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Carisoprodol, a muscle relaxant, is used with rest, physical therapy, and other measures to relax muscles and relieve pain and discomfort caused by strains, sprains, and other muscle injuries.
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The primary indications for cyclobenzaprine, metaxolone, methocarbamol, and carisoprodol are acute painful musculoskeletal conditions. Baclofen and tizanidine are indicated for spasticity associated with UMN disorders, but are frequently used off-label for painful musculoskeletal conditions. Diazepam is indicated for UMN muscle spasticity and local painful musculoskeletal spasm, as well as anxiety. Because the true mechanism of action on muscle spasm is unknown, the sedating side effects are often used to improve sleep. Muscle relaxants are mostly used for acute LBP or acute exacerbations of CLBP, rather than prolonged CLBP.
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Patients with CLBP who are most likely to experience improvements with common analgesics are those without any contraindications or sensitivities to a specific medication, and without risk factors for chronicity such as psychological dysfunction, financial disincentives, or poor social support systems. Given that most of these medications are used only to address symptoms and do not affect any structural changes to the lumbosacral area, they are perhaps best used during acute exacerbations of CLBP rather than on an ongoing basis. The ideal CLBP patient for this type of intervention should also be willing to engage in an active intervention such as therapeutic exercise to address possible physical contributors to their condition.
- The recommended dose of carisoprodol is 250 or 350 mg three times daily and at bedtime.
- The recommended treatment duration is 2 to 3 weeks.
- To avoid withdrawal symptoms, carisoprodol should be stopped gradually if it has been used for a long duration.
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