If you have a headache, backache, neck pain, or other conditions that are from having a muscle spasm, first try other therapies that don’t involve medications, such as a heating pad, exercise, biofeedback, or progressive relaxation, massage, or yoga.
If those don’t help, try over-the-counter pain relievers, such as acetaminophen (Tylenol and generics), ibuprofen (Advil and generics), or naproxen (Aleve and generics). Studies that compared those OTC pain relievers with muscle relaxants mostly found little difference in how well they improved pain or function—but the muscle relaxants were associated with much more sedation.
Taking an OTC pain reliever along with a muscle relaxant has not been shown to work any better than an OTC pain reliever alone for providing relief from a backache or other conditions that are due to spasms.
In some situations, muscle relaxants can be a preferred option for a short period. For example, some people may not be able to take acetaminophen if they have certain conditions, such as liver disease. And those with a history of bleeding ulcers, heart problems, or kidney problems may not be able to take ibuprofen or naproxen. Others may find that their muscle spasms make it difficult to sleep, so the sedation associated with the muscle relaxants could be viewed as a desirable side effect in this case.
When choosing among the many muscle relaxants, your doctor will take into account the severity of your symptoms, other medical conditions you have, and the common side effects muscle relaxants can cause. Those side effects, including dizziness and drowsiness, can be a concern for pilots, drivers, and people who use heavy or dangerous equipment.
Many of the muscle relaxants, including carisoprodol, chlorzoxazone, cyclobenzaprine, metaxalone, methocarbamol, and orphenadrine, are not recommended for use in people 65 years or older because the sedating effects could lead to accidents or falls.