn’t provide the relief you need, he or she may write a prescription for something higher-grade.

Prescription drugs: For more chronic pain and conditions where OTC medications just won’t cut it, your doctor may prescribe something stronger. Because of their more serious side effects, prescription muscle relaxers are designed for short-term use, after which your doctor will transition to other drugs or treatments.

Natural remedies: For minor soreness and stress-related symptoms, the only treatment you need might be drawn straight from nature. Before rushing off to the doctor for an examination and potential prescription, you might be able to administer an effective plant-based therapy right from home.

What is the best over-the-counter (OTC) medicine for muscle pain?

These are the medications that you can find while perusing the aisles at your local pharmacy or convenience store. Most of them are household names, and it’s not uncommon to keep them on hand, stashed in a medicine cabinet, just in case. Even though OTC medications are easy to obtain, they’ll do the job for many aches and pains, and doctors often recommend them prior to prescribing stronger treatment options.

“OTC NSAIDS, like ibuprofen and naproxen, are a good first line agent to decrease inflammation surrounding an injury,” recommends Joanna Lewis, Pharm.D., creator of The Pharmacist’s Guide. They might not have the same potency of high-grade muscle relaxants, but they’re still effective and have very few side effects. If you roll your ankle at the gym or wake up with back pain, try one of these before asking your doctor for a prescription.

  1. Advil (ibuprofen): This is a staple of parents, doctors, and athletes alike. Ibuprofen is one of the most widely used nonsteroidal anti-inflammatory drugs (NSAIDs) available. As such, Advil doesn’t just remedy pain, but also inflammation as well. It’s highly versatile. Use it to treat low back pain, osteoarthritis, menstrual cramps, fever, headaches, migraines, sprains, and other minor injuries. Low doses are available over the counter, but a doctor can prescribe higher doses as well.
  2. Motrin IB (ibuprofen): Don’t be fooled by the different brand name. Motrin IB and Advil are the same drug. Therefore, they shouldn’t be taken together, as it could increase the risk of overdose.
  3. Aleve (naproxen): Another medicine cabinet staple, naproxen is similar to ibuprofen in many ways. It’s also an NSAID, so it works by reducing inflammation. It’s useful in treating muscle pain, headaches, migraines, osteoarthritis, fever, cramps, and minor injuries. The main difference between naproxen and ibuprofen is their dosing. You can take naproxen every eight to 12 hours and ibuprofen every four to six, so Aleve is slightly longer-lasting.
  4. Aspirin: One more NSAID for you. Aspirin treats many of the same conditions, relieving pain and reducing inflammation. However, daily doses of aspirin have been proven effective at reducing the risk of blood clots, strokes, and heart attacks in some people. Ask your doctor before using for clot prevention. If you’re a candidate, you will likely take a “baby” aspirin, or 81 mg, coated tablet daily. Common brand names include Bayer or Ecotrin.
  5. Tylenol (acetaminophen): Unlike NSAIDs, acetaminophen focuses solely on treating pain—not inflammation. It’s used for muscle aches, headaches, migraines, back and neck pain, fevers, etc. However, if swelling and inflammation is the underlying cause of your pain, acetaminophen will not be nearly as effective as NSAIDs like those listed above. Acetaminophen’s wide range of uses and relatively few side effects make it the most popular OTC pain reliever worldwide.


Antispasmodic drugs are better for relieving muscle pain due to uncontrolled muscle contractions.

The following are muscle relaxants classified as antispasticity drugs:

  • baclofen (Lioresal)
  • dantrolene (Dantrium)

The following muscle relaxants are considered antispasmodic drugs:

  • carisoprodol (Soma)
  • chlorzoxazone (Parafon Forte)
  • cyclobenzaprine (Flexeril, Amrix)
  • methocarbamol (Robaxin)
  • orphenadrine (Norflex)

The following medications are classified as both antispasticity and antispasmodic medications:

  • diazepam (Valium)
  • tizanidine (Zanaflex)