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. Nonsteroidal or steroidal anti-inflammatories are rarely helpful, and usually only when there is a bursal tenderness or muscular local inflammation. Nitroglycerin patches, in individuals who don't react with severe headaches, can be of benefit.Side effects from these drugs are not infrequent and include increased headaches, stomach pain, tiredness, etc. My experience in prescribing hyperbaric oxygen therapy, although limited, has shown significant improvements in the ten or so individuals who have had access to it, although this requires a large number of treatments. Heparin has been found to have a specific anti-inflammatory effect that can dramatically decrease this kind of severe nerve pain, and I use it frequently to quell unresponsive flare-ups and to generally decrease pain levels. In many patients, infrared treatment (using an appropriate photon source) helps with hypersensitivity and pain when applied over the affected skin areas. If the above combination of modalities proves to afford no relief, then surgical decompression becomes an important consideration.