How Are Muscle Relaxants Used? Effect and Side Effects

Muscle relaxants are used to treat muscle spasms and involuntary muscle stiffness (spasticity). Muscle relaxants can be prescribed in order to reduce the hyperexcitability of the muscles in many problems that fall into the field of physical therapy and rehabilitation. They can be preferred for short-term (acute) pain and in cases where the pain makes it difficult to sleep.

Muscle spasm is sudden uncontrolled muscle contraction; can cause pain and limitation of movement. Muscle spasms can be seen in problems such as hernia, myofascial pain, fibromyalgia, which cause low back, back or neck pain. Spasm may occur for reasons such as muscle strain, sprain, nerve root compression (radiculopathy). The characteristic of muscle spasm is the inability of the person to relax their muscles voluntarily. Painful conditions can cause muscle contraction as a side effect. Another view is that muscle spasm is a protective mechanism that occurs to support damaged joint or spine structures.

Spasticity, which causes an increase in muscle tension, is a problem that occurs in brain or spinal cord diseases (stroke, traumatic brain injury, cerebral palsy, spinal cord paralysis, MS, etc.) Spasticity makes it difficult to control movements, can impair gait, speech and dexterity.

Muscle relaxants may be prescribed to reduce muscle spasm and spasticity and to treat associated pain and limitation of movement. These drugs reduce hyperexcitability without impairing the functionality of the muscles. They can provide this by the central nervous system, the junction of the nerve and muscle (nerve-muscle junction) or by acting directly on the muscle. Medicines for muscle spasm are called antispasmodics, medicines for spasticity are called antispastic drugs. Some drugs can have both antispasmodic and antispastic effects.

Antispasmodic Muscle Relaxants

These drugs have a central effect, that is, they relax the muscles through their effects on the central nervous system. It is thought that they have an effect thanks to their soothing and suppressing pain signals. It is not recommended to use them longer than 2-3 weeks due to possible side effects.

Molecules such as chlorzoxazone, tizanidine, and cyclobenzaprine are among the drugs in this group. Tizanidine is also used in the treatment of muscle spasticity.

Tizanidine can be preferred in the treatment of both spinal cord and brain spasticity. Suppressing pain signals in the spinal cord may be an advantage in chronic painful conditions such as fibromyalgia and MAS . It may have side effects such as sedative effect, dizziness, dry mouth.

It can be used together with muscle relaxant drugs, non-steroidal anti-inflammatory drugs and drugs containing acetaminophen. However, it has more side effects than pain relievers. They can have a calming effect (sedation). Side effects such as dizziness, drowsiness, and headache may also occur. Withdrawal symptoms such as tremors, hallucinations, anxiety, muscle twitches may occur if it is suddenly discontinued after prolonged use.

Side Effects of Antispasmodic Muscle Relaxants

Side effects such as drowsiness, dizziness, headache, irritability, red or orange urine color, and low blood pressure may occur. Ask your doctor or pharmacist about the side effects of a particular drug.

Antispastic Drugs

Baclofen, dantrolene, diazepam molecules are examples of drugs in this group.

Baclofen can be preferred for spasticity treatment in diseases such as MS, spinal cord injury. It acts via a suppressive molecular pathway (GABA) in the central nervous system. It blocks signals originating from the spinal cord that cause muscle spasm. It has less effect on spasticity originating from levels higher than the spinal cord, such as stroke and brain damage. When the treatment is started, the side effects of drowsiness may be more in the first days; then it usually decreases. It may have side effects such as nausea, dizziness, headache, weakness. In excessive doses, it can increase the frequency of seizures. If spasticity cannot be controlled with tablet form in diseases such as MS, spinal cord paralysis, and brain damage, the drug can be administered directly around the spinal cord by a method called an intrathecal baclofen pump.

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Dantrolene can be used to treat spasticity in diseases such as spinal cord injury, stroke, cerebral palsy and MS. It acts directly on striated muscles. Therefore, it can cause muscle weakness. It may cause side effects such as drowsiness, dizziness, weakness.

Diazepam can be used to reduce muscle spasms due to infection, trauma, or spasticity. It is thought to act by reinforcing the effect of the muscle activity-suppressing molecules in the spinal cord. It can have a sedative effect by affecting the levels higher than the spinal cord. It can cause drowsiness, weakness and muscle weakness. If used for a long time, it can cause addiction and addiction. Sudden discontinuation after long-term use may lead to effects such as seizures, anxiety, palpitations.

Botulinum toxin A injection into the relevant muscles is another option for spasticity that cannot be treated with tablets in the form of drugs and physical therapy methods .

How Should Muscle Relaxants Be Used?

Some muscle relaxants can be habit-forming. You should use it as prescribed by the doctor. If they are stopped suddenly, they can lead to different complaints called withdrawal symptoms.

Drugs that act by suppressing the central nervous system can reduce attention and alertness. For this reason, it is not recommended to be taken while performing tasks that require attention, such as using machinery and vehicles. It can be recommended to be taken before going to bed for the first time use.

While using muscle relaxants, it may be inconvenient to take alcohol, morphine derivative (opioid) drugs, sleeping pills and some herbal medicines together.

Muscle relaxants should not be used without a doctor’s prescription in those over 65 years of age, with liver disease or a disease involving the brain.

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