Have you ever tweaked your back, experienced a leg cramp, or woken up with a neck so stiff you can barely turn your head? If so, you’ve probably experienced a muscle spasm or muscle tension. Muscle spasms or tension can occur due to dehydration, overuse, or strain, and they can seriously impact daily activities like sleeping, driving, or lifting objects.

If you have neck or back pain, or you're dealing with some other condition that causes muscle spasms, your doctor might prescribe a muscle relaxer (or muscle relaxant) for you. Muscle relaxers are medications that help to reduce muscle spasms and tension. They work by blocking nerve impulses in the muscles, which helps your muscles relax.

Although muscle relaxers can only be prescribed by a doctor, muscle pain can also be alleviated by over-the-counter (OTC) pain medications with pain-relieving effects, such as acetaminophen (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve).

We’ve teamed up with Sesame’s medical director, Dr. Allison Edwards, MD, to explore popular OTC and prescription muscle relaxants, how they work, and important side effects and precautions. We’ll also discuss when and how to seek a medical provider for proper care.

Best over-the-counter muscle relaxers

Over-the-counter medications are drugs that can be purchased at your local pharmacy or convenience store. Although OTC medications are non-prescription and therefore not the same as prescription muscle relaxers, they can still be extremely effective at reducing pain from muscle pain and spasms. “Over-the-counter medicines like NSAIDs and naproxen can still provide muscle-relaxing effects, such as relief from muscle tension pain,” says Dr. Edwards. “They’re often the first line of defense when treating acute muscle pain.”

We’ve compiled a list of over-the-counter muscle relaxers and prices below as a guide to these medications. As with any over-the-counter medication, be sure to follow the directions on the bottle closely and to always touch base with your primary care provider before taking any new over-the-counter medications.

• Ibuprofen: Ibuprofen, sold under the brand names Advil and Motrin, is one of the most widely-used nonsteroidal anti-inflammatory drugs (NSAIDs) available. NSAIDs reduce pain and inflammation, so they’re able to help with some symptoms of acute (short-term) back pain or muscle spasms. Ibuprofen can also be used to treat pain from headaches or migraines, minor injuries, and reduce fever. It’s typically taken every 4-6 hours depending on strength. In terms of cost and effectiveness, generic ibuprofen is just as effective as Advil and Motrin and is far less expensive. For example, a 100-count bottle of 200mg Advil costs $9.26 at Walmart, while its generic counterpart costs $1.98.
  
• Naproxen: Naproxen, sold under the brand name Aleve, is also an NSAID and can be used to treat pain and inflammation. This makes it a great candidate for the treatment of muscle cramps and spasms. Naproxen is taken every 8 to 12 hours, while ibuprofen is taken every 4-6, so it’s slightly longer-lasting than ibuprofen. Generic naproxen is typically more affordable than its name-brand alternative Aleve. Because NSAIDs are closely related, do not combine different NSAID products, like naproxen and ibuprofen, simultaneously. CVS sells a 100-count bottle of 220 mg naproxen sodium tablets for $9.79, while a 90-count bottle of 220mg Aleve costs $12.49.
  
• Aspirin: Aspirin, also known as acetylsalicylic acid (ASA), is a medication commonly used to reduce fever, headaches, arthritis pain, fevers, colds and flu symptoms, as well as heart conditions such as angina. A 36-count bottle of 81mg aspirin costs $2.99, while its name-brand counterpart Bayers costs $3.59.
  
• Acetaminophen: Acetaminophen, known more commonly by its brand name Tylenol, is an analgesic (pain-relieving) drug commonly used to treat pain and fever. It works by blocking the production of certain chemicals in the body that are responsible for pain and fever sensations. Acetaminophen is available in many forms such as tablets, capsules, liquid solutions, and syrups. A 100-count bottle of 500mg generic acetaminophen costs $5.99 at Walgreens, while the same amount of Tylenol costs $11.99.
  
  

Do I need an over-the-counter muscle relaxer?

Over-the-counter pain relievers can help relieve back pain, neck pain, and other muscle pain symptoms for many people. If you’re unsure about using over-the-counter muscle relaxers, reach out to your doctor to discuss if OTC pain relief is the right solution for you.

“The best way to determine if you need an over-the-counter pain reliever is to talk to your primary care provider,” says Dr. Edwards. “Certain NSAIDs or other OTC pain relievers can still interact with prescription medications, and your healthcare provider can look at your existing prescriptions to ensure that there are no contraindications.”

However, if an OTC medicine doesn’t help you, contact your doctor. You may have another issue that requires prescription medication.

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Prescription muscle relaxers

If over-the-counter pain relief is not helping to alleviate your muscle pain or spasms, you may want to consider prescription medication. Prescription muscle relaxers are used to treat acute, painful musculoskeletal conditions, and are normally prescribed short-term in conjunction with physical therapy and other measures to help treat nerve pain and muscle pain. There are several types of muscle relaxers:

Antispasmodics. Antispasmodics are commonly prescribed for acute back pain or spasms caused by a spine-related problem, such as whiplash, fibromyalgia, or low back pain caused by strain. The most common antispasmodic muscle relaxers include:

• Soma (carisoprodol): Soma is generally used to treat pain associated with acute musculoskeletal conditions. Carisoprodol is a benzodiazepine that acts on the central nervous system to intercept neurotransmitters relayed between the nerves and the brain. It has been associated with addiction, so it should be used with caution. The average price of Soma is $253.24 for 30-count of 250mg tablets
  
• Lorzone (chlorzoxazone): Chlorzoxazone acts on the central nervous system to treat the pain and spasms associated with muscle and bone conditions. It is notably more expensive that some of the other muscle relaxants on the market at a cost of $1,043 for a supply of 100 375-mg tablets.
  
• Flexeril or Amrix (cyclobenzaprine): Cyclobenzaprine is a popular generic muscle relaxant often used short-term to treat muscle spasms and pain related to sprains, strains, etc. The average price of Flexeril is $51.72 for a 30-count of 10mg tablets.
  
• Skelaxin (metaxalone): Skelaxin treats non-chronic muscle pain and has a relatively low rate of side effects and sedation, but it is slightly more expensive at a cost of $190.35 for a 30-count of 800mg tablets.
• Robaxin (methocarbamol): Robaxin is commonly used to treat severe muscle spasms, back pain, and occasionally tetanus spasms. It costs an average of $81 for a supply of 20 750mg tablets.
  
• Norflex (orphenadrine): Norflex is used to treat injury-related pain and spasms, as well as trembling from Parkinson’s disease. It costs an average of $47.46 for a 20-count bottle of 100mg tablets.
  
  The most common side effects of antispasmodic muscle relaxers include:
  
  
• Dizziness
  
• Drowsiness
  
• Blurred vision
  
• Dry eyes
  
• Dry mouth
  
• Nausea
  
• Weakness
  
• Bloating
  
• Constipation
  
  

Antispastics: Antispastics are a class of medications that treat muscle spasticity, which is an abnormal increase in muscle tone or stiffness of muscle. They relax tight muscles and calm spasms. These are not commonly used for acute back pain but are prescribed to treat chronic conditions that involve dysfunction in the central nervous system or spinal cord. Antispastic drugs are frequently prescribed for multiple sclerosis (MS), cerebral palsy, and spinal cord injuries. Common antispastic prescription muscle relaxers include:

• Lioresal (baclofen): Baclofen is primarily used to treat spasticity (continuous muscle tightness or stiffness) caused by multiple sclerosis or spinal cord injury. It is given as an oral tablet or can be injected into the spinal canal (intrathecal injection). It costs an average of $255 for a supply of 20 ml, 0.5 mg/mL solution.
  
• Dantrium (dantrolene): Similar to baclofen, dantrolene is primarily used to treat spasticity. It’s effective for spasms associated with spinal cord injury, stroke, cerebral palsy, or multiple sclerosis, and is also sometimes used for malignant hyperthermia. It costs an average of $122 for a supply of 100 25-mg capsules.
  
• Zanaflex (tizanidine): Zanaflex is primarily used to treat stiffness and spasms associated with multiple sclerosis and cerebral palsy, similar to baclofen. It costs an average of $115.32 for 30 4mg tablets.
  
  

The most common side effects of antispastics include:

• Dizziness
  
• Weakness
  
• Headache
  
• Confusion
  
• Tiredness
  
• Problems falling asleep or staying asleep
  
• Nausea
  
• Constipation
  

The Food and Drugs Administration (FDA) has added a black box warning to benzodiazepine muscle relaxants and other CNS depressants due to their contraindication with opioid medications; according to the FDA, the combined use of opioid medicines with benzodiazepines or other drugs that depress the central nervous system (CNS) has resulted in serious side effects, including slowed or difficult breathing and deaths. Be sure to talk to your doctor if you are actively using or have recently used prescription opioid pain and prescription opioid cough medicines.

How do I get prescription muscle relaxers?

To obtain a prescription muscle relaxer, it is important to first discuss your symptoms with your healthcare provider. If skeletal muscle relaxants are deemed necessary, they will then write you a prescription for the medication. Depending on the particular muscle relaxer prescribed, you may be required to take it orally, through an injection or topically as a cream or ointment.

Before obtaining any prescription, it is important to be aware of all potential side effects associated with this medication. As noted above, common side effects include fatigue, drowsiness and dizziness. It is also important to follow all dosage instructions provided by your doctor in order to ensure that the drug works properly and safely, and that addictive habits are not formed.

Keep in mind that muscle relaxers are intended for short-term use only and should not be taken for longer than two weeks without consulting your physician first. In many cases, alternative treatments such as physical therapy or massage might be beneficial for treating chronic muscle pain and spasms instead of taking the medication over an extended time period.

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When to talk to your doctor?

If you’re unsure about whether or not you should consider prescription drugs such as muscle relaxers as a solution to your pain symptoms, talk to your healthcare provider.

While muscle relaxers can help to provide relief from muscle tension, spasms, and pain, there are also risks associated with their use. While these medications can work quickly when taken correctly, they can become habit-forming if misused or overdosed and can have extreme sedative effects. Additionally, individuals with certain medical conditions such as asthma should not use muscle relaxers since these drugs have been known to cause breathing difficulties in some people.

It is important for anyone considering taking a muscle relaxer to talk to their doctor about any possible risks associated with this type of drug before beginning treatment. Furthermore, it is important to remember that even though muscle relaxers are beneficial for many people who suffer from stiff or sore muscles, these types of drugs should only be used on a short-term basis and should not replace regular rest and physical therapy recommended by your doctor.

Sesame medical providers

Muscle relaxers are currently only available via prescription. This means the use of this drug must be authorized by a licensed healthcare provider.

Looking for a prescription? Providers on Sesame have the ability to write a prescription – or refill an existing one – during a virtual or in-person visit if deemed clinically necessary. Please note that because muscle relaxers have a potential for abuse and addiction, Sesame medical providers exercise extreme caution when prescribing these medications and are not obligated to write or refill a prescription.

The best way to determine whether or not muscle relaxers are right for you is to book an online consultation with a licensed provider on Sesame today. All prescriptions are at the discretion of your healthcare provider. Providers on Sesame cannot prescribe controlled substances.

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References:

• National Library of Medicine Muscle relaxants for back pain
  
• Cleveland Clinic
  • Muscle Relaxers
    
• FDA
  • Drug Safety Communication
    
• Mayo Clinic
  • Spasicity management for spinal cord injury