Often the first course of treatment will come from drugs. These can be oral medications or of injections, and their use is dictated by the severity of the crimped nerves and their location.
Sometimes the cause of the pain and disability that stems from this disorder comes from inflammation, which can impinge upon the nerves that flow down the backbone. If this is the case, some nonsteroidal anti-inflammatory drugs (NSAIDs) may offer relief. However, acetaminophen has no impact on inflammation, so it is usually not recommended. Likewise aspirin is not recommended because it takes high doses of aspirin to get maximum ant inflammatory results, and at that dose the drug can be harmful to the stomach.
If the disorder is making it difficult to sleep, your doctor may prescribe muscle relaxers. Muscle relaxers make you drowsy, so this form of relief is usually best taken in the evening. Muscle relaxers can increase the pain-relieving qualities of NSAIDs.
Certain specific forms of the disorder can be aided by gabapentin, carbamazepine and other anticonvulsants, which can offer sleep and relief from chronic pain. These drugs take a few weeks to work, so they are not suitable for acute pain.
Steroids may be taken orally or as injections. Oral steroids have the advantage of relieving pain within 24 hours. Injections are used for severe pain. Epidural injections may be used up to three times a year to reduce inflammation and swelling, though their effects are usually temporary.
Antidepressants can be helpful for nerve pain, but for older patients they may be a poor choice due to their side effects. These include dry mouth, dry eyes, constipation, and sleepiness.
In cases of severe pain, a short course of opioids may be prescribed. Because of their addictive properties, these drugs may come with special requirements, potentially including addiction counseling.