Muscle Relaxers for Back Pain: Do They Work, Which Ones and What to Know
Written by Cherlie Joseph, MSN, FNP-BC · Medically reviewed by Naurah Gaspard, DNP, FNP-C, FNP-BC · Updated November 2026
Prescription muscle relaxers such as cyclobenzaprine (Flexeril), methocarbamol (Robaxin) and tizanidine (Zanaflex) can give modest, short-term relief for a new back spasm, especially at night. Research shows the benefit is small and drowsiness is common, so they work best for a few days alongside movement, heat and an anti-inflammatory. They are not a long-term fix for chronic back pain.
In this guide
What muscle relaxers do
Despite the name, most "muscle relaxers" do not act directly on your back muscles. They work in the brain and spinal cord to calm nerve signals, which is why drowsiness is their most common side effect. For many people, that sedation is part of why they help: a better night of sleep during a painful back spasm.
The American College of Physicians lists skeletal muscle relaxants, along with NSAIDs like ibuprofen and naproxen, as medicine options for new (acute) low back pain when non-drug steps such as heat, massage and staying active are not enough.
What the research shows
The benefit is real but small. A 2021 review in The BMJ pooled 31 trials with more than 6,500 people. For new back pain, non-benzodiazepine muscle relaxers reduced pain by less than 8 points on a 100-point scale at two weeks, below what most people notice as a meaningful change, and they raised the chance of side effects such as dizziness, drowsiness, headache and nausea. A 2024 review in JAMA Network Open found little evidence that taking them long term helps chronic back pain.
In practice, that means a muscle relaxer may be reasonable for a few days of severe spasm, but it should not be the whole plan. Keep moving and see our lower back pain relief guide for the steps with the best evidence.
Back spasms keeping you up?
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Start a back pain visit →Common muscle relaxers compared
| Medicine | Good to know |
|---|---|
| Cyclobenzaprine (Flexeril) | Most studied for back pain; often taken at bedtime; drowsiness, dry mouth; avoid with certain antidepressants and some heart conditions |
| Methocarbamol (Robaxin) | Often less sedating; dizziness possible |
| Tizanidine (Zanaflex) | Can lower blood pressure and cause drowsiness; can affect the liver; many drug interactions |
| Baclofen | Used mainly for spasticity from nerve conditions rather than routine back strain |
| Metaxalone (Skelaxin) | Less sedating for some people; usually brand-name cost |
| Carisoprodol (Soma), diazepam (Valium) | Controlled substances with misuse risk; OurTopClinic does not prescribe them |
Choice depends on your other medicines, age, liver and kidney health, and whether you need to stay alert for work or driving.
Safety tips
- Do not drive or operate machinery until you know how the medicine affects you.
- Avoid alcohol, sleep aids, opioids and other sedating drugs while taking a muscle relaxer.
- Tell your provider about all your medicines, especially antidepressants, blood pressure medicines and antibiotics like ciprofloxacin, which interacts with tizanidine.
- Older adults are more prone to confusion, dizziness and falls; many guidelines advise avoiding these medicines after age 65.
- Use the shortest course that helps, usually days rather than weeks, and follow your label.
- Pregnancy or breastfeeding: ask before taking any muscle relaxer.
An online visit can review your symptoms and other medicines and, when appropriate, prescribe a non-controlled muscle relaxer or recommend a different plan. A prescription is never guaranteed.
Get in-person care or call 911 if you have:
- Loss of bladder or bowel control, or numbness in the groin or inner thighs
- Leg weakness that is getting worse or trouble walking
- Back pain with fever, after a serious fall or crash, or with a history of cancer
- Extreme drowsiness, confusion, fainting or trouble breathing after taking a muscle relaxer
- Signs of an allergic reaction: hives, swelling of the face or throat
Frequently asked questions
Which muscle relaxer is best for back pain?
There is no clear winner. Cyclobenzaprine is the most studied, and methocarbamol is often less sedating. The best choice depends on your other medicines, age and health, and any benefit is usually small and short-term.
How long can I take a muscle relaxer for back pain?
They are usually meant for a few days to a couple of weeks during a flare. Evidence does not support long-term use for chronic back pain, and side effects add up over time.
Can I take ibuprofen with a muscle relaxer?
Many people can take an NSAID such as ibuprofen or naproxen with a muscle relaxer, and it is a common combination. Check with your provider or pharmacist first, especially if you have kidney, stomach or heart problems.
Sources
- Cashin AG et al. Muscle relaxants for non-specific low back pain: systematic review and meta-analysis. The BMJ, 2021
- Oldfield BJ et al. Long-term use of muscle relaxant medications for chronic pain. JAMA Network Open, 2024
- MedlinePlus: Cyclobenzaprine
Keep reading
- Lower back pain relief: what works
- Sciatica: symptoms, causes and relief
- Online prescription refill in Florida
- Browse all conditions and treatments A to Z
Back spasms keeping you up?
$79 visit, no appointment needed. Adults 18+ in FL, NM, OR and WA.
Start a back pain visit →
Cherlie Joseph, MSN, FNP-BC
Board-certified family nurse practitioner licensed in Florida, caring for adults online at OurTopClinic. Meet our providers.
This article is for general education and is not a substitute for medical advice. Treatment, including any prescription, is decided by a licensed provider after reviewing your health history. OurTopClinic is not for emergencies; if you have a medical emergency, call 911. OurTopClinic serves adults located in Florida, New Mexico, Oregon and Washington. Learn more at ourtopclinic.com.
