26/01/2026
Lots of MDs say they don’t “believe” in chiropractic or refuse to give their patients a referral, then turn around and prescribe Flexeril for back pain. Here’s why it’s worth calling out:
Despite its prevalence of use, research repeatedly found only “modest” short-term pain relief from skeletal muscle relaxers for acute low back pain (~a few days to 2 weeks) and carry side-effects such as drowsiness. There is no evidence that they are effective for sub-acute, chronic back pain or long-term use. Clinical guidelines often list muscle relaxers as an option NOT FIRST-LINE- and recommend non-drug conservative care for most back pain.
•The American College of Physicians treatment guidelines for low back pain recommend non-drug options FIRST including spinal manipulation, manual therapy like massage, superficial heat and acupuncture.
•A randomized clinical trial found chiropractic adjustments reduced pain more than muscle relaxants or placebo for subacute low back pain- A Randomized Clinical Trial Comparing Chiropractic Adjustments to Muscle Relaxants for Subacute Low Back Pain. Kathryn T. Hoiriis et al. (2004)
•SMT is associated with modest improvements in pain and function in acute back pain and is among the few non-surgical treatments with evidence of benefit- Paige NM, Miake-Lye IM, Booth MS, et al. Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. JAMA. (2017)
If you’re offered a muscle relaxant for low back pain, ask: “Is this to get me through a few painful days, or do you expect it to fix the problem long-term?”
