When you have back pain, your doctor may recommend muscle relaxants—a group of drugs that are typically obtained with a doctor’s prescription. These drugs have the potential to decrease tension and spasm within a sore muscle, which may reduce pain.

1. Muscle relaxants are typically a second-line treatment for back pain

Scientific evidence and medical consensus indicate that back pain must be treated first with pain-relieving medications, such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs). If these treatments fail, doctors may prescribe skeletal muscle relaxants for a short duration.1,2 Examples of prescription skeletal muscle relaxants include cyclobenzaprine and carisoprodol. Research isn’t very robust on the use of muscle relaxants for back pain. The use of these drugs may also be considered controversial by some physicians.

2. Acute back pain may benefit more from a muscle relaxant

While treating acute musculoskeletal back pain, a short course of muscle relaxants may be more effective when used as an adjunctive treatment in the first 3 weeks. They may also be used when back pain causes disturbed sleep (for their sedative effect).3 These drugs exert their muscle-relaxing effects by inhibiting nerve signals in the brain and spinal cord and may help break the pain-spasm-pain cycle, where pain causes your muscles to spasm as a protective response, and those spasms, in turn, cause more pain.

3. They may be more suitable for younger adults

Skeletal muscle relaxants may cause the functions of your central nervous system (CNS) to slow down, leading to CNS depression. As a result, the drowsiness and gait disturbances caused by muscle relaxants may pose a risk of falls and subsequent injury, especially in the elderly population

4. Potential side effects may occur

Several side effects are possible with the use of skeletal muscle relaxants, including but not limited to1: Drowsiness Dizziness or lightheadedness Headache Fatigue Gait disturbances

5. Abuse and serious risks are possible

Muscle relaxants can be addictive, so it's ideal to use them for the shortest possible time and keep them away from other adults and children. Because these medications depress the central nervous system, breathing can be affected, and an overdose can be fatal. Combining a muscle relaxant with alcohol or another medication that also has a sedating effect is especially dangerous.

6. They must be discontinued gradually

If you've been taking a muscle relaxant for an extended period, don't abruptly stop taking it one day. Doing so may set you up for some unpleasant withdrawal symptoms, such as nausea, vomiting, and trouble sleeping. When these drugs need to be discontinued, doctors typically taper the dose gradually before stopping the medicine. It's good to keep in mind that muscle relaxants are just one part of pain control for your back problem. To keep back pain from returning, your doctor may recommend other treatments, such as physical therapy and exercise, ergonomic changes at work, and/or epidural steroid injections.