Medicines You Can Safely Take (Considering your NSAID allergy) Since you cannot tolerate NSAIDs except etoricoxib and piroxicam, we will use medicines that are safe for you. 1. Etoricoxib 60 mg once daily after food OR Piroxicam 20 mg once daily after food Choose only one, NOT both. These are safe anti-inflammatory options for people who cannot take regular NSAIDs. 2. Muscle Relaxant (very important) You can use ONE of the following: • Thiocolchicoside 4 mg – Twice daily OR • Tolperisone 150 mg – Twice daily OR • Tizanidine 2 mg – At bedtime These help reduce the muscle spasm causing the nerve pain. 3. Neuropathic Pain Relief (for radiating arm pain) • Pregabalin 75 mg at night OR • Gabapentin 300 mg at night This reduces nerve irritation and helps sleep. Additional Supportive Care Warm compress Warm water bag on the neck and shoulder 10–15 minutes, 2–3 times daily Avoid pillow for 2–3 days Or use a thin soft pillow only. Neck movement rule Avoid: • Sudden neck turning • Looking down at mobile • Lifting weight • Driving long distances

When to See a Doctor Urgently • Severe weakness in the arm • Numbness spreading to fingers • Pain worsening day by day • Fever or swelling at neck

AVOID HIGH PILLOW WHILE SLEEPING DO SIMPLE NECK EXERCISES LIKE MOVING SIDE BY SIDE UP AND DOWN 10 SECONDS EACH SIDE

IMMEDIATELY CONSULT A CLINIC IF U R EXPERIENCING NUMBNESS AND TINGLING IN ARM OR HAND