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. They can seriously impact daily activities like sleeping, driving or lifting objects.

If you have neck or back pain, or another 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.

Muscle relaxers can only be prescribed by a doctor. However, muscle pain can also be alleviated by some over-the-counter (OTC) pain medications. Examples include 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 discuss explore popular OTC and prescription muscle relaxants. We'll chat about how they work, 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. OTC medications are non-prescription and therefore not the same as prescription muscle relaxers. However, they can still be 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. Always touch base with your doctor before taking any new OTC medications, and read bottle instructions closely.

• Ibuprofen
  Ibuprofen is sold under the brand names Advil and Motrin. It's 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, 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 is sold under the brand name Aleve. It's 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 is also known as acetylsalicylic acid (ASA). It's a medication commonly used to reduce fever, headaches, arthritis pain, fevers, colds and flu symptoms. It can also provide relief from 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 is known more commonly by its brand name Tylenol. It'd 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. 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.

List of 10 most common 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. They are normally prescribed short-term in conjunction with physical therapy and other measures to help treat nerve pain and muscle pain. There are two types of muscle relaxers - antisposmodics and antispastics. There are also several medications that fall into both of those categories. Here's how they differ in catgory, symptom treatment, and cost:

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 relaxer names include:

1. 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. Without insurance, the average price of Soma is around $260 for a 30-count of 250mg tablets.
   
2. Lorzone (chlorzoxazone)
   Chlorzoxazone acts on the central nervous system to treat the pain and spasms associated with muscle and bone conditions. It is slightly more expensive than some of the other muscle relaxants on the market, at a cost of roughly $375 for a supply of 30 750-mg tablets without insurance.
   
3. 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 cash price of Amrix - without health insurance- is quite expensive in comparison to other miscle relaxants: about $1,670 per 30, 15mg extended release capsule.
   
4. Robaxin (methocarbamol)
   Robaxin is commonly used to treat severe muscle spasms, back pain, and occasionally tetanus spasms. It's an injection which typically costs about $160 per 2, 10 mL of 1000 mg/10 mL solution without insurance.
   
5. Norflex (orphenadrine)
   Norflex has been discontinued in the U.S. However, generic versions of orphenadrine are still available. It's used to treat injury-related pain and spasms, as well as trembling from Parkinson’s disease. Generic orphenadrine costs about $47 for a 20-count of 100mg tablets.
   
6. Skelaxin (metaxalone)
   Skelaxin is the brand name for metaxalone. While it has been discontinued, the medication is still available in generic form. It treats non-chronic muscle pain and has a relatively low rate of side effects and sedation. If you're uninsured, it costs about $200 for a 30-count of 800mg tablets.
   
   The most common side effects of antispasmodic muscle relaxers include:
   
   
   • Dizziness
     
   • Drowsiness
     
   • Blurred vision
     
   • Dry eyes
     
   • Dry mouth
     
   • Nausea
     
   • Weakness
     
   • Bloating
     
   • Constipation
     
     

Antispastics treat muscle spasticity, an abnormal increase in muscle tone or stiffness. These medications relax tight muscles and calm spasms. These are not commonly used for acute back pain. However, they 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:

7. 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.
   
8. 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 around $100 for a supply of 90 25-mg capsules if you're uninsured.
   
   

The most common side effects of antispastics include:

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

There are also two muscle relaxants that fall into both categories: tizanidine and diazepam.

9. 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 $120 for a 30-count of 4mg tablets if you're uninsured.
   
   
10. Valium (diazepam)
    Valium is the brand name for the medication diazepam. Its sedative effects can help to reduce anxiety, relax muscles and induce sleep. Without insurance, it typically costs around $285 for a 30-count of 5mg tablet.
    
    

In 2016, the Food and Drugs Administration (FDA) 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.

When to talk to your doctor?

Unsure if prescription drugs such as muscle relaxers can help with your pain symptoms? Talk to your healthcare provider! 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. They should not replace regular rest or physical therapy recommended by your doctor.

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.

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 necessary. Please note that muscle relaxers have a potential for abuse and addiction. Therefore, Sesame medical providers exercise extreme caution when prescribing these medications. They are not obligated to write or refill a prescription.

The best way to determine if 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.

References:

• Drug Safety Communication. FDA.
  
• Muscle Relaxers. Cleveland Clinic.
  
• Spasicity management for spinal cord injury. Mayo Clinic.
• Tulder, M., Touray, T., Furlan, A., Solway, S., Bouter, L. Muscle Relaxants for Back Pain. National Library of Medicine.