{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:16:04Z","timestamp":1793146564597,"version":"4.5.0"},"reference-count":80,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi241032-4\"><jats:title>Importance<\/jats:title><jats:p>Stricter opioid prescribing guidelines have increased prescriptions of skeletal muscle relaxants (SMRs) for chronic pain, but the efficacy of long-term use of SMRs for chronic pain is unknown.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241032-5\"><jats:title>Objective<\/jats:title><jats:p>To systematically review the effectiveness or efficacy of long-term use of SMRs for chronic pain.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241032-6\"><jats:title>Evidence Review<\/jats:title><jats:p>Two reviewers systematically searched Ovid MEDLINE, Embase (Ovid), Web of Science, CINAHL, and Cochrane through December 4, 2023. They included articles published in English, Spanish, or Italian. Only randomized clinical trials (RCTs) and cohort studies with comparator groups evaluating at least 1-month duration of SMRs for chronic pain were included. The reviewers dually reviewed data abstraction, risk-of-bias, and quality. They characterized studies by chronic pain syndrome: low back pain, fibromyalgia, headaches, painful cramps or spasticity, and other syndromes.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241032-7\"><jats:title>Findings<\/jats:title><jats:p>A total of 30 RCTs with 1314 participants and 14 cohort studies with 1168 participants assessed SMRs for chronic pain. Studies were primarily short-term (4-6 weeks). Nine unique SMRs were represented by the studies identified. Eleven studies (25%) examined baclofen, 8 (18%) examined tizanidine, and 7 (16%) examined cyclobenzaprine. Evidence for effectiveness was strongest for SMRs used for trigeminal neuralgia, neck pain, and painful cramps; evidence suggested SMRs for fibromyalgia, low back pain, and other syndromes were not more beneficial than placebo. The most common adverse effects were sedation and dry mouth. RCTs had a low to moderate risk of bias, and the quality of cohort studies was fair to good.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241032-8\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this systematic review of long-term use of SMRs for chronic pain, findings suggest that their long-term use may benefit patients with painful spasms or cramps and neck pain; their long-term use for low back pain, fibromyalgia, and headaches did not appear to be beneficial. Clinicians should be vigilant for adverse effects and consider deprescribing if pain-related goals are not met.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.34835","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T16:27:52Z","timestamp":1726763272000},"page":"e2434835","source":"Crossref","is-referenced-by-count":30,"title":["Long-Term Use of Muscle Relaxant Medications for Chronic Pain"],"prefix":"10.1001","volume":"7","author":[{"given":"Benjamin J.","family":"Oldfield","sequence":"first","affiliation":[{"name":"Program in Addiction Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut"},{"name":"Fair Haven Community Health Care, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brynna","family":"Gleeson","sequence":"additional","affiliation":[{"name":"Virginia Tech Carilion School of Medicine, 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