Editing Muscle relaxant (section)

===Clinical use===
Spasmolytics such as [[carisoprodol]], [[cyclobenzaprine]], [[metaxalone]], and [[methocarbamol]] are commonly prescribed for [[low back pain]] or [[neck pain]], [[fibromyalgia]], [[tension headaches]] and [[myofascial pain syndrome]].<ref name="pmid18448752">{{cite journal |vauthors=See S, Ginzburg R |title=Choosing a skeletal muscle relaxant |journal=Am Fam Physician |volume=78 |issue=3 |pages=365–370 |year=2008 |issn=0002-838X |pmid=18711953}}</ref> However, they are not recommended as first-line agents; in acute low back pain, they are not more effective than [[paracetamol]] or nonsteroidal anti-inflammatory drugs ([[NSAID]]s),<ref name="pmid17909209">{{cite journal | vauthors = Chou R, Qaseem A, Snow V, Casey D, Cross JT, Shekelle P, Owens DK | title = Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society | journal = Ann. Intern. Med. | volume = 147 | issue = 7 | pages = 478–91 | date = October 2007 | pmid = 17909209 | doi = 10.7326/0003-4819-147-7-200710020-00006| doi-access = free }}</ref><ref name="pmid12804507">{{cite journal | vauthors = van Tulder MW, Touray T, Furlan AD, Solway S, Bouter LM | title = Muscle relaxants for non-specific low back pain | journal = Cochrane Database Syst Rev | issue = 2 | pages = CD004252 | date = 2003 | volume = 2017 | pmid = 12804507 | doi = 10.1002/14651858.CD004252 | pmc = 6464310 }}</ref> and in fibromyalgia they are not more effective than [[antidepressants]].<ref name="pmid18448752"/> Nevertheless, some (low-quality) evidence suggests muscle relaxants can add benefit to treatment with NSAIDs.<ref name="pmid15767833">{{cite journal | vauthors = Beebe FA, Barkin RL, Barkin S | title = A clinical and pharmacologic review of skeletal muscle relaxants for musculoskeletal conditions | journal = Am J Ther | volume = 12 | issue = 2 | pages = 151–71 | date = 2005 | pmid = 15767833 | doi = 10.1097/01.mjt.0000134786.50087.d8 | s2cid = 24901082 }}</ref> In general, no high-quality [[evidence-based medicine|evidence]] supports their use.<ref name="pmid18448752"/> No drug has been shown to be better than another, and all of them have [[adverse drug effect|adverse effects]], particularly [[dizziness]] and [[drowsiness]].<ref name="pmid18448752"/><ref name="pmid12804507"/> Concerns about possible abuse and [[drug interaction|interaction]] with other drugs, especially if increased sedation is a risk, further limit their use.<ref name="pmid18448752"/> A muscle relaxant is chosen based on its adverse-effect profile, tolerability, and cost.<ref name="See-2008">{{cite journal | vauthors = See S, Ginzburg R | title = Skeletal muscle relaxants | journal = Pharmacotherapy | volume = 28 | issue = 2 | pages = 207–13 | date = February 2008 | pmid = 18225966 | doi = 10.1592/phco.28.2.207 | s2cid = 43152771 }}</ref>

Muscle relaxants (according to one study) were not advised for [[orthopedic]] conditions, but rather for [[neurological]] conditions such as spasticity in [[cerebral palsy]] and [[multiple sclerosis]].<ref name="pmid18448752"/> Dantrolene, although thought of primarily as a peripherally acting agent, is associated with CNS effects, whereas baclofen activity is strictly associated with the CNS.

Muscle relaxants are thought to be useful in painful disorders based on the theory that pain induces spasm and spasm causes pain. However, considerable evidence contradicts this theory.<ref name="pmid15767833"/>

In general, muscle relaxants are not approved by [[FDA]] for long-term use. However, [[rheumatologists]] often prescribe [[cyclobenzaprine]] nightly on a daily basis to increase stage 4 sleep. By increasing this sleep stage, patients feel more refreshed in the morning. Improving sleep is also beneficial for patients who have fibromyalgia.<ref>{{cite web |url=http://arthritis.about.com/od/musclerelaxers/f/musclerelaxers.htm |title=When Are Muscle Relaxers Prescribed For Arthritis Patients? |access-date=2010-07-09 |archive-date=2010-12-05 |archive-url=https://web.archive.org/web/20101205111526/http://arthritis.about.com/od/musclerelaxers/f/musclerelaxers.htm |url-status=dead }}</ref>

Muscle relaxants such as [[tizanidine]] are prescribed in the treatment of [[tension headaches]].<ref>{{MedlinePlus|000797|Tension Headache}}</ref>

[[Diazepam]] and [[carisoprodol]] are not recommended for older adults, [[pregnant women]], or people who have [[Major depressive disorder |depression]] or for those with a history of drug or alcohol [[addiction]].<ref>{{cite web |url=http://www.webmd.com/back-pain/muscle-relaxants-for-low-back-pain |title=Muscle Relaxants |access-date=2010-07-09}}</ref>