Ask Suzy Cohen: What’s the Best Prescription Muscle Relaxer?

Muscle injuries are not easy to treat, and sometimes the pain can be debilitating. So what will bring relief? Lifescript’s expert pharmacist Suzy Cohen has some remedies, both prescription and natural, to relieve aches. Plus, read more advice on easing hemorrhoid pain, getting ready for hurricanes and other natural disasters and more...

Dear Suzy Cohen,
I was in a car accident and have been taking medicine for muscle aches and pain. Once the drug wears off, though, my pain returns. What are the best prescription muscle relaxers, and are there natural alternatives?

-K.B., Los Angeles

Dear K.B.,
Muscle relaxant drugs offer temporary relief for a pulled muscle, sprain, strain, stiff neck or other muscle problem. Medications are fine for a little while, but most people will need to tease out the underlying cause of their pain.

Many of you suffer with muscle spasms and may not realize that you take a drug that depletes a nutrient from your body, which then causes chronic muscle spasms or cramps. That could cause pain and frustration, and might force you to take muscle relaxant drugs forever!

Hundreds of drugs can cause muscle aches and pains, including blood pressure drugs. In my book, Drug Muggers: Which Medications Are Robbing Your Body of Essential Nutrients – and Natural Ways to Restore Them (Rodale), I list medications that deplete nutrients, such as calcium, magnesium, CoQ10, vitamin D and vitamin B6, and may potentially cause weakness, cramps and spasms.

Also, see a physician and consider physical therapy, gentle chiropractic care and massage. The following popular herbs and medications temporarily relieve pain. All can cause brain fog, drowsiness and dizziness. Please don’t take these and drive.

Baclofen (Lioresal), prescription: Used for muscle spasms. It improves levels of our natural GABA, which calms our nervous system. Often used in multiple sclerosis and amazingly, it could help reduce cravings for alcohol.
Cramp bark, herbal supplement: This herb may reduce leg cramps, spasms and pain resulting from a stiff neck, as well as menstrual cramps. It’s sold in health food stores as tea, tincture and capsule. Be careful, it can lower blood pressure.

Metaxalone (Skelaxin), prescription: This blocks pain sensations temporarily. It helps with all sorts of muscle aches and pains, and one advantage over other drugs is that there is much less potential for abuse.

Valerian, herbal supplement: Often used for insomnia and anxiety, but it also relaxes muscles. Cyclobenzaprine (Flexeril), prescription: This is related to antidepressants and can cause dry mouth, urinary retention, constipation and dizziness.

Carisoprodol (Soma), prescription: It blocks the transmission of signals in the brain and spinal cord. It makes you terribly sleepy so you don’t feel pain. I’ve seen a lot of abuse with this drug.

Kava kava and passionflower, herbal dietary supplements: Both support muscle health and cause relaxation. Take one or the other, sold at health food stores, but not together.

Methocarbamol (Robaxin), prescription: It’s related to a cough syrup called guaifenesin. It has no direct effect on striated muscle or nerve fiber, but may help temporarily. Take with lots of water.

Dear Suzy Cohen,
I’m concerned about diabetes. I’m overweight, and it runs in my family. My sister has your book, Diabetes Without Drugs: The 5-Step Program to Control Blood Sugar Naturally and Prevent Diabetes Complications (Rodale) and said you recommend Holy Basil, among other herbs and nutrients. Is that the same as regular basil and would you tell me more?

-A.L., Rockwall, Texas

Hi A.L.,
Holy Basil a fabulous herb. It has been prized for centuries and is considered a sacred plant. It is related to other types of basil, but not the same as the fresh basil you buy in American supermarkets (which is great too) or the dried spice form.
Holy Basil is also called “Tulsi” in Ayurvedic medicine; both terms refer to the herb known in Latin as Ocimum sanctum. Whatever you call it, it delivers!

Holy Basil acts as an “adaptogen” in the body, meaning it helps you adapt. It protects cells, improves endurance and helps you cope with stress by supporting adrenal and thyroid function.

Compounds in Holy Basil have been shown in clinical trials to nourish the pancreas, and specifically help generate healthy new beta cells. These beta cells are the body’s insulin-production factories, and insulin lowers blood sugar.

Holy Basil helps other cells in your body open up their receptor (their door), which welcomes insulin like a long lost friend. This is a beautiful thing, because it lightens the load on your liver and precious adrenal glands. You may notice fewer cravings for sweets.

Listen up if you have high cholesterol or triglycerides. Conventional medicine might call for statin drugs to reduce these markers. Studies suggest that Holy Basil can help reduce blood fats, which contribute to heart disease and remain a devastating complication of diabetes.

Holy Basil also is a potent antioxidant, sweeping away damaged cells that could run amok. Tulsi also has antibacterial and anti-fungal properties. Consider using Holy Basil this fall to reduce the risk of cough and cold.

I drink Holy Basil every day in the form of tea (called Tulsi tea). I keep the tea bags in my purse, so when at restaurants, I just ask for a cup of hot water and steep it at my table.

Holy Basil is stronger when taken as an oral supplement. Organic India, New Chapter and Source Naturals all make commercial brands.

It’s been used for eons and has an impressive track record. But because it lowers blood sugar, don’t combine it with prescribed diabetes medication unless you closely monitor your blood sugar and are supervised by doctors so they can reduce medication dosage when necessary.
Dear Suzy Cohen,
What are the best treatments for hemorrhoids, both internal and external? My wife and I suffer from these.

-S. D., Gainesville, Fla.

Dear S.D.,
In the U.S., about half of all people will suffer from hemorrhoids at some point in life, usually between 20 and 50 years old. It’s not necessarily a problem of the elderly or constipated.

Hemorrhoids – internal or external – are caused by weak veins that swell from pressure. If these occur on the legs, they’re called “varicose” veins. The blood pools, causing veins to swell and engorge.

Many situations can cause this, including obesity, pregnancy, lifting heavy objects or boxes, straining on the toilet, coughing, sneezing, standing or sitting for long periods. People who eat a high fiber diet and stay well hydrated are less likely to suffer with hemorrhoids. People who eat processed foods will eventually feel it.

The primary difference between internal and external hemorrhoids is pain.

With internal hemorrhoids, there’s no pain because the swollen veins are higher up in the rectum where there are no nerves. You may experience no symptoms or have bleeding after a bowel movement.

For some that may be the first and only sign of internal hemorrhoids. Others may have a thin stool and the urge that you’re not finished your bowel movement yet.

External hemorrhoids hurt like crazy and, if untreated, can thrombose, meaning it can turn purplish-blue and bleed. They can itch, burn and irritate the anus, and you can feel them easily.

No matter the type, don’t sit too much, or let your butt fall asleep on hard chairs!
Here are some ideas for hemorrhoid relief:

Witch hazel: A natural astringent that helps with the swelling and pain.

Hydrocortisone or calendula cream: Apply externally to ease pain.

Preparation H suppositories: Perfect for internal hemorrhoids.

An ice cube or pack: Apply to the painful spot, but wrap it in a paper towel first to avoid ice burns in sensitive areas.

Ibuprofen: An anti-inflammatory can do a lot to reduce inflammation and pain.

Quercetin: A dietary supplement related to vitamin C that may help improve vein strength. Take 300-1,000 mg three times daily.

Warm sitz baths: 10-20 minutes.

Butcher’s Broom and horse chestnut: These two herbs have a long history with hemorrhoids. Butcher’s Broom contains ruscogenin, which helps tighten blood vessels. Horse chestnut contains aescin, which tones vein walls and is commonly used in Europe.

Aloe vera juice: It may help constipation.

Please see a specialist, who can make sure that pencil thin stools, bleeding or other symptoms are related to hemorrhoids and not something more serious. Physicians also can offer many helpful treatments.
Dear Suzy Cohen,
I just dealt with the ramifications of the earthquake in Virginia, and then a hurricane barreled toward us. What tips can you offer?

-T.R., Richmond, Va.

Hi T.R.,
Depending on where we live, we might face earthquakes, tornadoes, power outages, flash floods, fires or hurricanes. Climate-related disasters give us little or no time to think about medications, because we are focused on protecting our family, property and staying safe. The following tips should help with your emergency preparedness:

Have a written list of all your medications that includes dosage, directions, your local pharmacy and physician and their phone numbers. Include both generic and brand names. Pharmacies can actually print you a comprehensive list, but make sure it’s current.

Be ready to grab your medications and dietary supplements, and go! Buy a toiletry or make-up bag, and store a 10-day supply of medications in it. Put your name and contact information in it. Only take important medicine, for example, those used for epilepsy, blood pressure, pain, heartbeat rhythm, asthma, migraines, and diabetes. Keep the drugs in their original pharmacy container. Rescuers and relief team members may dispense your medications to you, so it must be correctly labeled.

Include a water bottle so you can take your medicine when needed, a flashlight and a spare set of eyeglasses. Have a little first-aid kit.

If you take refrigerated medications, like insulin, you have two options to keep it cool during a power failure: One, buy an ice pack and keep it frozen, preferably in a sealed baggie. When the power goes out, grab the pack from your freezer, drop it in that toiletry or tote bag, and go. Or purchase a ready-made cooling case, usually sold in the diabetes section of pharmacies and online. This stores insulin, and might also fit antibiotic suspensions, suppositories, growth hormone or epoetin (Procrit, Epogen). Two popular cooling cases are made by Frio and Medicool. These are great for regular travel too.

If you live in a region where fires are common, keep a 10-day supply of medications in a fire safe box. In a quick Internet search, I found two companies, Sentry and First Alert, that sell fireproof and waterproof boxes. Another option: Purchase a plastic waterproof container from the boating section of a sporting goods store.

If you’re prone to floods, or live in a hurricane zone, water purification tablets are good idea. They use chlorine dioxide to destroy microorganisms within 15 minutes, killing Giardia, Cryptosporidium and other pathogens. Hikers and campers often carry these. A popular brand is Katadyn Micropur tablets. These tablets are usually available in sporting goods stores and online.