Cyclobenzaprine in the Treatment of Low Back Pain

Having a muscle spasm means that one or more of your muscles is contracting and the twitching or cramping is out of your control. It can happen for a lot of different reasons, and can sometimes be very painful. If you’re dealing with spasticity and chronic pain related to neurological disease or injury, such as multiple sclerosis or spinal cord injury, then baclofen may be best for you. Additionally, if you’re pregnant or nursing, you should use baclofen only if the perceived benefits of the drug outweigh the risks to the fetus or infant (2). Don’t opt for an excessively long treatment duration with baclofen, as you might find yourself dealing with life-threatening withdrawal symptoms as you try to wind down the treatment.

• However, it is only for short-term relief from acute muscle pain and other skeletal conditions.
• Muscle relaxers (also called muscle relaxants) are prescription medications that affect muscle function.
• Be aware of contraindications and drug interactions when taking these medications.
• Because of this possibility, we conducted a file drawer test to see how many unpublished studies with negative findings would have to be filed away somewhere to negate our findings.
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Eight of 46 RCTs that were retrievable enrolled patients with acute muscle spasm and pain of the neck and/or back. Cyclobenzaprine is used with rest, physical therapy, and other measures to relax muscles and relieve pain and discomfort caused by strains, sprains, and other muscle injuries. Cyclobenzaprine is in a class of medications called skeletal muscle relaxants. It works by acting in the brain and nervous system to allow the muscles to relax. Oral steroids, a non-narcotic type of prescription medication, are very powerful anti-inflammatory medications that are sometimes effective treatment forlow back pain. Like narcotics agents, oral steroids are intended for use for short periods of time (one to two weeks).

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For persistent pain, your primary care physician may recommend muscle relaxants. Cyclobenzaprine (Flexeril) is structurally similar to TCAs and, as such, demonstrates significant anticholinergic side effects. It is generally used for musculoskeletal conditions, including fibromyalgia and low back pain. Cyclobenzaprine is best used in short-term treatment but may be used intermittently or long-term for chronic pain.

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Be aware of contraindications and drug interactions when taking these medications. The research regarding the efficacy of baclofen for the treatment of common musculoskeletal conditions, such as back pain, is limited (2, 4). One study found that patients with acute lower back pain treated with ibuprofen (NSAID) alone had similar pain and function levels to patients treated with baclofen and ibuprofen (7). Antispastic drugs work at the spinal cord or on specific muscles to reduce muscle tone and involuntary movement. As the name suggests, they treat spasticity, a muscle’s resistance to movement that’s dependent on the speed of movement. Spasticity commonly results from injury to the central nervous system.

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Among these 14 trials, 11 found benefit and 3 did not, although only 8 were placebo controlled. The review concluded that there was strong evidence for the benefit of muscle relaxants and that the different types of muscle relaxants were equally effective in treating acute back pain. Outcomes included global improvement and 5 specific domains of back pain (local pain, muscle spasm, range of motion, tenderness to palpation, and activities of daily living).

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If you notice any other effects, check with your healthcare professional. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

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At oral doses of up to 10 times the human dose, cyclobenzaprine did not adversely affect the reproductive performance or fertility of male or female rats. Cyclobenzaprine did not demonstrate mutagenic activity in the male mouse at dose levels of up to 20 times the human dose. If you’re experiencing acute back or neck pain as a result of musculoskeletal injury or fibromyalgia, then cyclobenzaprine is your best option. The intrathecal administration of baclofen must be monitored closely by the medical team and patient to ensure the pump is working properly (2). Any issues with the delivery system can induce withdrawal from the drug in patients who have been using baclofen for more than two months (2).

Examples of conditions involving muscle spasticity include cerebral palsy, multiple sclerosis, and spinal cord injury (1). Baclofen is a common antispastic prescribed to treat these conditions. Cyclobenzaprine reduces pain and leads to global improvement compared with placebo for 1 in every 3 to 9 patients in the first week. Taken 3 times daily, 5 mg is as effective as 10 mg, with less somnolence. Yes, cyclobenzaprine can make you very sleepy and this side effect may get worse with higher doses.

The drug comparison information found in this article does not contain any data from clinical trials with human participants or animals performed by any of the drug manufacturers comparing the drugs. Ultram may also interact with antibiotics, antifungal medications, heart medications, medicines to treat HIV or hepatitis C, antipsychotic medicines, and migraine headache medicines, medicines to treat serious infections. Side effects of Flexeril that are different flexeril is it controlled substance from Ultram include dry mouth or throat, blurred vision, fatigue, loss of appetite, gas, or muscle weakness. Side effects of Flexeril and Ultram that are similar include headache, drowsiness, dizziness, stomach pain or upset, nausea, diarrhea, or constipation. Flexeril is a muscle relaxant and Ultram is a pain reliever (analgesic). Overdose symptoms may include severe drowsiness, vomiting, fast heartbeats, tremors, agitation, or hallucinations.

Flexeril usually takes between 45 minutes to an hour to work after being ingested to show relaxation activity. It peaks at around 3 to 4 hours, and then the effects begin to wear off. This timeline is appropriate for an immediate-release formulation. In the case of an extended-release formulation, the effects last for up to 24 hours.