Alternatives to Flexeril (Cyclobenzaprine hydrochloride)

By Daniel Hough, DC

Flexeril is prescribed for the relief of muscle spasm. It is in a class of drugs called spasmolytics. It acts on the central nervous system rather than the muscles, per se - it is a central-nervous-system depressant.

Flexeril is manufactured by Merck and Co., Inc., the third largest pharmaceutical company in the world. Merck’s total 2006 sales were more than $22.5 billion.¹ Price Rite Drug in Bozeman, Mont., where I practice, charges $10.60 for 30 tablets (10 mg each) of the generic equivalent of Flexeril, which is a 10-day supply.

Problems With Flexeril

In his book Best Pills Worst Pills, written in collaboration with the AARP, Dr. Sidney Wolfe advises against the use of cyclobenzaprine.² He states, ” Cyclobenzaprine has not been shown to be any more effective than painkillers or anti-inflammatory drugs such as aspirin for relieving the pain of local muscle spasm.” He further advises that Flexeril is structurally similar to tricyclic antidepressants and may cause some of the same dangerous side effects, particularly in older patients. It is also addictive.²

My PDR lists more than 65 adverse side effects for Flexeril, including dizziness, abnormal heartbeat, aggressive behavior, agitation, confusion, convulsions, hallucinations, headache, hepatitis, muscle twitching and severe allergic reactions.³

Localized muscle spasm is predominantly caused by spinal cord reflexes resulting from pain.⁴ Pain stimuli arising from muscles can be caused by muscle damage (strain), severe cold, metabolic abnormalities, inflammation and dysfunction of the joint moved by those muscles. Hilton’s Law states that a joint is innervated by the same nerve trunk that innervates the muscles which move the joint.

Safer Alternatives

Skullcap and valarian root are anti-spasmodic herbs.⁵ Bromelain taken between meals and eicosapentaenoic acid (fish oil) are good natural anti-inflammatories.⁶ Ice and massage are also beneficial in reducing muscle spasm and inflammation.

Chiropractic adjustment relieves muscle spasm by addressing the cause. There are chiropractors who will not attempt to adjust an acute subluxation, and I have patients who have been told by their medical doctor to wait until the muscle spasm subsides to be adjusted. The sooner you adjust a subluxated joint, the better. No health care provider would advocate that a dislocated shoulder be left dislocated until the muscle spasm stops. Reduce the shoulder and the spasm stops. Adjust the dysfunctional joint and the local muscle spasm stops.

Hope you found this useful. 

Your Palmdale and Lancaster Chiropractor signing off

Dr. Dave

In the initial review of literature, the study points out that chiropractic was founded on a vitalistic and holistic philosophy to patient care.  The author noted that the care of the chiropractic patient was not dependent on the patient’s presenting symptoms or medical diagnosis but rather the detection and elimination of spinal and extraspinal subluxations.

The study points out how wide spread the problem of infertility is by noting that data from the Centers for Disease Control and Prevention indicate that there were 7.3 million infertile women in the U.S. in 2002 with 1.2 million women having had an infertility-related medical appointment in that timespan.

In all three of the cases reported in this study the women were in their thirties ranging from 33 to 35 years of age. All had attempted medical interventions to become pregnant and all had been unsuccessful for between 7 months and 4 years. In each of these cases chiropractic care was initiated for the correction of subluxations detected in their spines.

The study noted that in addition to the specific correction of subluxations with the chiropractic care, nutritional intervention and counseling on stress management was provided to the patients involving goal setting, affirmations, meditation, massage, exercise, alteration of work schedule and overall paradigm shifts in lifestyle modification.

The research noted that two of the three women in this study also had complaints of low back pain. The results in these cases showed that between 12 days and 2 months after the initiation of chiropractic care all three women had become pregnant.

A strain is an injury sustained by muscle or tendons.  Muscles attach to the bone via tendons.  Any injury done to either the muscle or the tendon is a strain.   This is usually done by overuse and/or overload of the muscle or tendon.

A sprain is an injury to the ligament.  Ligaments are like rubber bands that stabilizes joints.  When the joint goes further than the normal range of motion, the ligaments are generally compromised, or overstretched.  This would be a sprain.  Since they are like rubber bands, if they are overstretched, then the ability to stabilize the joint would be decreased.  This is why when someone dislocates a shoulder and doesn’t rehab it properly, the chances of repeated dislocations in the future is great. 

There are different grades or degrees of injuries to the soft tissue above.  Conservative acute treatment would be to:

Rest - Refrain from using that injured part.  By limiting actions of the affected part, it allows the natural healing process to occur without chances or reinjury.

Ice - Ice the injured area for 10 minutes.  Then take it off for 10 minutes.  Then put it on for 10 minutes.  2-3 cycles 2-3 times a day should be adequate for minor injuries.  This would decrease inflammation.

Compression - If you have a brace or an ACE bandage, wrap the injured area tight to prevent further inflammation.

Elevation - When possible, place the injured area above the level of your heart.  For example, if you injured a leg or a foot, lie down on your back with your feet under some pillows. 

By remembering the acronym RICE, you can help decrease the signs and symptoms of the injuries.  It is also important to do exercises and stretches that would improve the integrity of the injured area. 

If you have any questions, please ask.

Your Palmdale and Lancaster Chiropractor signing off,

Dr. Dave

Hi Cherry Pickers,
We’re getting excited as more and more of the Cherries are starting to turn yellow and even red.  I just took some new photos which I will have posted on our web site www.upickcherries.com within a couple of days.  You’ll see why we’re getting excited.  It will be a great season with most of the trees loaded with Cherries!
We will be opening on June 6th.  The Brooks are almost ripe now! We are hopeful that we will have ripe Bings and Rainiers on the 6th also.  I will send out another email when we get closer to the date.  Also be sure to always check our Cherry Hotline 661 270-1356 to hear last minute updates before driving to the orchard.  Because the Cherries are ripening a little more slowly this year, we will only have 5 or 6 weeks of cherry picking.  Some years we have had 7 or 8 weeks of picking.  So, when the Cherries are ready, come and get them!
As always, we have no parking or entrance fees.  You only pay for the Cherries you pick.  We have decided not to raise our prices again this year.  All varieties of Cherries (Brooks, Tulares, Early Burlats, Bings and even the Rainiers) will still be $3/lb.  We have lots of raw honey ready for you too.
And remember, we NEVER spray any pesticides or insecticides on any of our Cherries!
You might like to check our web site for suggestions such as:  wear comfortable walking shoes, preferably closed toed, wear a hat and bring sunscreen.  These suggestions will make your day more enjoyable.  Also, we do sell water at the stand but feel free to bring your own drinks and snacks.  (Of course, we ask that you don’t leave any trash in the orchard.  We pride ourselves on having a clean, well kept orchard that everyone will enjoy.)
If you are bringing a large group (30 people or more), it’s a good idea to email us ahead so we can set aside a special area for your group to pick in.  We want everyone to have a great, memorable time.
For those of you coming from the Antelope Valley, I just heard that Godde Hill Road will be closed to traffic from June1 thru June 20th, so take Palmdale Blvd/Elizabeth Lake Road west toward Leona Valley.  It will bring you right to our parking lot.
That’s it for now.  We look forward to seeing you at the Cherry Farm in a couple of weeks!
Maxi and Gary
Villa del Sol Sweet Cherry Farms

Your Palmdale and Lancaster Chiropractor signing off,

Dr. Dave

1. Drink Water.  Then Drink More Water.  Studies have shown that when thirsty, people stop drinking water when 65% of their thirst has been quenched.  What that means is that the “thirsty” sensation ceases well before the body has the amount of water it needs.  Knowing this, make sure you keep drinking, even though you do not have that urge to drink anymore.  This is a good habit to have throughout the year.
2. Water Down Drinks.  With respect to quenching thirst, people tend to drink more beverages such as soda, juice, and sports drinks because of their flavor.  However, because of the amount of salt and sugar, water does not get absorbed as readily as plain water.  With that said, diluting the beverage with water increases absorption of water.   
3. Limit Your Caffeine and Alcohol Intake.  Caffeine and alcohol are diuretics.  Diuretics induce elimination of water from your system.  This is one of the reason why frequent trips to the bathroom are made after drinking alcohol and/or coffee. 
4. Keep Your Skin Moisturized.  Applying lotion to your skin has a few benefits.  Your skin requires an amount of moisture to stay healthy.  Lotion will not only add moisture to your skin, but it will also prevent the moisture from evaporating by providing a barrier against evaporation.  This also prevents the skin from drawing more water from the body.
5. How Much Water to Drink?  I get this question a lot.  It really depends on your diet.  Most of the water your body takes in is from food.  So, depending on what types of foods you eat, the requirement changes.  Fruits and vegetables generally have higher water content than foods high in starch and protein.  Then what’s the answer?  My answer is to always monitor your body’s water content every time you urinate.  The urine is supposed to be clear.  If it is, then your water level is adequate, assuming you are not on any diuretics.  Another thing to remember is that you cannot overdose on water.  So, when in doubt, hydrate. 

If you have any questions, please ask.

Your Palmdale and Lancaster Chiropractor signing off,

Dr. Dave

Cherries have many health benefits. I thought I would share some of them with you:

1. Minimizes the effects of gout. Cherries have shown to decrease levels of uric acid in the body. High levels of uric acid are responsible for the onset and progression of gout.
2. Anti-inflammatory properties. They can relieve symptoms of arthritis and also decrease the chance of heart disease.
3. Antioxidants. Cherries possess many antioxidants, which decreases the chance of cancer. These antioxidants also protect brain neurons. Studies have shown that ischemic stroke victims had less damage to the brain tissue if they had higher levels of the particular antioxidants that cherries possess.
4. Diabetes control. Compounds found in tart cherries have been shown to decrease complications associated with diabetes.
5. Melatonin. This compound is responsible for regulating your circadian rhythm, or your sleep-wake cycle.

There are many other health benefits to cherries. If you would like more information, please feel free to ask.

1. Lie completely on your back with both legs fully extended on a firm padded or carpeted surface.  A bed would be too soft.
2. Cross your right leg over your left leg so that your right ankle is just above the left knee.
3. Bring your left knee closer to your chest while relaxing the lower left leg. 
4. By reaching around the left side of your left leg with your left hand and reaching through your legs with your right hand, clasp your hands behind the left knee.
5. Gently pull your hands toward your chest and hold.
6. You should feel a nice stretch on your right gluteal area. 
7. Repeat with the left side.

I found this picture on the web:

1. The monitor should be directly in front of you, not angled to the side.
2. The top of monitor should be at your eye level.
3. The monitor should be about 2 feet away.
4. Don’t use laptops for work that will take longer than 15 minutes in one sitting.  The keys on the keyboard are more cramped and the monitor is way too low compared to a desktop computer.  This forces you to look downward.  If done too long, this can aggravate your trapezius muscles. 
5. Keyboard and mouse should be positioned so that your elbows are at your side at 90 degrees. 
6. Wrist pads for the keyboard and mouse should be used to rest your hands while you are not typing or moving.  While moving or typing do not rest your wrist on the pad.  Too much rubbing and friction on the wrist can lead to aggravation and inflammatiion.  This can lead to carpal tunnel.
7. Make sure you have the right amount of lighting.  Too much lighting behind you can cause glare, which can be uncomfortable to the eyes.

If you would like me to look at your workstation and evaluate it, take a picture of your station and send it to me.

Your Palmdale and Lancaster Chiropractor signing off,

Dr. Dave

A few ways you can help combat your allergies this season:

1. Drink lots of water.  This will help flush out the allergens in your body.
2. Change your shirt after you have been outside for awhile, especially if it has been windy, which is never in Antelope Valley. 
3. Keep windows closed when it’s windy.
4. Wash your bedding once a week in hot water.
5. Although mold is not much of a problem here, air out damp clothes or shoes before storing.
6. Get Adjusted.  By releasing stress on the nervous system, chiropractic adjustments permit the immune system to develop properly and function more effectively.

If you have any questions, ask! 

Your Palmdale and Lancaster Chiropractor signing off,

Dr. Dave