If you've ever had a back or neck muscle spasm, you know they can hurt, a lot. But taking muscle relaxants, especially every day, isn't a good idea, according to our experts at Consumer Reports Best Buy Drugs.

In fact, they recommend against taking Soma (generic name carisoprodol) at all because it poses a high risk of abuse and addiction, and isn't very effective. Most people are better off skipping the other muscle relaxers, too, such as cyclobenzaprine (Fexmid and generic), and metaxalone (Skelaxin and generic), which can trigger potentially dangerous side effects, such as sedation and dizziness.

The FDA has not approved any skeletal muscle relaxant for long-term use, says Charles E. Argoff, M.D., a professor of neurology at Albany Medical College and director of the Comprehensive Pain Program at the Albany Medical Center. Soma (carisoprodol) in particular is a bad choice because of its abuse and addiction potential, Argoff adds. It's been linked to a high number of emergency department visits and dozens of deaths and is the the only muscle relaxant classified as a controlled substance. 

Instead, first try other therapies that don’t involve medications, such as stretching, a heating pad, exercise, biofeedback, progressive relaxation, massage, or yoga. Those strategies can sometimes help relieve headaches, neck pain, backaches and other conditions muscle relaxers are commonly prescribed to treat.

If those don’t help, try over-the-counter pain relievers, such as acetaminophen (Tylenol and generics), ibuprofen (Advil and generic), and naproxen (Aleve and generic). They ease pain as well as muscle relexants, but are safer, research shows.

There are a few exceptions where muscle relaxers can be a preferred option, but only for a short period—no longer than three weeks and shorter if possible. For example, people with liver disease may not be able to take acetaminophen. And ibuprofen and naproxen might not be safe for those with a history of bleeding ulcers, heart problems, or kidney problems. Some people have such painful muscle spams, they can’t sleep, so the sedation triggered by the muscle relaxers might be helpful in those cases.
 

If you and your doctor together decide a muscle relaxer makes sense in your situation, watch out for side effects. In addition to sedation and dizziness, they can make you feel tired and weak. People 65 or older should skip them altogether because the sedation could lead to falls and dangerous fractures.

If your spasms last longer than a few weeks, ask your doctor whether you are truly benefiting from the muscle relaxer and whether other therapies should be tried.
 

Editor's Note: These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).