Long-term use of skeletal muscle relaxants (SMRs) for chronic pain is only effective for certain conditions, such as painful spasms, painful cramps, and neck pain, according to a review published online Sept. 19 in JAMA Network Open.
Benjamin J. Oldfield, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues conducted a systematic literature review to assess the effectiveness or efficacy of long-term use of SMRs for chronic pain.
Based on 30 randomized controlled trials (1,314 participants) and 14 cohort studies (1,168 participants), the researchers identified nine unique SMRs (11 examining baclofen, eight examining tizanidine, and seven examining cyclobenzaprine). The strongest evidence for effectiveness was seen for SMRs used for trigeminal neuralgia, neck pain, and painful cramps. SMRs used for fibromyalgia, low back pain, and other syndromes were not more beneficial than placebo. Sedation and dry mouth were the most common adverse effects. There was a low-to-moderate risk for bias for randomized controlled trials, and cohort studies had fair to good quality.
“These findings suggest that long-term use of muscle relaxants may only be beneficial for certain syndromes,” the authors write. “Clinicians should be vigilant for adverse effects and consider deprescribing if pain-related goals are not met.”
More information:
Benjamin J. Oldfield et al, Long-Term Use of Muscle Relaxant Medications for Chronic Pain, JAMA Network Open (2024). DOI: 10.1001/jamanetworkopen.2024.34835
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Skeletal muscle relaxants beneficial for only certain conditions (2024, September 24)
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