Reddit reviews Aspercreme with Lidocaine Maximum Strength Pain Relief Cream, 4.7 oz.

Sort of joining in the chorus here, but yep, that sounds like a muscle spasm. Chronic, gnarly, treatment-resistant muscle spasms are super common with EDS- they're usually associated with a particularly unstable joint, what your muscles freak out overcompensating for, but can be caused by other things as well.

The "zingy" nerve pain is probably caused by impingement- either by the unstable joint subluxing onto it, or the spasmed muscles squeezing the crap out of it. Given your description of the timing, it's probably a subluxation. My random IANAD guess would be AC joint, just because your description sounds a lot like what happens when mine slips.

Treating these things is a bitch and a half. Here are some of the things I do, which help somewhat.

• When it first starts, some self-administered trigger-point masage can sometimes stop it. Here are some tools I use: Neck knobby thing, spine knobby thing, foam roller. You can also use tennis balls or lacross balls, but I uh.. broke them \^\^;;;
  
• Aspercreme / Blue Emu - I find the classic Trolamine Salicylate works best for me, but if you have an aspirin allergy, or if Lidocaine works better for you, they make a version with that as the active instead. There's also a spray form for when an area is too tender to touch. They can be a little pricey, but Amazon has a Subscribe & Save discount on them, which helps.
  
• Combine the above with Tiger Balm or Icy Hot, if you can tolerate them, and I find it makes them more effective than either separately. I think they maybe help the ingredients in the above penetrate better?
  
• If you can get it, adding a final layer of CBD lotion or oil is extra effective. I use Ethos Muscle Melt.
  
• Slap a quality heating pad with a washable cover on the above and bake that shit in- (NOTE: I AM DEFINITELY NOT A DOCTOR, AND THE ASPERCREME LABEL SPECIFICALLY SAYS NOT TO DO THIS but damned if it isn't effective and at this point I'll do anything that works?)
  
• If that fails, grab some alcohol swabs to wipe all that shit I just recommended off from a few spots and then use a TENS unit.
  
• Medicate: this part is obviously dependent on your own rxs and state legislature, etc, but muscle relaxants and CBD are helpful things to have. For an OTC option, I've found that some antihistamines can be useful, but then again I've got MCAS as a complication so YMMV.
  
• Physical therapy- PTs often recommend certain stretches to help prevent spasms, but in my experience, every single time they have at best done nothing and at worst they've triggered/exacerbated them. I have had some good results with exercises designed to strengthen the unstable joint that caused the whole mess, though-
  very light, irritatingly soft and repetitive exercises that drive me crazy but actually are maybe kind of effective? BUT I AM NOT A DOCTOR.
  
  Hopefully this will be of some use. I swear some of the worst pain I've experienced in EDS has been from muscle spasms, geez.

I’ve used a bunch, tizanidine is one that can also help with migraines (side effects: drowsiness, dizziness, dehydration, etc.). There are lidocaine patches your primary/specialist can prescribe that are really awesome — you can leave them on for 12 hours, shower in them, wear them to work, to bed, super convenient, covered by insurance, all that good stuff. If you can’t get them from your doc you can get OTC aspercream w/ lidocaine (there’s a spray now, too) and it’s super effective, as well. Anyway, lidocaine has really helped me with my chronic pain related migraines — effective and cheap with no side effects.

Get some topical anaesthetic (with lidocaine) and smear it on. Let it soak in for 10min before you put on underwear and it will make a huge difference. This is what has allowed me to sleep through the night (I'm on day 14).