Further your impact on patients with these natural muscle relaxers to combat stress, injuries and more…
DO YOU HAVE PATIENTS WHO COMMONLY COMPLAIN of tense, unyielding muscles or spasms? You may have thought about using natural muscle relaxers to help your patients get more relief and heal faster — but this can sometimes cause confusion. With dozens of different types of supplements, pharmaceuticals and more on the market, which ones do you choose for your patients, all the while making sure they are having the desired effect?
Finding the cause of the issue
Before randomly assigning a muscle relaxant or telling your patient to grab the nearest over-the-counter remedy that can possibly help, you need to know the cause of the muscle problem, or why the patient needs a muscle relaxant in the first place. Is it due to stress? An injury? Nutritionally related?
The different causes call for different therapies, and that’s why knowing the types of natural and pharmaceutical muscle relaxants can give you a much broader range of treatment options that work faster.
Pharmaceutical vs. natural muscle relaxers
Within the pharmaceutical industry, there are two types of muscle relaxants: antispastics and antispasmodics. Each of these works in different ways.
Antispastic medications work specifically on the spinal cord or within muscles to halt involuntary movements. The main action is to slow down or stop muscle spasms and relax tension. Spastic motion generally results from direct injury to the nerves, such as spinal cord injury, or autoimmune conditions such as multiple sclerosis. In the case of autoimmune conditions, Baclofen is a commonly prescribed antispastic. Other antispastic medications include Dantrolene and Tizanidine.
By altering the signal conduction within the central nervous system, antispasmodic medications help limit muscle spasms across the entire body. Their main actions occur within the brain, brain stem or spinal cord to reduce nerve transmission. The most common antispasmodic medication prescribed is Flexeril (cyclobenzaprine), often used to treat acute pain and irritable bowel syndrome. When it comes to musculoskeletal pain identified by primary care physicians, this is a very common prescription given. Other antispasmodic medications include Diazepam, Carisoprodol and Metaxalone.
The biggest problem with these medications is the side effects of drowsiness, lethargy and forgetfulness. Some medications also may interact with other medications for depression, blood pressure or gastrointestinal issues (e.g., reflux) or cause gastrointestinal issues and excessive dryness of the mucus membranes.
But these prescriptions are not the only options. Other prescriptions have off-label uses. Things like anti-inflammatory cyclooxygenase inhibitors (commonly referred to as cox inhibitors), sedatives, antidepressant medication and vasodilators can help relax muscles and muscle tension.
Natural muscle relaxants
And then there are the natural muscle relaxers. Most natural remedies do not work as thoroughly or acutely as prescription medications. They tend to work with multiple systems within the body and provide gentler, whole-body relaxation.
Examples of natural muscle relaxers include chamomile, cherry juice, blueberry, cayenne pepper, vitamin D, magnesium, CBD, Epsom salt, lavender, arnica oil, turmeric/curcumin, capsaicin, lemongrass and peppermint.
Of course, when it comes to natural muscle relaxation, manual therapies such as massage, TENS, kinesiology, meditation and myofascial release can also help.
Although most herbs and supplements help relax the muscles, they aren’t specific to muscle relaxation. Things like chamomile, lavender and peppermint help calm the mind and bring a sense of peace. Others such as cayenne pepper and turmeric help reduce inflammation.
How chiropractors can use muscle relaxants effectively
You should always check with your local regulations to determine if you can prescribe medication or recommend reducing or stopping a patient’s medication.
In New Mexico, chiropractors have the authority to prescribe certain medications (16.4.15), while in every other state, they may not. This may be changing as at least 12 other states have introduced legislation for 2022 to include chiropractors as either primary care physicians or prescribing physicians.
In some instances, when you first see a patient, they may have already seen an emergency physician in the case of injury, or someone who’s been treated long-term by medical doctors and specialists.
However, during your initial examination, you may discover an underlying cause of the injury that may have been potentially missed or overlooked by another provider. Determining these underlying causes can help direct the course of treatment and to know if any medications or supplements could be helpful or not.
Let’s look at a few simplified examples to see the range of options you have available.
Case study: post-traumatic pain patient
A fictitious patient, Rachel, said she was in a car accident and hurt her back. Upon initial examination and imaging, you find no broken or fractured bones, but severe muscle tension causes a misalignment of the spine and significantly reduced flexibility.
Rachel says she was prescribed a muscle relaxant and pain medication to cope with the pain. She took the muscle relaxant but refuses to take any more because it left her feeling sleepy and disoriented. This scenario is not uncommon for accident victims and a standard practice treatment for non-specific muscle injury.
However, as a chiropractor, you know that fixing the alignment issues will help reduce her pain and improve flexibility, and addressing the muscle tension will help the patient recover more quickly as well.
While your patient has been prescribed medications for the muscle relaxation, you can also provide her additional natural therapies for muscle relaxation and relief. One option would be performing massage or manual therapy with CBD oil. The manual manipulation of muscles can help reduce tension and the CBD can help reduce inflammation and muscle tension. As always, it’s important to identify any potential drug-herbal interaction in the body prior to offering natural options. Afterward, an adjustment could help reset posture and alignment to provide lasting relief.
For other natural muscle relaxers the patient could be told to take a warm bath using Epsom salt (magnesium) to reduce muscle tension, use arnica homeopathy, or begin a course of turmeric (cox inhibitor) supplementation as even further options for relief.
The takeaway: There are many natural therapies that can help patients with muscle relaxation, so finding the right one that works with your patient’s injury is the key to increasing patient compliance and satisfaction. In this case, the combination of natural and conventional treatment along with additional tools such as adjustments, massage and TENS therapy, among others, can provide gentler, longer-lasting effects.
Case study: chronic pain patient
Ralph, another fictitious patient, was referred to you to help reduce chronic pain in both of his wrists. Ralph has had rheumatoid arthritis for many years and is already on specific medication to slow down the progression and reduce pain.
The referral notes dictate specific joint problems but no specific injury to the wrists. The referring physician has requested you follow up for a round of conservative treatment, including adjustments and pain management therapy such as TENS, heat and anything else you think is beneficial for the patient.
Your initial examination confirms no specific acute problem and a round of conservative treatment is warranted. In this case, you also identify some additional supplements that will help with overall muscle relaxation and inflammation, including boswellia and ginger, that don’t interact with the patient’s prescription medication. Additionally, you prescribe your patient joint support supplements, glucosamine/chondroitin and MSM, and physical therapy for prosper posture.
The takeaway: Even with prescription medication for this condition, there are additional therapies that can greatly enhance the patient’s life. In this case, natural muscle relaxants can be of additional support.
Case study: multiple sclerosis patient
A young woman, Sarah, was recently diagnosed with multiple sclerosis. Confused over the many options of prescription medication, natural therapies and false promises of miraculous cures, Sarah turned to you upon a recommendation from a friend.
Many chiropractors have had success helping people live normal lives who had significantly reduced pain or debility. In addition, a combination of proper medication and chiropractic adjustment may help to reduce debility and improve overall quality of life.
Discussing the options with your patient, you educate her on the proper use of natural muscle relaxants and associated therapies and even recommend discussing the use of prescription medications with her physician as an additional option. You could also recommend regular chiropractic adjustments combined with supplements to help with energy, focus and pain.
The takeaway: Education is the key in this case. Muscle relaxants may help improve disease progression and allow your patient to live a full, meaningful life. Combining multiple therapies, including that of natural supplementation and proper chiropractic adjustments, provides the full and meaningful regimen for managing a lifelong disease.
A chiropractor’s next step
The world of natural remedies is only getting bigger every year. Having the basic knowledge of the typical natural therapies, as well as prescription medications often given to patients, along with the knowledge of mechanism of actions in the body and the desired results, will help you understand why and when to use these different options.
Knowing the desired effects of these natural and prescriptive therapies will give you the targeted results you are looking for with your treatment. More complex health problems your patients may present with can possibly require more complex treatments which go beyond just the chiropractic adjustment. This may include using tools such as natural muscle relaxers and more.
Discover the problem first. Once you know the origin of your patient’s pain and suffering, using a muscle relaxer for a targeted result may help to improve your patient’s satisfaction and health. And as a provider of more therapies than just chiropractic adjustments, you become a resource for solutions to many problems.
ANTHONY CRIFASE, DC, CNS, DACBN, is double board-certified in clinical nutrition and maintains an active virtual functional medicine and chiropractic practice. With experience in multiple different industries and as a seasoned chiropractor who understands the ins and outs of functional medicine, chiropractic and practice management, he is on a mission to help other practitioners maximize their time, revenue and systems. Learn more at drcrifase.com.