Cervical Radiculopathy Medication

Updated: Oct 08, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Medication

Medication Summary

NSAIDs are commonly prescribed for their effects on pain and inflammation. In cervical radiculopathy, much of the pain is secondary to inflammation of the nerve root, usually due to a mechanical irritation of the nerve. In general, 10-14 days of regular dosing of an NSAID is all that is needed to control the pain and inflammation in cervical radiculopathy.

Oral steroids have been used to reduce the associated inflammation from compression. No controlled study exists to support the use of oral steroids in the treatment of cervical radiculopathy; however, these agents have been found to be clinically useful. Doses as high as 60 mg daily for 7 days and continuing for 5 days have been used without evidence of adrenal suppression. Longer-term use is not recommended. Tricyclic antidepressants can be a useful adjunct in controlling radicular pain. Opioid medications are generally not necessary for pain relief, but these drugs can be used when other medications fail to provide adequate relief or if other agents are contraindicated. When opioid medications are prescribed, adequate doses and appropriate dosing schedules should be used.

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Nonsteroidal anti-inflammatory drugs

Class Summary

Various NSAIDs are available either over the counter or by prescription. Proper doses should be used in the acute phase around the clock for approximately 7-10 days.

Ibuprofen (Motrin, Ibuprin)

DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

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Tricyclic antidepressants

Class Summary

Tricyclic antidepressants are a complex group of drugs that have central and peripheral anticholinergic effects, as well as sedative effects. These agents have central effects on pain transmission and block the active reuptake of norepinephrine and serotonin.

Amitriptyline (Elavil)

By inhibiting the reuptake of serotonin and/or norepinephrine by the presynaptic neuronal membrane, may increase the synaptic concentration in the CNS. Useful as an analgesic for certain chronic and neuropathic pain.

Nortriptyline (Pamelor, Aventyl HCl)

Has demonstrated effectiveness in the treatment of chronic pain. By inhibiting the reuptake of serotonin and/or norepinephrine by presynaptic neuronal membrane, may increase synaptic concentration in the CNS.

Pharmacodynamic effects, such as the desensitization of adenylate cyclase and downregulation of beta-adrenergic receptors and serotonin receptors, also appear to play a role in its mechanisms of action.

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