Muscle relaxers?
 

Does anyone else find that they have unusually tight muscles? If so do you take a muscle relaxer? Which one is the most effective. I take flexural and I stopped taking it because it does absolutely nothing for me. Any one else have success with other medicines?

Yeah i have alot of spasming, so im on soma and diazapam, both 4x daily as needed for me.

I stopped all muscle relaxers because none of them relaxed my muscles.
Epsom salt baths work wonders. Alongside decent exercise and diet, getting some time to relax every day, my body has become way less tense.
I personally try to rely as little on medications as I can.
Best of luck

I take tizanidine at bedtime. My spasms had been waking me up at night and the tizanidine has worked well. It has the additional effect of knocking me out within half an hour so I have to plan to have everything done before taking the pill. During the daytime, I use Ketamine cream on my tight muscles. It helps a little. Warm water also helps to the point I never want to come out of the pool. Epsom salt baths also help.

I take Metaxalone (Skelaxin), 800mg x4 per day, so 3200mg per day. It doesn't "fix" the muscle tightness or spasms, but I can definitely tell the difference compared to when I don't take it. It also doesn't make me dizzy or anything like that. Less dizziness and nausea are always a plus haha.

I have found the only thing that works for my spasms is soma. It is an older muscle relaxor, but it still works for me and last longer then most. Can't do the epsom salt baths because of all the pain patches I am on.

Soma may be a good drug, but I couldn't stay awake if I tried, even on a small dose. I wore a fentanyl patch and still wear a lidocaine patch, and I just threw a tagaderm cover on the lido and it worked very well. If anybody wears patches, the tagaderm are a godsend. Water cannot penetrate.

I have had tremors and spasms, also hyper extension of toe with strong contractions. Muscle relaxors I am on include clomazepan 2x/day and Tizanidine 1-2 at bedtime. For me, the big contractions are gone, small tremors remain.

I think this is an important topic because these things can lead to "fixed dystonia" with unnatural positions of joints and/or lead to bigger tremors. Saw a video with a girl with her feet both curled completely under. Scary stuff. I'll take my meds, thank you.

Aloha,
Jenny

What is tagaderm?

They can be bought in drug stores or if someone has a fentanyl prescription, certain manufacturers provide these free.
They are very thin shrink wrap type plastic you place over the patch. They are a little bigger than a dollar bill. You can cut smaller if you wish, but it is like an extra skin. It works very well. I'm not sure how much they cost in stores.

Muscle Relaxer
 

First if it was a primary muscle relaxer your heart would relax and you would die . The Docs say the only good one is Baclofen it helps muscle spasms but Soma adds potency and what soma is mixed with does a double head bang I guess other drugs like Morphine or alcohol if you just want to get losaded then Soma ,I take Baclofen and I have 3 Diazepam a day Avinza best Morphine and Diazepam makes me sleeps or maybe buzzed its Valium ,IO know the Baclofen really helps and I read in Lancet and JAMA its only muscle relaxer .(they never had a few soma and opiates from Vicodin to Oxy they potentiate each other but Doctors on Res said please try this instead I was taking 360 Soma and 360 #4 and I was out there ,I like being as close to being me better ,but we are all different , I first had RSD DXed in 1968 but we all hurt the same at this instant the past is gone get out of pain and keep your brain ,being a loadie looks awful to me

Gentle Hug
rsdno

I also take tizanidine (zanaflex) 4mg 3 times a day...I usually have to break up my daytime dose to 2mg otherwise I fall asleep at work, but at night time I take the full 4mg dose. I think I am going to have to up the dose though....I have started working out recently and as I build up my muscles and lose more weight (lost 80 so far), I hope to rely less on muscle relaxers too!

agree re Bacolofen, etc., but what was the FDA doing when it okayed Soma in 2007???
 

Hey. We're in agreement on Baclofen. Am advised my neurologist that it is by far and away the best (if not really) the only medicine specifically used for CNS induced spasms, as opposed to those cause by strains, sprains and other muscle injuries, such as Flexeril or Soma: see below. So it's a leading med for folks with MS as well. I currently take the maximum suggested oral dose of 50 mg/day. And for people with far more severe hardship - say dystonia - there are implanted Baclofen pumps, although I understand that's a mater not without controversy. And for me - once I stopped practicing law at least - the side-effects are minimal: but when I was still working, it had an unacceptable effect on my memory. (Sort of a joke though, compared to the number CRPS was going to wind up doing on my memory as time went on.)

And completely agree with your advice to others:

keep your brain, being a loadie looks awful to me

There may be more problems, however, in combining Baclofen with Soma (carisoprodol), or even using Soma on a long-term basis, than you've been told by your docs. (Funny how that happens too often in the world of prescription medicine and devices.) This from the FDA mandated Prescribing Information sheet for Soma:

SOMA should only be used for short periods (up to two or three weeks) because adequate evidence of effectiveness for more prolonged use has not been established and because acute, painful musculoskeletal conditions are generally of short duration.

* * *

SOMA has sedative properties (in the low back pain trials, 13% to 17% of patients who received SOMA experienced sedation compared to 6% of patients who received placebo) and may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a motor vehicle or operating machinery. There have been post-marketing reports of motor vehicle accidents associated with the use of SOMA.

Since the sedative effects of SOMA and other CNS depressants (e.g., alcohol, benzodiazepines,opioids, tricyclic antidepressants) may be additive, appropriate caution should be exercised with patients who take more than one of these CNS depressants simultaneously.

In the post-marketing experience with SOMA, cases of dependence, withdrawal, and abuse have been reported with prolonged use. Most cases of dependence, withdrawal, and abuse occurred in patients who have had a history of addiction or who used SOMA in combination with other drugs with abuse potential. However, there have been post-marketing adverse event reports of SOMA-associated abuse when used without other drugs with abuse potential. Withdrawal symptoms have been reported following abrupt cessation after prolonged use. To reduce the chance of SOMA dependence, withdrawal, or abuse, SOMA should be used with caution in addiction-prone patients and in patients taking other CNS depressants including alcohol, and SOMA should not be used more than two to three weeks for the relief of acute musculoskeletal discomfort. [Emphasis added.]

And incredibly, Soma was approved for release in 2007 under (ahem) a prior administration, based on only the following:

The safety and efficacy of SOMA for the relief of acute, idiopathic mechanical low back pain was evaluated in two, 7-day, double blind, randomized, multicenter, placebo controlled, U.S. trials (Studies 1 and 2). Patients had to be 18 to 65 years old and had to have acute back pain (≤ 3 days of duration) to be included in the trials. Patients with chronic back pain; at increased risk for vertebral fracture (e.g., history of osteoporosis); with a history of spinal pathology (e.g., herniated nucleus pulposis, spondylolisthesis or spinal stenosis); with inflammatory back pain, or with evidence of a neurologic deficit were excluded from participation. Concomitant use of analgesics (e.g., acetaminophen, NSAIDs, tramadol, opioid agonists), other muscle relaxants, botulinum toxin, sedatives (e.g., barbiturates, benzodiazepines, promethazine hydrochloride), and anti-epileptic drugs was prohibited.

That's right folks, the trials lasted for all of two weeks and people using any other analgesics were specifically excluded, so of course there could be no pre-release reports of drug interactions. :eek: Oh yeah, this too:

Long term studies in animals have not been performed to evaluate the carcinogenic potential of carisoprodol.

SOMA was not formally evaluated for genotoxicity. In published studies, carisoprodol was mutagenic in the in vitro mouse lymphoma cell assay in the absence of metabolizing enzymes, but was not mutagenic in the presence of metabolizing enzymes . . . .

SOMA was not formally evaluated for effects on fertility. Published reproductive studies of carisoprodol in mice found no alteration in fertility although an alteration in reproductive cycles characterized by a greater time spent in estrus was observed at a carisoprodol dose of 1200 mg/kg/day. In a 13-week toxicology study that did not determine fertility, mouse testes weight and sperm motility were reduced at a dose of 1200 mg/kg/day. In both studies, the no effect level was 750 mg/kg/day, corresponding to approximately 2.6 times the human equivalent dosage of 350 mg four times a day, based on a body surface area comparison. The significance of these findings for human fertility is not known.

And with that, I suspect I've said enough about Soma.

But of course medication is not and can't be the complete answer to spasms: if it was I would have to be sitting around wasted on Marinol [a synthetic Delta-9 THC] for much of the time, as I was for years. Instead, a new type of physical therapy, specifically "nerve gliding" exercise entered my life, and that had made all the difference. Please see my post from Thursday, look for a "DPT" in the New To Board - Physical Therapy Question thread.

Forgive me for going on, but you have my full attention. Be well, friend.

Mike

TY Michael :People Listen
 

So many folks get soma and opiates I went out with a RSD Friend and she fell pace first into her Cioppino (I'm like a life saver, watch that Ciopino)and it felt like the whole restaurant was watching me, "Oh yeah They were ) the first time on most pain helper. You will never get the Buzz or whatever you cal,l it like the first time .
The best High is being clear minded ,dont be afraid of your Doctor but let her help you work out what you need ,if you ever want to see what I do rsder1@gmail.com or just talk online

There is a place for Medications to though

Can I ask why? I am on buprenorphine patches and would like to try the epsom baths but read this. Thanks!

As for muscle spasms, I was given diazepam (only 4 tablets and only 2mg strength) when I had my recent very bad bout (that put me in hospital). It did take the spasms away for a couple of hours but I was zonked for much much longer and so I don't want to use it again unless it's absolutely unavoidable. With the other meds I'm on, I wouldn't be able to stay awake.

Epsom salts are a very good idea... magnesium is commonly deficient in Americans, and some studies say up to 70% do not consume the RDA of this critically important mineral.

When low muscles cannot relax properly, after use (contraction), this may be due to poor magnesium supply.

Also magnesium will lower high blood pressure (relaxes artery contraction).

Magnesium also blocks the pain receptor NMDA...(calcium and aspartate, glutamate stimulate this receptor).

NMDA antagonists are used to control chronic pain conditions. Examples are in addition to magnesium, Namenda and Dextromethorphan.

The magnesium in epsom salts crosses the skin into the body.
We at PN forum here use it for foot pain.
When soaking in epsom salts works, then that indicates an oral
product may be also needed.

Here is my magnesium thread, that discusses depletions due to certain drug use, poor diet and foods that provide magnesium for you, and how to choose a good oral supplement (avoid oxide form).

http://neurotalk.psychcentral.com/thread1138.html

I really think many here can benefit from some sort of magnesium intervention. And you cannot live without it. Get too low and your heart rhythm can be impaired and you may
suffer from an arrhythmia.

musicgirl

Yes. I still have boughts with severe spasticity and Dystonia. At one point, my spasticity was so severe it permanently curled my feet inward and toes under severely, and legs inward to some degree too (as noted by jpcrps). I have been retrofitted with a baclofen pump that takes care of the spasms for the most part. Though, My Neurologist is still adjusting it each time I go in. I did have to undergo an inpatient trial before the neuro surgeon would install it. The spasms are pretty persistent. I still have them; though, there has been considerable improvement. My Neurologist also added tizanidine 4mg at night to my prescription regimen. I am allowed another 4 mg if necessary. The tizanidine knocks me for a loop. That is why I only take it at night. Even with, I still only sleep 2-3 hours. I watch a lot of late night infomercials. ShamWow! For pain I am on the fentanyl patch 150 mcg and oxicodone 5 mg (up to 2 tablets) for breakthrough pain.

I cannot get in and out of the tub. The Epsom salts are out. I do have an awesome shower with multiple jets. Sometimes that helps. Usually, it just wears me out.

I do use the tegaderm over my fentanyl patches as Morgan has suggested. I get mine off Amazon at a fairly reasonable price. http://www.amazon.com/Tegaderm-Trans..._sim_sbs_hpc_1

As far as the baclofen pump is concerned, (Others please correct me if I am wrong) I believe I was told the medication is more affective at a lower dose when it is administered directly through the spine. Orally I was at the maximum dose. With the pump, I have room for higher adjustments. Also it can be directed to just the lower part of my body by picking specific vertebrae in the spine. So I don't have some of the negative side affects.

I am hoping you will achieve relief soon.
I am hoping for better days ahead for you and for all of us that suffer.

There are topical magnesium products for those who cannot
get in a tub or use foot tubs.

Epsom-IT is one.
Magnesium sulfate cream by Kirkman.
Magnesium oil sprays. (they are not really an "oil" but are thick like an oil is.

We discuss all of these on that thread link I gave.

I personally like the topical the best for myself.

Ideally eating foods that provide magnesium is the best IMO.
nuts, beans, oatmeal, yogurt are good sources. Lots of greens also,
since magnesium is in the chlorophyll of plants.
3oz of almonds have 270mg of magnesium.
Supplements include chelates, and SlowMag. Oxide forms are not absorbed nor is the magnesium listed on multivitamin mixtures, called magnesium stearate. So those two types will provide nothing, since they remain in the bowel and are eliminated.

I recently started using muscle relaxers on a nearly daily basis. I'm taking Norflex 100mg 2x day and 10-20mg flexeril at night. I'm not entirely sure the Norflex is doing anything. I spoke to my PMD at my last appointment and asked if there was something else we could try as I am still having horrible tightness. He did bump up the flexeril to 20 mg which is helping, but of course making me sleepy ( which is fine since I don't sleep well)

He said there wasn't anything stronger he could/would want to add because of the interaction with my other medication.

Mrs D I find the info about magnesium interesting. I remember reading info on it years back when I was researching my migraines. I take 250 mg-500mg oral daily.

Please make sure it is not Oxide form...that does NOT work.

Thanks I will check.

@fmichael:

The Soma product in 2007 was a NEW patent for a different dosing. The little company who has that patent, goes back several sales and mergers ago--so I would expect studies to have dates around that time. The original manufacturer was Wallace who also had Meprobamate (Miltown). The launch and thrust of the new Soma was to block generics and re-establish a brand name for the product and hence make more $$ for Meda.
This rather failed however at the time, as doctors and insurance formularies refused to pay for the added expense. However, I just did a search on Orange Book at the FDA site, and could not find generic Soma anymore. So something happened when it went on control I presume.

Soma is derived from Meprobamate BTW. So it has abuse potential. Also it has all the side effects etc. It is now a Federally controlled substance category IV. (4)
http://en.wikipedia.org/wiki/Carisoprodol

Wallace was purchased and the name changed to Medpointe, which was also sold and became Meda. As far as I can remember this company provides all the raw material Soma powder to generic manufacturers still (there is a combo product with aspirin generically still available). (but that may have changed with the Meda takeover..so don't quote me on that).

Meprobamate has fallen into disuse in the US.

This is the listing from FDA Medwatch reports on Soma:
http://www.drugcite.com/?q=Soma

This drug in combination with opiates has a controversial status as contributing to death, by accident or suicidal intent.
In the past I've seen autopsy stats on this combo listed in several states in combination with hydrocodone. For this reason some doctors today may refuse to prescribe it.

This link shows the new patent for Soma 250mg issued in 2007.
http://www.drugs.com/availability/generic-soma.html

However, it also shows generic companies for it... but they do not show
up on the FDA listings today. So I don't know what the availability is for generics.

I take Skelaxin (Metaxalone) 800mg 4 time a day. For me, it helps. It isn't a cure all medicine or anything, but it takes the edge off enough for me to be able to do stuff. It also doesn't make me feel nauseous or drowzy, something that's really important since I'm a college student and since I have two jobs. It's not something I really "notice" working, but it's one of those that takes the edge off enough for me. I know that if I forget to take it a day, I definitely feel the difference...

Edit: Oops...just realized I apparently commented pretty much the same thing a few months ago haha...

Cyclobenzaprin helps some - never is it gone. I also use salan Paz patches and Deep Blue Rub, along with neck wraps daily.
Good luck

Low Magnesium
 

mrsD:
Thanks again for the info on low magnesium levels. I've opted to go the 3 oz of almonds each day and MagnesiumIT lotion route. The lotion is ordered. Meanwhile I'm enjoying the almonds. I'm glad to have the option of not taking another pill. The information in the links you provided is very interesting. Sounds like the magnesium might just be what I need. I hope so. I'm looking forward to some relief.

I Find Small Amounts Can Work
 

[QUOTE=KathyUK;971191]Can I ask why? I am on buprenorphine patches and would like to try the epsom baths but read this. Thanks!
I think Buprenorphine is Narcan so it may be an agonist and antagonist . It keeps you from feeling opiates and your Doctor probably thinks with RSD you may be on meds for years . I hope you were given a choice to try others . I have RSD and Rheumatoid Arthritis pretty serious ,I hope I can find a way to wipe ? Fibro too but I think all the Autoimmune diseases I list are a part of another disease. I only take 15 Mg of Baclofen 15 mg of Valium but it does help good luck
Gentle Hug
Mark

Best Nuscle Relaxant
 

Definitel Baclofen you wont get a high until you realize howw much better your muscles are
Gentle Hug
Mark

I used to take flexeril and got rid of it and my anti inflammatory several years ago. I do have constant tightening of my muscles, like I can never relax. I am laying in bed now, my butt is tight, my neck is strained and tight, my legs, tight. I lay in bed trying to relax and when I focus on a body part, I realize it's very tense and constricted. Fr me taking more medication weighs heavily on me, so taking the muscle relaxer is not what I want to do.

I find that because f the narcotics, I easily have trouble getting enough water to drink. If I don't get enough fluid, then I have tighter muscles and Charlie Horse like cramps that wake me and have me leaping out of bed to release the tension. So make sure you are getting enough fluids, that could be exasperating the problem. Sometimes the solution is so simple we overlook it. Have so many peripheral issues that the RSD brings into our lives, so meant details, between taking so many meds at different intervals through the day, paying attention o what helps and what does not help managing the pain. It's easy to over analyze what is going on. The Pain Spec. I had when I lived in Az used to caution me, to to try figure it all out, focus on more whole body needs. When I do that, I have an easier time remembering to stay hydrated, to slow down and not force myself to perform to someone else's expectations. Best of luck. sylvia

Muscle relaxers
 

Hi-
I have focal dystonia in my left qauds & hip flexors. The only thing that works for me, so I can ambulate is clonazepam, 2mg at night, 1 mg in AM. i also have 4mg of tizanadine I can take PRN...I cannot keep my eyes open for very long w/ it. My movement disorder doc & I have tried several different combinations....this is what works for me. I think everyone is different.
:grouphug:

I can't do the patches because I can't have them touch my skin. I use baclofen because I am either allergic to or have used everything else. I don't sleep, spasms suck. Nothing seems to help much except for the Epsom salt bath for me and I use the lavender for calming effect. because usually by the time I get the my whole body has gone into spasms and my husband is trying to get me in the bath. I guess what I am trying to say is it just goes by what your body can handle, I am one of those that is allergic to everything so I am a pain in the hinny to treat. Good luck to all of us. And God Bless anyone that hasn't found us yet.:grouphug:

I am SO in touch with this statement. Had the same thing just last night, and now my lower back. So very, very PAINFUL!:(

Fentanyl patches with tagaderms
 

I did not read all the posts here but I did see that someone mentioned it is ok to to put a tagaderm cover over a fentanyl patch and you will be ok to take a hot bath. I'm pretty sure that if you read the paperwork that comes with the patches that you will see it says never take a hot shower, use a blow dryer, use a sauna, use a hot tub, etc. because the tagaderm will make sure the patch does not get wet and have to be thrown away but since fentanyl patches get delivered by heat, you will be essentially be over dosing when you get the patches hot. The patches are suppose to last 72hrs but if you get them hot even for minutes you can use up all the fentanyl in under 24 hours which means you will probably go thru withdrawal too. Not fun.

If you have been on fentanyl patches for years and are tired of dealing with this problem ( because we can't stop our body from sweating and overheating when you have CRPS), then consider a pain pump.

All I'm saying is be careful please