SynthesisJAMA network open2024
Long-Term Use of Muscle Relaxant Medications for Chronic Pain: A Systematic Review.
Synthesis in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparison of clinical efficacy of different acupuncture methods in the treatment of fibromyalgia: a network meta-analysis based on randomized controlled trials.Frontiers in neurology · 2026Pooled it
- Comparison of clinical efficacy of different exercise therapies in the treatment of chronic nonspecific neck pain: a network meta-analysis.Frontiers in neurologyPooled it
- Decoding pain in axial spondyloarthritis: Mechanisms, management, and future directions.Best practice & research. Clinical rheumatology · 2026Review
- Emerging Pharmacological Strategies for Trigeminal Neuralgia.CNS drugs · 2026Review
- Article
- Efficacy and safety of Wuwei Xiaodu Drink in root canal therapy for chronic pulpitis: A retrospective cohort study.Medicine · 2026Article
- Myofascial pain in older adults: a geroscience-informed framework integrating precision geriatrics and digital therapeutics.Frontiers in aging neuroscience · 2026Review
- Intravenous magnesium and methocarbamol for acute pain crises in refractory trigeminal neuralgia: A retrospective analysis.Headache · 2026Article
- Centrally Acting Skeletal Muscle Relaxants Sharing Molecular Targets with Drugs for Neuropathic Pain Management.Brain sciences · 2025Review
- Intrathecal Drug Delivery Systems for Chronic Pain Management: A Narrative Review of Pharmacologic Agents, Clinical Applications, and Considerations.Pharmacy (Basel, Switzerland) · 2025Review
- Routine medical care for adults with musculoskeletal disorders in the Indigenous community of Pimicikamak, northern Manitoba before and after implementing the Global Spine Care Initiative model: a retrospective chart review with a 10-month post-implementation window: A collaborative research project between World Spine Care Canada (WSCC), Pimicikamack Okimawin, and Cross Lake Nursing Station.The Journal of the Canadian Chiropractic Association · 2025Article
- Genetic variants associated with chronic postsurgical pain: evidence from the China Surgery and Anaesthesia Cohort study.British journal of anaesthesia · 2025Observational
- Effects of Hydrocodone Rescheduling on Pain Management Practices Among Older Breast Cancer Patients.Current oncology (Toronto, Ont.) · 2025Article
- Relationships between psoas muscle index, lumbar lordosis, and chronic low back pain in middle-aged and elderly people.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Review
- Myofascial Pain Syndrome: An Update on Clinical Characteristics, Etiopathogenesis, Diagnosis, and Treatment.Muscle & nerve · 2025Review
- Effectiveness of Acupuncture for Neck Pain: Systematic Review and Meta‑analysis with Trial Sequential Analysis.Journal of pain research · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
Importance: 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. Objective: To systematically review the effectiveness or efficacy of long-term use of SMRs for chronic pain. Evidence Review: 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. Findings: 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. Conclusions and Relevance: 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.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.