From the Guidelines
Valium (diazepam) can be used as a muscle relaxant, but its use should be limited to short-term treatment due to the risks of abuse, addiction, and tolerance. According to the American College of Physicians and the American Pain Society, benzodiazepines, such as diazepam, seem similarly effective to skeletal muscle relaxants for short-term pain relief 1. However, they are not FDA-approved for the treatment of low back pain and should be used with caution.
Key Considerations
- Typical dosing ranges from 2-10 mg taken orally 2-4 times daily as prescribed by a healthcare provider.
- Treatment duration should be limited to 2-4 weeks to avoid dependence and tolerance.
- Diazepam is particularly effective for acute muscle spasms, musculoskeletal pain, and spasticity associated with neurological conditions.
- Side effects may include drowsiness, fatigue, and impaired coordination, so patients should avoid driving or operating machinery while taking it.
- Diazepam can be habit-forming, so it should not be stopped abruptly after prolonged use.
Recommendations
- Clinicians should consider the addition of nonpharmacologic therapy with proven benefits, such as spinal manipulation, intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, yoga, cognitive-behavioral therapy, or progressive relaxation, for patients who do not improve with self-care options 1.
- Herbal therapies, such as devil's claw, willow bark, and capsicum, may be safe options for acute exacerbations of chronic low back pain, but benefits range from small to moderate 1.
- Systemic corticosteroids are not recommended for treatment of low back pain with or without sciatica, as they have not been shown to be more effective than placebo 1.
From the FDA Drug Label
Diazepam is a useful adjunct for the relief of skeletal muscle spasm due to reflex spasm to local pathology (such as inflammation of the muscles or joints, or secondary to trauma), spasticity caused by upper motor neuron disorders (such as cerebral palsy and paraplegia), athetosis, and stiff-man syndrome Diazepam is a benzodiazepine that exerts anxiolytic, sedative, muscle-relaxant, anticonvulsant and amnestic effects.
Valium (diazepam) can be used as a muscle relaxant. It is indicated for the relief of skeletal muscle spasm due to various conditions, and it has muscle-relaxant effects. However, it is often used as an adjunct, meaning it is used in addition to other treatments. 2 2
From the Research
Valium as a Muscle Relaxant
- Valium, also known as diazepam, is a benzodiazepine that can be used as a muscle relaxant 3.
- However, studies have shown that benzodiazepines like diazepam do not appear to be beneficial in improving pain over 24 hours or one week in patients with rheumatoid arthritis 3.
- A systematic review found that there is fair evidence that cyclobenzaprine, carisoprodol, orphenadrine, and tizanidine are effective compared to placebo in patients with musculoskeletal conditions, but diazepam was not found to be effective 4.
- Another study found that among patients with acute low back pain treated with a nonsteroidal anti-inflammatory drug, skeletal muscle relaxants, including diazepam, do not improve outcomes more than placebo 5.
- The use of diazepam as a muscle relaxant is associated with adverse events, including drowsiness and dizziness 3, 5.
Comparison with Other Muscle Relaxants
- A study compared the efficacy of seven skeletal muscle relaxants, including diazepam, and found that the between-group differences were not statistically significantly different 5.
- Cyclobenzaprine has been evaluated in the most clinical trials and has consistently been found to be effective in patients with musculoskeletal conditions 4.
- Tizanidine and baclofen have also been found to be effective in patients with spasticity and musculoskeletal conditions 4.
Adverse Effects
- The use of diazepam as a muscle relaxant is associated with adverse events, including drowsiness and dizziness 3, 5.
- Cyclobenzaprine has been associated with more adverse effects, including dry mouth and drowsiness, compared to other muscle relaxants 4, 5.
- Dantrolene and chlorzoxazone have been associated with rare serious hepatotoxicity 4.