Nathan Wei asked:


One question that comes up repeatedly is, “Where do muscle relaxants fall into the treatment approach for different musculoskeletal conditions”?

Patients will sometimes ask about them and physicians who see these patients sometimes wonder if these drugs should be considered.

Skeletal muscle relaxants are the most widely prescribed drug class in the United States for non-specific low back pain.

In addition, this class of drugs is used for neck pain, muscle spasms, fibromyalgia, and myofascial pain.

Goals for the treatment of musculoskeletal conditions include relief of muscle pain and improvement in function and therefore, a return to normal activities of daily living.

The two primary categories of skeletal muscle relaxants are anti-spastic agents (eg, baclofen [Kemstro and Lioresal] or dantrolene [Dantrium]) for diseases like cerebral palsy, spastic torticollis, and multiple sclerosis and anti-spasmodic agents for muscle-related conditions.

Anti-spastic agents are rarely used for musculoskeletal conditions; however, some rheumatologists report success in treating fibromyalgia using baclofen. Since this is an “off-label” use, caution should be exerted and the lowest possible doses should be prescribed… and then only by specialists who have much experience. Patients should be informed as to the potential side effects.

Antispasmodic agents are much more widely used for musculoskeletal conditions.

The most often prescribed antispasmodic agents are carisoprodol [Soma}, cyclobenzaprine (Flexeril), metaxalone (Skelaxin), and methocarbamol (Robaxin). In terms of effectiveness, there appears to be no one muscle relaxant that is superior to another. Often, physicians will prescribe the muscle relaxant they are most familiar with. Another reason one is selected over another is that a physician may have samples in his closet that he can give to a patient to try before giving the patient a prescription.

The most widely studied and used agent is cyclobenzaprine. This has been shown to be effective for various musculoskeletal conditions but causes drowsiness, as does tizanidine [Zanaflex]. As a result, patients with insomnia caused by muscle spasms, may find tizanidine or cyclobenzaprine to be useful. Cyclobenzaprine is particularly helpful for many patients with fibromyalgia.

All skeletal muscle relaxants have adverse effects which include most commonly dizziness, drowsiness, and dryness of the mouth.

Methocarbamol and metaxalone may be are less sedating than tizanidine and cyclobenzaprine. However, they may also be more habituating in some cases.

Skeletal muscle relaxants are generally not considered first-line therapy for musculoskeletal conditions. Most physicians will start with acetaminophen (Tylenol) or non-steroidal-anti-inflammatory drugs (NSAIDS) first. Many clinical trials have supported the notion that NSAIDS are superior to muscle relaxants in patients suffering from acute low back pain. However, it is also known from the data that muscle relaxants are superior to placebo.

For acute low back pain syndromes, skeletal muscle relaxants may be used as additional therapy to NSAIDS.

For acute low back pain, muscle relaxants should be used short term (2 weeks). Some patients with chronic back conditions as well as patients with fibromyalgia may require chronic long-term use of muscle relaxants.

Muscle relaxants should be avoided in frail elderly patients because of the danger related to sedation and falling.



The Fat Loss Secret

David LeAche asked:


If you’re like me then you need some sleep help. If you tend to have difficulties getting to sleep or wake up at odd times during the night it may be that your body and mind are just not ready for sleep when you think they should be.

Sometimes, in order to get a good night of sleep, you first need to teach yourself to relax so that falling asleep becomes more natural: your body and mind are ready for sleep!

Relaxation and sleeping is not the same thing, although many would have you believe they are. Obviously they are closely related but relaxation being the opposite of stress, it has to be a pre-cursor to actually sleeping because few of us sleep well when under great stress.

Sleep is a semi-unconscious state when our bodies and our minds rejuvenate themselves and much of the mass of information that bombards us during the day gets sorted and evaluated. We know we need about eight hours of good sleep as an adult, but many of us have difficulty achieving this. Our sleep help should come in the form of sleep preparation commonly called relaxation.

Here are five different ways I have used to successfully prepare both body and mind for much needed deep sleep.

1…Exercise has been shown to be one of the greatest natural stress reducer. One very good way to relax is to take an evening walk or an evening swim at your local activity center. Yoga based exercises have been very successful. I was once told not to allow my soccer team players to swim before they went to bed, the evening before the tournament final, because they would be too relaxed and not play so well. Actually it was quite the reverse, and they played better than ever!

2…We must make sure our sleeping environment is conducive to sleep. Turn off the noise, turn down the light, make sure there is fresh air and then take some time to do some pre-sleep relaxation. This may be reading or doing breathing exercises but the environment should be a supportive one or your efforts will be wasted.

3…Consider what you have eaten or drank before you try to sleep. Alcohol is not conducive and neither is caffeine but not being hungry or thirsty is also to be considered. Personally I have a bowl of non-sugared, whole wheat cereal and one percent milk, which makes me feel well fed and yet has few calories. Toast is good: consider something that is healthy, caffeine free and very low on sugar. Large late night suppers are not a good preparation for a good night sleep as your body doesn’t relax under heavy digestion.

4…Another area of relaxation for me is having a relaxing hobby that takes your mind away from the day’s problems and acts as a relaxing activity for the mind. Some collect and organize coins or stamps, some draw and paint others write or ‘blog’. Whatever it is should put you into a state of “slow down” so your mind can relax and the move to sleep is but a short step. I know several people whose hobby involves a pet such as a cat, and this is the trigger to relaxing before sleep. Sleep help in the form of a family pet such as a small dog or cat to cuddle up to can be a very powerful trigger.

5…Most of us need to meditate in some form before sleeping. This can take the form of deep breathing and thinking or taking a long warm bath. Reading helps for some but whatever the method we need to involve both our body and mind. Listening quietly to books on tape, listening to soft music perhaps in a quiet environment often promotes a meditative sleep.

Many of us need to train our bodies and minds to relax before we can enjoy a good, deep night’s sleep. Besides making sure you’re ‘tired’ from a good day’s work there are methods we can employ to promote the pre-sleep relaxation. Give yourself some sleep help and devise some relaxation methods that work for you.



Burn The Fat, Feed The Muscle

Linda Dunkelberger asked:


Considering using alternatives to chemical relaxers? Kinky, curly and frizzy hair can be difficult to manage. Often chemical relaxers contain lye, which is sodium hydroxide. By using these harsh chemical relaxers you can damage your hair, burn your scalp and possibly cause hair loss. Other complaints are hair breakage, hair thinning and lack of hair growth all caused from chemical hair relaxers. For best results, look for alternatives to chemical relaxers. Alternatives to chemical relaxers provide natural, healthy non-chemical hair relaxer solutions.

By using healthy alternatives to chemical relaxers, you will be able to relax your hair, add body and give you healthy vibrant hair. With a non-chemical hair relaxer you will get relaxed hair without being stripped of all your body but look more natural by keeping beautiful body and shine. Don’t be fooled into wrong alternatives to chemical relaxers, a non-chemical hair relaxer does not contain lye or any other chemical promising to be less harsh. A non-chemical hair relaxer is made with only natural ingredients. When shopping for alternatives to chemical relaxers look at the ingredients. Some ingredients that you want to see in a non-chemical hair relaxer are alkaline water, soda ash & minerals, protein powder, natural vitamins, minerals and oils. These ingredients along with a proper care system will allow you to keep your hair relaxed and manageable. A non-chemical hair relaxer is easy to use and does not require going to a salon to do it. Reading and following the instructions carefully will give you a non-chemical hair relaxer treatment and salon results at home.

When using alternatives to chemical relaxers and all hair relaxers, including a non-chemical hair relaxer, you want to make sure that you maintain healthy hair with conditioners and vitamins. A regular schedule of shampoos, conditioners and vitamins will help fortify the hair and restore the natural ph balance to your hair. Special shampoos and conditions that contain vitamins, minerals, amino acids and natural oils will give you maximum results if used with a non-chemical hair relaxer.

You should always be cautious when blow drying and styling your hair even if you use non-chemical hair relaxer. Heat and thermal tools often damage hair if not used properly. Using the right thermal styling moisturizer and styling products are important to healthy hair manageability.

By using alternatives to chemical relaxers you are already one step ahead in your goal to achieve healthier hair. Be sure to keep your hair conditioned and use the proper styling products to protect against heat and thermal damage. Make sure to keep your hair vibrant with the proper vitamins and minerals. Alternatives to chemical relaxers are good for the health of your hair. By eliminating the harsh chemicals, alternatives to chemical relaxers are good for the environment as well.



The Fat Loss Secret