Can Muscle Relaxers Help Treat Migraine?

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Do muscle relaxers help migraines? Muscle relaxers are commonly used to alleviate muscle tension and spasms in various parts of the body. However, when it comes to migraines, their effectiveness may vary.

Migraines are complex neurological conditions that involve multiple factors, including blood vessel dilation, nerve inflammation, and chemical imbalances in the brain.

While muscle tension in the neck and shoulder area can contribute to migraines, it's important to understand that migraines are not solely caused by muscle issues.

Therefore, the use of muscle relaxers for migraines should be approached with caution and under the guidance of a healthcare professional.

In this article, we will explore the relationship between muscle relaxers and migraines to better understand their potential benefits and considerations.

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Muscle Relaxants For Migraines

Surprisingly, muscle relaxants may be an efficient preventative therapy for migraines. Migraine affects the brain rather than the muscles, thus this finding comes as a surprise.

People often find relief from migraines by stroking their temples and the back of their heads, which is consistent with the findings of research showing that muscles are highly tensed during a migraine episode.

Although we first believed that Botox relieved tension by easing muscular contractions, we now know that it also affects nerve terminals. As an added bonus, muscle relaxants also help with the underlying causes of migraines in the brain.

Tizanindine (Zanaflex) is the only muscle relaxant shown to be effective against migraines. Dr. Alvin Lake and his colleagues conducted a double-blind research that demonstrated excellent effectiveness with little adverse effects.

The recommended dosage was 8 milligrams (mg) three times day, while the typical amount was 18 mg. This medication mostly causes drowsiness but has few additional negative effects.

Another muscle relaxant shown to be useful in a double-blind research for the prevention of migraines is baclofen (Lioresal). Daily dosages of 15–40 milligrams (mg) were administered three times.

Sedation is also a major adverse effect of baclofen. Some people have reported relief from using muscle relaxants as metaxalone (Skelaxin), cyclobenzaprine (Flexeril), clonazepam (Klonopin), and others; however, there are no studies demonstrating their effectiveness in migraine.

Can Muscle Relaxers Treat Migraine?

Skeletal muscle relaxants are typically not FDA approved for migraine treatment. When a doctor prescribes a muscle relaxer for migraine relief, it is usually for an off-label purpose.

Muscle relaxants are classified into two types:

Antispasmodics - These medications are used to treat muscular spasms and cramps. They are often prescribed by doctors to alleviate stomach pains and fibromyalgia.
Antispasmodics - These medications lower muscular tone and stiffness caused by diseases such as multiple sclerosis (MS), cerebral palsy, or spinal cord injury.

It's unclear why muscle relaxants could help with migraines. Antispasmodics are sedatives that do not directly affect your muscles.

Each muscle relaxant operates somewhat differently and has a distinct safety profile.

Tizanidine (Zanaflex)

Tizanidine is an antispasmodic as well as an antispastic. It is FDA-approved for the treatment of spasticity in MS, stroke, traumatic brain damage, spinal cord injury and ALS (amyotrophic lateral sclerosis).

Tizanidine is also used off-label by doctors to treat persistent migraines. That is when you get migraine headaches at least 15 days a month. They may also use it to treat rebound headaches caused by drug discontinuation.

Tizanidine is also used off-label to treat chronic neck and lower back pain, as well as other regional pain disorders.

An ongoing clinical experiment is investigating if tizanidine helps prevent acute migraine episodes in migraineurs. The following are some of the most prevalent tizanidine adverse effects:

drowsiness
nervousness
hallucinations
muscular movement that is not voluntary
muscle wasting
rhinitis constipation
vision distortion

Tizanidine has few significant adverse effects in most individuals. Adverse events, such as anaphylaxis and hypotension, are quite infrequent.

Flexeril (Cyclobenzaprine)

Cyclobenzaprine relaxes your muscles by acting on your central nervous system. It may be prescribed by a doctor to assist reduce pain from injuries such as strains and sprains. It is FDA-approved for usage in conjunction with rest and physical therapy for this purpose.

Cyclobenzaprine is used off-label to treat fibromyalgia and myofascial pain caused by jaw joint issues.

Cyclobenzaprine's structure is comparable to that of a class of medications that may be useful in avoiding migraine headaches. However, there is little evidence to support the use of cyclobenzaprine to prevent migraines.

Cyclobenzaprine's most prevalent adverse effects are:

severe exhaustion
nausea
dizziness constipation
heartburn with dry mouth

More significant adverse effects of cyclobenzaprine include:

a fast heartbeat (tachycardia)
urine retention bowel muscle movement loss (ileus)
confusion hallucinations

Robaxin (methocarbamol)

Methocarbamol is an older drug that was initially licensed in 1957 to treat muscular spasms. It, like cyclobenzaprine, is used to treat acute musculoskeletal pain in conjunction with rest and physical therapy. There is no particular evidence that it can successfully cure migraines.

Methocarbamol has the following side effects:

sleepiness
dizziness
fever
impaired vision
irritable stomach metallic flavor dark urine that is often green, black, or blue

Other Muscle Relaxants

Other muscle relaxants have been investigated as migraine treatment by researchers. However, there is little evidence to support their safety or efficacy in migraine treatment. Examples are soma (carisoprodol), metaxalone (Skelaxin), baclofen (Lioresal) and diazepam (Valium).

Natural Muscle Relaxer

Although not all natural medicines and nutritional supplements work as muscle relaxers, they may aid with headaches and migraines. Some examples are; riboflavin (vitamin B2), magnesium, feverfew and coenzyme Q10.

Some individuals use peppermint oil to ease headache discomfort. While there isn't a lot of proof to back it up, it's typically safe and well-tolerated.

Another natural medicine with migraine treatment potential is butterbur. However, it is advised to utilize it with care.

Because of substantial safety concerns, the American Academy of Neurology ceased prescribing butterbur for migraine in 2015. The National Institutes of Health recommends only using butterbur products that are labeled as free of pyrrolizidine alkaloids (PAs). PAs have the potential to harm your liver, lungs, and circulatory system.

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Can Muscle Relaxers Treat Other Types Of Headaches?

Some muscle relaxants may help alleviate headaches other than migraines.

Headache Caused By Tension

Tension headaches arise when the muscles in your head and neck tense. Tizanidine is occasionally used off-label by doctors to treat persistent tension headaches. However, there is little evidence to support their usage for this purpose.

Because muscle relaxers include the potential of addiction, a doctor will most likely recommend other treatments for tension headaches.

Neuralgia Of The Occipital Region

Occipital neuralgia is an uncommon kind of persistent headache. These brief, excruciating headaches begin in your occipital nerves, which run through your neck and back of your head.

Muscle relaxants may aid in the treatment of occipital neuralgia. Other therapeutic options include:

NSAIDs (nonsteroidal anti-inflammatory medications)
local nerve blockade anticonvulsants antidepressants

Headache From The Sinuses

Sinus headaches are really pressure from sinusitis. Muscle relaxants are seldom used in the treatment of sinusitis. Antibiotics may be used if sinusitis is caused by a bacterial infection.

Some home remedies for sinusitis include:

Using a humidifier
Nasal irrigation
Over-the-counter (OTC) decongestants
A cluster of headaches

Cluster headaches may be as unpleasant as migraine headaches, although they are generally less severe. Off label, some clinicians may give baclofen, an antispastic, to treat or prevent cluster headaches. However, physicians seldom employ muscle relaxants for this reason.

Oxygen therapy and triptans are the first-line therapies for cluster headaches. Triptans are prescription drugs that are often used to treat migraines.

Verapamil, a blood pressure drug, may also be used by doctors to treat cluster headaches and migraine.

Recurring Headache

When you use too much of a treatment to treat your migraines, you get rebound headaches, also known as medication-overuse headaches. They might be the outcome of withdrawal symptoms if you stop using the medicine.

Tizanidine may be prescribed off-label by a doctor to treat rebound headaches. It may be used as part of a program to assist you with discontinuing your initial medicine.

What Are The Approved Treatments For Migraine?

Migraine therapy aims to alleviate symptoms and prevent future episodes. There are several drugs available to treat migraines. Migraine medications are classified into two categories:

Pain-relieving medications - These medications, often known as acute or abortive therapy, are administered during migraine episodes and are intended to relieve symptoms.
Medication for prevention - These medications are used on a regular basis, frequently daily, to minimize the intensity or frequency of migraines.

Your treatment options are determined by the frequency and intensity of your headaches, if you have nausea and vomiting with your migraines, how debilitating your headaches are, and any other medical issues you may be suffering from.

Medications used to reduce migraine pain work best when given at the earliest warning of an impending migraine - as soon as migraine symptoms appear. It may be treated with the following medications:

Pain Relievers

Aspirin and ibuprofen (Advil, Motrin IB, and others) are examples of over-the-counter or prescription pain medications. When used for an extended period of time, they may produce medication-overuse headaches, as well as ulcers and bleeding in the gastrointestinal system.

Migraine treatment drugs including caffeine, aspirin, and acetaminophen (Excedrin Migraine) may be beneficial, but only for mild migraine discomfort.

Triptans

Migraine is treated with prescription medications such as sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt, Maxalt-MLT), which block pain pathways in the brain.

They may ease many migraine symptoms whether taken as tablets, injections, or nasal sprays. They may not be suitable for those who are at risk of having a stroke or a heart attack.

Dihydroergotamine (Trudhesa, Migranal)

This medicine, which is available as a nasal spray or injection, is most effective when used early after the onset of migraine symptoms for headaches that last more than 24 hours. Migraine-related vomiting and nausea may intensify as a side effect.

Dihydroergotamine should be avoided by those who have coronary artery disease, excessive blood pressure, or renal or liver illness.

Lasmiditan (Reyvow)

This newer oral tablet is authorized for migraine therapy with or without aura. Lasmiditan dramatically reduced headache pain in clinical studies.

Lasmiditan has a sedative effect and may induce dizziness, therefore persons who take it should avoid driving or using equipment for at least eight hours.

Gepants are oral calcitonin gene-related peptide antagonists. Oral gepants ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT) are licensed for the treatment of migraine in adults.

In clinical studies, medications in this class were more effective than placebo in relieving pain two hours after administration. They were also beneficial in relieving migraine symptoms such as nausea and light and sound sensitivity.

Dry mouth, nausea, and excessive tiredness are common side effects. Ubrogepant and rimegepant should not be used with powerful CYP3A4 inhibitors, such as several cancer medications.

Intranasal Zavegepant (Zavzpret)

The FDA has authorized this nasal spray for the treatment of migraines. Zavegepant is a gepant and the only migraine medication available in nasal spray form. It relieves migraine discomfort in 15 minutes to 2 hours after a single dosage.

The medication is effective for up to 48 hours. It may also help with other migraine symptoms including nausea and sensitivity to light and sound. Zavegepant side effects include a change in taste, nose congestion, and throat irritation.

Opioid Pain Relievers

Narcotic opioid drugs may be useful for those who are unable to use other migraine treatments. Because they may be very addictive, they are often only used when no other therapies are successful.

Anti-nausea Medications

If your migraine with aura is accompanied by nausea and vomiting, they may be beneficial. Anti-nausea medicines include chlorpromazine, metoclopramide (Gimoti, Reglan), and prochlorperazine (Compro, Compazine). These are frequently given in conjunction with pain relievers.

Some of these drugs should not be used while pregnant. If you're pregnant or attempting to become pregnant, don't take any of these drugs without first seeing your doctor.

Final Thoughts

Do muscle relaxers help migraines? The use of muscle relaxers for migraines is not a definitive solution. While muscle tension and spasms can contribute to migraines, they are just one aspect of a complex neurological condition.

Muscle relaxers may provide temporary relief for migraines that are triggered or exacerbated by muscle tension, particularly in the neck and shoulder area. However, it's essential to consult with a healthcare professional before using muscle relaxers for migraines.

They can assess your specific situation, evaluate the underlying causes of your migraines, and recommend appropriate treatment options.

Other migraine-specific medications and therapies, such as triptans, analgesics, preventive medications, and lifestyle modifications, are often more effective in managing migraines.

It's crucial to work closely with your healthcare provider to develop a comprehensive and personalized treatment plan that addresses the specific triggers and symptoms of your migraines.

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