Trapped Nerve Pain Relief Medication

Trapped Nerve Pain Medication
Which Pain Killer Will It Be Today?

I do enjoy keeping up to date with the latest in health news and research. To try keep up the latest developments I like to attend an annual pain symposium. At this pain symposium various medical specialities get together to talk about different concepts in pain diagnosis and pain management. It is primarily attended by GP’s, rheumatologists, neurologists and anaesthetist’s so the focus on how to control pain levels for back and neck pain patients is geared towards a pharmaceutical viewpoint.

Why would I attended a pharmaceutical discussion as a chiropractor? As I said I like to be up to date with what patients in pain are going to be prescribed by their doctor. I like to know the evidence and thinking behind different pain medication prescriptions so that I can help guide people if they aren’t finding the right medication or maybe on a dosage that is too weak or strong.

That is why today I want to let you know what kind of information I discovered at this recent pain symposium, in particular, regarding pain medication for a trapped nerve . Please carry on reading if you want to know which is the best nerve pain medication to take or not to take.

Trapped Nerve Pain Pills

When a doctor looks at prescribing pain killer drugs for you they should first ask themselves if the source of the pain is:

  1. Neuropathic,
  2. Inflammatory or
  3. Nociceptive.

This reason you want to know this is so you know what part of your body is telling your brain there is pain.

I’m going to be looking at just one type of pain today, neuropathic pain (nerve pain).

WHO Pain Relief Medication Ladder

WHO Drug Prescription Pain Medication Ladder
Prescription Pain Medication Ladder

The World Health Organisation developed a pain relief ladder protocol to help doctors prescribe better pain relief medication for cancer patients in the 80’s.

The same pain relief ladder can be used for other kinds of pain as well.

However, pinched nerve pain does not tend to respond as well to the WHO pain ladder.

It has been suggested that for a pinched nerve in your neck or diabetic neuropathy pain that other medications be taken by patients.

Nerve Pain Relief Medication Ladder

Here is a guidance to what nerve pain medication steps where suggested at the pain symposium.

First-Line Drug Treatment

Some choices here are:

  1. Certain Anti-depressants (i.e., tricyclic antidepressants and dual reuptake inhibitors of both serotonin and norepinephrine),
  2. Certain Anti–epileptics (i.e., gabapentin and pregabalin),
  3. Topical anesthetics (i.e., lidocaine).

Second-Line Drug Treatment

  1. Opioid analgesics (i.e., tramadol)

Third-Line Drug Treatment

  1. Topical capsicum.

As you may have noticed normal anti-inflammatories (NSAID’s) typically don’t feature in nerve pain protocols. However, they may be used to help other pain sources, including inflammatory pain, associated with an injury.

This nerve pain medication protocol is suggested by Finnerup NB et al. which you can read from their research below:

Download (PDF, 104KB)

I hope this helps you understand why your GP, orthopaedic or neurosurgeon has prescribed you certain medication.

There are many times people ask “why did my doctor give me anti-depressants when I’m in pain?” Well now you know anti-depressants are not always used for just one use.

So speak with your GP to get the correct pain pills you need for your specific pain.

Further Reading:

  1. Finnerup NB, Otto M, McQuay HJ, Jensen TS, Sindrup SH. Algorithm for neuropathic pain treatment: an evidence based proposal. Pain. 2005 Dec 5;118(3):289-305.
  2. Finnerup NB, Sindrup SH, Jensen TS. The evidence for pharmacological treatment of neuropathic pain. Pain. 2010 Sep;150(3):573-81.
  • m edwards

    ive had chronic compression of nerves in my neck at C2-C3,C3-C4, C4-C5 was on tramadol for 6 years finally off it-pain same but non of the side effects-im looking for the epidural direct to the pain site-would you recommend??

  • martyn watkins

    I got a trap nerve in my shoulder and its hurts and my fingers are a part .?

  • Natalie

    I need help. I’ve got severe scoliosis, which I have always coped quite well with. One year ago while moving house, I picked up a heavy pot, i felt something ‘shift or happen’, I kept going. Once i stopped moving the pain was so intense i was not able to move my legs for 3 hours, i was stuck, its happened like that a few more times, but not as severe. Now it hurts ALL the time, like electric shocks, shooting all over my body, i feel ill, shaky, and like i’m going throw up and fall over, my left leg turns numb and cold, the pain is horrific mid/lower left region. I’ve seen doctors, physios, chiropractors and an othorpaedic surgeon. Had MRI, bone scan etc and yet nothing shows up for this problem on lower left. (usually everyone is so fascinated with the severity of my curvatures – the biggest of 3 bends is at 70 degrees – but luckily that is not the problem.
    Physio exercises have again set off this horrific pain and numb leg. I can hardly move my left leg as it feels like an elephant is sitting on it. The dr has now prescribed Tramadol slow release, it helped for a while but no longer. He’s now prescribed me valium which I’m so very hesitant to try because the pain is so bad i feel i could just take the whole box and be done with it. I wouldn’t but, the pain is so horrific that I think these things. I’m at a complete loss and at a dead end – where to go, who to see and who can help me?

  • Naproxen is a “non-steroidal anti-inflammatory” (NSAID) and so doesn’t fall into the three categories mentioned above. Most first contact doctors will prescribe a NSAID which for those with neuropathic pain may not be what’s needed. However, everyone is different and has different past and current medical health histories which need to be taken into account. That is why researchers like Finnerup and others are looking if someone finds the magic combination or drug that can help a trapped nerve pain.

  • Kanana


  • glass_back

    Hi, injured my back a year ago this month, pain continued to get worse until I ‘dropped’ on Christmas day 2010, I haven’t been to work since, the pain peaked twice a day after bending movement (toilet visits too!) when this happened I would freeze for up to 30 mins unable to move at all with a sickeneing pain shooting across my lumbar region that swept across me in waves, caused me to go in to a form of shock each time. Got prescribed Tramadol (very nast drug, avoid), didn’t work, Movelat cream, amitryptylene which didn’t work, am now on Gabapentine and these have worked! I have stenosis in L4, L5 but this was not the cause. doc sed I had discs pressing my nerve which was ‘trapping’ between my discs, and pain, the worst pain I have ever endured in my life! If I had to go through it again i would seriously consider doing myself in! Yes it was that bad. Am on the road to recovery now and am relatively pain free 🙂

  • Thanks KJ for letting us know. Each person is like a chemistry experiment with some drugs working better than others. Did it take long for the amitriptyline to give you pain relief?

  • kj

    i can safely say that the anti depresant amitryptline has helped my pain..wheraa the drug tramadol(which is menat to be stronger) was zero help for pain.

  • Maybe you need an orthopaedic or neurology referral to confirm the source of your pain. Sounds like you had an accident on one of the rides in the theme park so should be a mechanical source of pain. If the consultant feels there is nothing they can do then trying conservative care could be a route to look at to manage the pain. Hope you get some relief soon.

  • Tinhead8

    i have had lower back pain for a couple off years now i went o florida and went on the rides,after that i had pains in my legs very bad ending up going to there hospital,my doc sent me for mri scan,come back clear,they put me on gabapentin and tramadol for the pain these only mask it ,i am at the end off my theather and no one can give me any answers,could anyone give me some advice pleas x

  • Hi Afeeza you may need a neurological consult with a neurosurgeon, orthopaedic surgeon or neurologist. I came across a surgical article on painful sacral cysts causing the same pain as you describe. It may be something to discuss with your attending doctor to see if your treatment plan needs changing. Unfortunately looks like there may not be a clear consensus as to how best to take care of a sacral cyst at this stage. Hope you get some pain relief soon.

  • Afeeza123

    i have lower back pain radiating to the rt leg for >8weeks now. having physio and analgesia does not work. MRI ok just showing sacral cyst at L2.
    Been told trapped nerve. physio not helping, weakness in leg, lower back pain slightly better but lots of pain in sacral area.
    dont know what to do.