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The Best Painkillers for a Pinched Nerve in the Neck

A pinched nerve in the neck, also known as cervical radiculopathy, can cause severe pain that radiates down the arm and shoulder. This painful condition is caused by compression or irritation of a nerve root in the cervical spine. While pinched nerves often heal on their own over time, finding an effective pain relief method is crucial for managing symptoms in the meantime. Certain over-the-counter and prescription medications can help reduce inflammation and provide pain relief for a pinched nerve. This article explores the most effective painkiller options to discuss with your doctor for getting relief from a pinched nerve in the neck.

Over-the-Counter Anti-Inflammatories

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve) are usually the first line of defense for pinched nerve pain. NSAIDs work by blocking the production of prostaglandins, inflammation-fueling chemicals in the body. This helps decrease swelling, pressure, and discomfort associated with a pinched nerve.

For neck pinched nerves, NSAIDs taken orally at over-the-counter doses can offer mild to moderate pain relief. They may also allow you to reduce use of stronger prescription medications. However, NSAID side effects like gastrointestinal bleeding and kidney damage can occur with long-term use. Be sure to take OTC NSAIDs exactly as directed and avoid exceeding maximum recommended daily amounts.

Topical NSAID creams, gels or patches applied directly over the painful area are another option. Topical diclofenac (Voltaren) is one commonly used preparation. This focuses the anti-inflammatory effect at the site of pain while limiting systemic side effects.

Acetaminophen

Acetaminophen (Tylenol) is another go-to option for managing pinched nerve discomfort. While not technically an NSAID because it has minimal anti-inflammatory effect, it is an effective analgesic (pain reliever). Compared to oral NSAIDs, acetaminophen is less likely to cause stomach irritation or bleeding issues.

The maximum recommended daily dose of acetaminophen is 3,000 mg per day. Excessive or prolonged use can result in liver damage in some cases. Acetaminophen offers only mild pain relief, but is often combined with NSAIDs or other medications for a multi-modal approach to pain management.

Muscle Relaxants

Muscle relaxants like cyclobenzaprine (Flexeril) or tizanidine (Zanaflex) can also help alleviate pinched nerve pain originating in the neck region. These work by causing relaxation of the muscles surrounding the compressed nerve. This may help reduce inflammation and take pressure off the irritated nerve.

Muscle relaxants are generally prescribed for short-term use in combination with NSAIDs or other analgesics. Common side effects include drowsiness, dizziness and dry mouth. These medications should be used cautiously because they can cause sedation and impair driving abilities. They are not recommended for older adults due to increased risks like falls or accidents.

Nerve Pain Medications

Medications specifically developed to treat nerve pain, or neuropathic analgesics, can provide more robust relief from a pinched nerve. There are several types of nerve pain medications prescribed for moderate to severe cases:

  • Anticonvulsants: These include gabapentin (Neurontin) and pregabalin (Lyrica). Though originally used to prevent seizures, they are increasingly prescribed off-label to treat nerve pain. They work by calming overactive nerves.
  • Antidepressants: Tricyclic antidepressants like amitriptyline are used in low doses to modify nerve pain signals. The SNRI duloxetine (Cymbalta) is FDA-approved for diabetic neuropathy and fibromyalgia.
  • Topical anesthetics: Capsaicin creams derived from chili peppers and lidocaine patches can temporarily numb areas of neuropathic pain when applied to the skin.
  • Opioids: Strong prescription opioids like oxycodone or morphine act on opioid receptors to block pain signals. However, they carry a high risk of dependence and adverse effects. Opioids are typically reserved for severe acute pain that doesn’t respond to other treatments.

The decision to prescribe neuropathic medications for a pinched nerve will depend on the severity of symptoms and response to conservative treatments. Your physician will be able to determine if one of these nerve pain medications is appropriate for managing your condition.

Steroid Injections

If the pinched nerve is causing severe pain or weakness, your doctor may recommend injecting corticosteroid medication around the compressed nerve root. Steroid injections work by reducing local inflammation to help relieve pressure on the nerve. Most people experience significant but temporary relief from a steroid cervical injection. However, pain may return after the effects wear off in a few months.

Only a limited number of steroid injections per year are advised due to potential side effects like weakening of nearby bone and cartilage. Risks also include infection, bleeding and nerve damage from the needle itself. Epidural steroid injections are performed by an interventional pain specialist or spine surgeon. Though often effective for pinched nerve pain, injections are not usually the sole solution. Additional pain management and physical therapy are incorporated into a well-rounded treatment plan.

Lifestyle Remedies

In addition to medications and injections, adopting certain lifestyle measures at home can support pain relief from a pinched neck nerve:

  • Heat or cold therapy – Use heating pads, hot packs or ice to help ease muscle tension and inflammation. Alternate heat and cold to determine what feels most soothing.
  • Rest – Take frequent breaks from activities that aggravate your symptoms to calm nerve irritation. Avoid extended sitting or repetitive neck motion.
  • Ergonomics – Adjust workstations, phone positioning, driving setup, and furniture to optimize neck comfort and support. Use assistive devices as needed.
  • Physical therapy – Gentle stretching and exercises can improve range of motion and take pressure off compressed nerves. A physical therapist can provide a customized therapy program.
  • Stress management – Practice relaxation techniques like yoga, meditation, or deep breathing to help control muscle tension and anxiety related to chronic nerve pain.
  • Posture correction – Improve posture habits when sitting, standing or sleeping to avoid neck positions that pinch nerves.

Conclusion:

Pinched nerves in the neck can greatly disrupt daily life due to debilitating pain symptoms. A combination medication approach of NSAIDs, muscle relaxants, neuropathic drugs, and localized steroid injections often provides the most effective relief. Lifestyle remedies like heating pads, ergonomic modifications, and physical therapy also play an important role in managing neck nerve compression. Work closely with your healthcare providers to find the right pain management plan and get your pinched nerve under control.