Normally, nerves branch off the spinal cord through spaces between the vertebrae. If one of these exit spaces shrinks, it can squeeze the nerve root (the radicular nerve) and cause symptoms in the area served by the nerve. A number of problems can cause a pinched nerve, including a herniated disc, spinal stenosis, or degenerative disc disease. Age-related degenerative changes in the spine account for 70% to 90% of all cases.
The good news: there are multiple options for pinched nerve treatment, which almost always begins with conservative therapies. Your doctor will likely recommend an over-the-counter pain reliever, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin) or naproxen (Aleve). While you want to remain physically active, stop any movement that causes pain intensity to spike. For a pinched nerve in the neck, you may be told to use a cervical collar for a brief period of time, as well as a cervical pillow while you sleep. Physical therapy, range-of-motion exercises, and strengthening exercises can lead to faster pain relief.
If your pain is severe, your doctor will likely prescribe stronger medications. For example, he or she may prescribe a short course of an oral corticosteroid (prednisone). Some anticonvulsant and antidepressant medications can be especially effective at reducing nerve pain. Common one doctors prescribe include gabapentin, amitriptyline and duloxetine. Epidural glucocorticoid injections are sometimes given for persistent pain.
Surgery is not usually considered for pinched nerve treatment unless the pain has not eased after six to eight weeks of medial therapy, you experience increasing difficulty moving, or there is evidence of spinal cord compression.
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