Patient/caregiver was instructed upon therapeutic uses of Tizanidine as follows:

• Norepinephrine is a neurotransmitter synthesized in human body. Upon release, norepinephrine can improve the conduction of nerve impulses to the skeletal muscles and thus increase the force of skeletal muscle contraction.
• Tizanidine is a medication that works by reducing the release of norepinephrine. Inhibition of norepinephrine release by tizanidine leads to inhibition of conduction of nerve impulses from the spinal cord to the muscles.
• Conduction of nerve impulse to the muscle results in muscle contraction. Inhibition of nerve impulse conduction from the spinal cord to the muscle with tizanidine leads to muscle relaxation.

Tizanidine can be used in clinical conditions for control of pain and relief of muscle spasticity and tightness as follows:

Fibromyalgia

• Fibromyalgia is a condition affecting the musculoskeletal system, probably secondary to altered processing of pain signals by the brain and spinal cord.
• Pain signals travel along the nerves to reach brain and spinal cord, where the signals are realized and processed. This helps with awareness of pain and contributes to taking necessary steps for pain control.
• In individuals with fibromyalgia these signals are amplified contributing to significantly increased pain perception. This contributes to severe body pains and multiple tender points in the body. Poorly controlled pain leads to sleep disturbances, altered mood, and fatigue. Also, exaggerated pain levels limit the activity and range of motion in the joints, leading to stiffness and tightness in various body parts, which contributes to further pain.

• Tizanidine by controlling and relieving the stiffness and tightness, relaxes the muscle, and contributes to relief of pain and improvement of symptoms in individuals with fibromyalgia.

Degenerative disc disease

• Osteoarthritis involving the vertebrae can exert pressure on the spinal cord, inflame, irritate, and damage the nerves running along the spinal cord. This can result in abnormally increased muscle tone, pain, spasticity, and rigidity.
• Tizanidine intake inhibits conduction of impulses along these inflamed nerves to the muscles, help relieve the spasticity and tightness, relax the muscle, and contribute to relief of pain and stiffness.