How to deal with arm/hand nerve pain flare ups if cold and heat both make it worse..other than pain medications. it gets shaky/ weak and my pinky becomes purple/blue. it gets to the point i can't even hold a pen?

The color change you describe usually indicates a circulatory issue, possibly Raynaud’s phenomenon (spasm of blood vessel- usually happens with cold exposure) , though there may also be a neurological issue. A full evaluation of the nerves & vessels of the arm & hand is important. A calcium channel blocker medication can often help Raynaud’s symptoms