From the Guidelines
Managing pinched nerve pain involves a combination of rest, medication, and physical therapy, with a focus on reducing inflammation, relieving pressure on the nerve, and modulating pain signals. The most recent and highest quality study, 1, recommends the use of first-line treatments for neuropathic pain, including antidepressants, α2-δ calcium channel ligand anticonvulsants, and topical lidocaine. For pinched nerve pain, start by taking over-the-counter anti-inflammatory medications like ibuprofen (400-600mg every 6-8 hours with food) or naproxen (220-440mg twice daily with food) for up to 10 days to reduce inflammation and pain. Apply ice for the first 48-72 hours (20 minutes on, 20 minutes off), then switch to heat therapy using a heating pad on a low setting for 15-20 minutes several times daily. Rest the affected area while maintaining gentle movement to prevent stiffness. Avoid positions that worsen the pain and consider using a supportive pillow while sleeping.
Some key points to consider when managing pinched nerve pain include:
- The use of physical therapy exercises targeting the specific nerve area to help relieve pressure and strengthen supporting muscles
- The potential benefits of prescription medications like muscle relaxants (cyclobenzaprine 5-10mg) or gabapentin (starting at 300mg daily) for persistent pain
- The importance of seeking medical attention if symptoms persist beyond 4-6 weeks or include severe pain, numbness, weakness, or bladder/bowel changes, as more aggressive treatments like steroid injections or surgery might be necessary
- The need to individualize treatment based on the specific type and location of the pinched nerve, as well as the patient's overall health and medical history, as noted in 1 and 1.
Overall, the goal of managing pinched nerve pain is to reduce morbidity, mortality, and improve quality of life, and the most effective approach will depend on the individual patient's needs and circumstances.
From the FDA Drug Label
Management of neuropathic pain associated with diabetic peripheral neuropathy Management of postherpetic neuralgia Management of fibromyalgia Management of neuropathic pain associated with spinal cord injury
The FDA drug label does not answer the question about pinched nerve pain management.
From the Research
Pinched Nerve Pain Management Options
- Conservative treatment strategies for managing pinched nerve pain include medications, physical therapy, and exercise 2
- These treatment options can be tailored to individual patients, taking into account the underlying cause of the pain and the patient's overall health status 2
- Conservative treatments for chronic pain, which may include pinched nerve pain, frequently used in clinical practice include:
- Pharmacological therapy: anticonvulsants, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, antidepressants 3
- Procedures: injection of steroids and local anesthetics, pulsed radiofrequency (PRF), repetitive transcranial magnetic stimulation (rTMS), prolotherapy 3
- Exercise: various forms of physical therapy and exercise can be used to manage chronic pain, including pinched nerve pain 2, 3
Treatment Considerations
- Treatment considerations for each category of medication and physical therapy should be discussed with a physician to determine the best course of treatment for individual patients 2
- Clinicians should manage chronic pain, including pinched nerve pain, actively to improve patients' quality of life and prevent psychiatric disorders such as depression and anxiety 3