Research shows Carisoprodol should be used with more care

Habits are wonderful, just like prejudices. They let you do things automatically without ever thinking about whether what you are doing is right. It hurts. Here’s a painkiller. I’ve got lower back pain. Here’s a muscle relaxant. OK, so let’s actually think about this. There’s a range of musculoskeletal conditions from tension headaches, through fibromyalgia to lower back pain. When a group of researchers analyzed the data on the number of prescriptions written by doctors, there was an interesting pattern. Rather than prescribe painkillers, the largest number of prescriptions was for muscle relaxants. This is not necessarily wrong. This class of drugs is useful, particularly if the drug prevents or limits spasms. Often people with back injuries are prone to spasms which can be painful and cause further damage. However, there’s absolutely no evidence from any clinical trials showing that muscle relaxants are better than the more usual painkillers and anti-inflammatories for lower back pain. Such comparative research as exists actually prefers antidepressants to muscular relaxants for fibromyalgia. The treatment guidelines for tension headaches also prefer painkillers unless there’s evidence of an allergic reaction. Put another way, there’s no medical evidence to support this habit of prescribing muscle relaxants. Indeed, the evidence prefers the use of non-steroidal anti-inflammatory drugs (NSAIDs) as the first response.

Why should this be of interest? The answer is easy. There’s a mountain of evidence to show the NSAIDs as very safe. Even the slightly more powerful painkillers have a better record than the muscle relaxants when it comes to side effects which most commonly sedate you, the patient. Before you take any of the more commonly prescribed muscle relaxants, you should understand the likely problems of drowsiness, dizziness and some slight loss of coordination. This means you should discuss your current medical problems with a doctor and make an informed choice. In many cases, it will be better and safer to go for a combination of painkiller, antidepressant and a program of physical exercise rather than a muscle relaxant. Of course, you may prefer a relaxant like Carisoprodol given the precise nature of the injury and past experience with other types of treatment.

Making an informed choice is always the best because you have balanced the costs against the expected benefits. So long as you are confident that you can get the intended benefits in a short period of time before the risk of dependence gets too high, you will probably get the best physical outcome. Carisoprodol used responsibly is highly effective, particularly when combined with a well-designed exercise program. But the evidence suggests you will be in a minority. Many doctors are encouraging the use of muscle relaxants out of habit or prejudice, ignoring the existing evidence for the use of NSAIDs and antidepressants. At best, a drug like Carisoprodol should be a second line of treatment for lower back pain after the first has proved ineffective. For the record, this is now the recommendation of both the American College of Physicians and the American Pain Society.