- Is There a Role for Muscle Relaxants in Migraine Management? A Narrative Review
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Heba Banihani, Marta Waliszewska-Prosół, Christopher Robinson, Abdulrazaq S. Albilali, Jeannine Abrons, Kinga Gecse, Merve Kozak, Mario M. F. Peres, Sait Ashina
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Received June 8, 2026 Accepted September 21, 2026 Published online October 26, 2026
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DOI: https://doi.org/10.62087/hpr.2026.0025
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 Abstract
- Migraine is a debilitating neurological condition that affects approximately 15% of the global population and frequently co-occurs with musculoskeletal conditions that add to its burden. Neck pain affects 73%–90% of patients and often prompts off-label prescribing of muscle relaxants to relieve perceived muscular contributions to headache. This narrative review examines the clinical evidence, pharmacological profiles, and safety considerations for centrally acting antispasmodic and antispasticity agents (tizanidine, baclofen, cyclobenzaprine, and methocarbamol), peripherally acting agents (dantrolene), and other agents (carisoprodol and eperisone). Although limited data from landmark trials in the early 2000s suggest potential preventive benefits of tizanidine and baclofen, high-quality, contemporary evidence supporting the routine use of muscle relaxants for migraine is lacking in the broader literature. Their substantial adverse effects, including sedation, dizziness, and the risk of dependence, may further increase patient disability. This review supports current clinical guidelines that prioritize migraine-specific therapies and suggests reserving muscle relaxants for individual cases with prominent musculoskeletal symptoms. Further studies are needed to assess the efficacy and safety of their short- and long-term use in migraine management.
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