Muscle Relaxants in Rheumatoid Arthritis

Pain management is important for rheumatoid arthritis (RA) patients. Despite the scarce information available about the efficacy of muscle relaxants in treating RA patients, they are generally accepted as adjuvant therapy for managing chronic musculoskeletal pain.

To evaluate the safety and efficacy of muscle relaxants in this patient population, researchers conducted a metaanalysis of 6 trials including 126 patients. Their results were published online on January 18, 2012, in the Cochrane Database of Systematic Reviews. The muscle relaxants studied were short- and longacting benzodiazepines and a non-benzodiazepine.

The 6 trials included in the meta-analysis compared the effect of muscle relaxants with placebo over a period of up to 2 weeks. Overall, these trials did not show evidence of a beneficial effect of using muscle relaxants in terms of pain intensity, quality of life, or function. In addition, 2 of the 3 trials that lasted longer than 24 hours showed an increased rate of adverse events such as drowsiness and dizziness associated with muscle relaxants.

As a result of this metaanalysis, the authors conclude that benzodiazepines do not appear to provide a benefit as muscle relaxants for patients with RA over 24 hours or 1 week. The non-benzodiazepine studied also did not appear to reduce pain in RA patients over a 2-week treatment period. This suggests that muscle relaxants used as adjunct therapy in RA may not be as beneficial to patients as has been thought.

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