We’re going to talk about, do muscle relaxers stop pain, and how do they work, and answers to common questions and concerns.
Chris does an excellent job of talking and giving you good layman’s explanations. These are questions that, when you leave the doctor or the pharmacist, you’d say, “Geez, I wish I would have asked this question, that question about the medication.” So Chris gets 30 seconds per customer, right? Or roughly, because there’s a big line.
Discussion on Muscle Relaxers
Oh yeah, it seems like it. Yeah, and we’re going to take much longer than that. So this is a really good culmination of information for you. So, uh, are we ready, Chris? I think we’re ready. Yeah, all right, okay.
Types of Muscle Relaxers
All right, uh, so, uh, the medication is muscle relaxers. Now, that covers a whole, yeah, there’s a whole bridge of, I mean, there’s several that we use. So, I mean, is there anyone that’s most common? Or, yeah, I’d say probably cyclobenzaprine is probably the most common. Say that again, they’re pretty psycho… benzoprene, okay? Psychobenzality, yeah, they always have these big words on there. We don’t get out of school till we say each name five times fast. I mean, it’s just, you gotta rattle it off, otherwise, they don’t give you a degree. Yep, I understand.
Clarification on Pronunciation
I just wanna make sure that the listeners, uh, you know, get a hold of it. Yeah, um, so that’s one of the more positive, yeah, I would say this, yeah, it’s one of the more common ones that I see. Yeah, I mean, you’re going to see methylcarbonyl, metaxalone, you know, you’ll see tizanidine, you’ll see baclofen. Sometimes you’ll see diazepam, actually. So there’s a lot of different reasons why they’ll prescribe different ones.
Specific Muscle Relaxer
The one that we, uh, you know, Carisoprodol, we can talk about that because that’s addictive. So, oh, okay, yeah, so, yeah, we’ll make a side note on that, cover this. So, uh, let’s go back to muscle relaxers, uh, and it’s like the title says, do they stop pain? So what’s the most commonly, uh, prescribed reason for a muscle relaxant?
Purpose of Muscle Relaxers
Yeah, well, I mean, the general term is gonna be a muscle spasm. And so, this, you know, we’re walking right into the, uh, the hallmark of your arena, I think. And, and so, when people come in, it can be for a variety of different reasons. So let’s say you have a patient that’s suffering from fibromyalgia, and they have real tight, painful muscles. It could be just a back strain, a neck strain, maybe they were in a car accident, a weekend warrior project, you know, I mean, so there’s a lot of reasons why our muscles go into a spasm or they’re very tight.
Muscle Spasms and Pain
And then, when they go on that tight spasm, pain, it hurts, associated with a bad day, I mean, it can, it can screw up your posture, I mean, you can’t stand up straight, maybe. If you have something, I mean, personally, I’ve had, you know, problems with L4 and L5 in my spine, and I’ve had points where I, you know, see for Chris, and I also look like the letter C,
because I was hunched over like a, uh, you know, a little, little, that’s not funny, but, no, you did a good job. But, I mean, it, it can hurt quite a bit. And so, you know, it’s always, it’s gonna be an urgent care visit, in a lot of cases, you usually aren’t gonna have time to, uh, I’d like to schedule an appointment with Dr. Smith today
Urgent Care Visits
I’m really in a lot of pain. You know, you’re gonna go in, it’s gonna be an urgent situation, and, you know, interesting, the mainstays, and a lot of people will try Tylenol or ibuprofen or Aleve, because those are kind of the mainstays of therapy at first, because, yeah,
because they’re, they help with the pain, and the first thing that people, like, gosh, I’m in just, they’re uncomfortable, and you can, when they come in to see me, they’re having trouble walking back to the pharmacy, they’re, you know, maybe not real comfortable, counter, so you can see that it’s definitely affecting them.
How Muscle Relaxers Work
Mechanism of Action
And so, well, I just want to, don’t skip the point of why do these muscles, we have an injury, why do they contract and spasm and cause more pain? It doesn’t make sense. Yeah, I mean, it’s, you know, it’s a whole complex, complicated events that go on to lead to that point. I mean, really, in a lot of cases, spasming really is kind of trying to act as a protective mechanism. Your body recognized something wasn’t right, so they’re trying to correct it.
Protective Mechanism
So it’s actually, and I knew this, but I still want to make, oh yeah, yeah, the viewers, the viewers understand, the muscles are contracting around the injury to splint it. Yep, to keep it from moving and protect it. But the over-spasm, and once the muscle contracts that tight for so long, it becomes very painful, because we get the lactic acid buildup,
we don’t have circulation, and it’s a compound, yeah, and it is, and like you say, it’s kind of like that proverbial snowball rolling downhill, the problem, it might be, you know, it’s kind of funny, sometimes these injuries, you’ll get, it’s kind of mild, and also, it’s like, oh, in the later house, and you kind of cool off, you’re like, oh, this is not good, sure.
Common Muscle Relaxers
Cyclobenzaprine
And so, they go in, and they see the doctor, and, interesting, so they come in, and we’ll just, we’ll just pick on cyclobenzaprine for starters, just take that one, and so they’ll come and see me, and, usually, it’s dosed as a five or a 10 milligram tablet, and, usually, any from it can be dosed up to three times a day. Most commonly, because the biggest side effect of these things is sedation.
Side Effects of Muscle Relaxers
Drowsiness and Sedation
And that’s probably why it works, I mean, when these muscles are really tight, and, and hammered on like that, where they just don’t want to relax, basically, it’s not fully understood by anyone, of the muscle reactions that we prescribe, but we just know that it works in a central, so it works on the spinal system, it works centrally, except for the one that’s called dantrolene, which is the only peripheral one, other than, like, Botox, but we aren’t going to talk about those.
Relaxation of Skeletal Muscles
Um, but they kind of help to just relax, that, the whole central nervous system, it kind of calms down, all that conduction velocity with the nerve, all the fancy stuff that kind of goes on, and, another one is, telling the muscle to relax, but, it doesn’t, yeah, it doesn’t just tell the tight muscles to relax, again, it relaxes all skeletal muscle, so, I mean, so let’s say you’ve got a back problem,
I mean, you could, and that’s one of the problems, especially as we age, too, that these effects can be much compounded, and there’s this fancy drug list called the Beers list, which are drugs that we would call inappropriate for people over the age of 65.
Beers List and Age Considerations
Age-Related Concerns
Beers, beers, like, just like we’re drinking beers, okay, the Beers list, it’s named after a physician, so you can go online and find this. Yeah, you really can, and, actually, it’s a very important, uh, topic for pharmacists, because we deal with this quite a bit, sure, because we, you know, we know the age of everybody that’s coming in, so we’re going to, oh,
Age-Related Concerns
…oh, you got cyclobenzaprine, Mrs. Smith, and I see you’re 68 years old, you need to be very cautious with this, because it’s going to make you very tired. Now, a lot of times, doctors recognize fully that these drugs are on the Beers list, but there really aren’t a lot of other choices,
I mean, so they kind of, so they’ll go with a lower dose, and then what we do is, pharmacists, hey, you need to be careful with driving, you should not be driving, you should not be drinking alcohol with these products, you know, you need to know exactly how you can respond.
Precautions and Interactions
Important Safety Information
Um, I wouldn’t be planning on doing, you know, extra heavy yard work, because you may not have total control of your muscles, because they’re more relaxed, so you might perceive some weakness. So these are things that can all occur, across the board, and any one of these muscle relaxants will cause all of those.
Alternatives to Muscle Relaxers
Physical Therapy as an Alternative
So let’s say I talk about metaxalone, I talk about methylcarbomol, I talk about tizanidine, baclofen, they all have this side effect profile, so it’s not just one. And so, when I speak to them, it’s going to be a very generalized set of terms, be careful, because this is going to make you tired. And as a physical therapist, I cannot tell you how many times I’ve had patients come in,
they’ve seen the doctor, the doctor prescribes the muscle relaxants, oftentimes for back spasms, uh, and that’s the biggest complaint I’m getting, so tired, I, I just can’t function, uh, and then as a therapist, I’m thinking, well, did you try a cold pack, did you try positioning, uh, and I don’t ask them that, I’m thinking that, yeah, so it’s possible.
Importance of Physical Therapy
Addressing Underlying Issues
And I think, I don’t know if it’s very possible, but there’s good odds that there are options that a physical therapist could help you with, for example, cold pack with proper positioning of the body to reduce low back pain and back spasms can be very effective, and then you may not need the muscle relaxation, and that’s, you know, and fully, I think that’s the point that we need to touch on, that’s really important for everybody out there, that uses these things.
Conclusion
Key Takeaways
Is you know, a lot of times, I see people, because they come in an acute situation, you know, I think doctors are just trying to treat the pain and move them on, because they’re in such a busy situation, I think, you know, and I, I often times,
at the console, and say, hey, if this doesn’t seem to solve your problem in a couple of days, I would really ask your doctor about getting set up with physical therapy, because they can recondition those muscles, they can get you back on your feet much faster than just relying on the drug alone.
Final Thoughts
Importance of Physical Therapy
I mean, the studies do suggest that with or without treatment, the muscle will go back on its own, but the reality of it is, is you got pain, you got discomfort, people have busy lives, they don’t have time to be down, so we give them these products to help them to get on their feet more quickly, but at the same time, probably the fastest mechanism,
getting back to better, is seeing you, seeing a physical therapist, to actually help to recondition that muscle, and get it back to its natural state, that’s in our wheelhouse, we all the modalities, the options, the way to treat it without medications, that’s what we do, and that’s what’s best, yeah, frankly.
Closing Remarks
Final Words
The doctors really don’t always have the time, like you said, they may have 15 minutes, and they may have, you know, or less, 10 more patients waiting for them, uh, and the people want relief now, and so, and they do, and they’re very good at judging what they need, and it’s again, it’s a triage position, they come from a point of, well, I’ve got this bad person, this bad back, or bad neck, or they’re in a car, you know, whatever,
