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!

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. 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

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.