Keep from freezing. After removing a used patch, fold the patch in half with the sticky sides together. Make sure to dispose of it out of the reach of children and pets. There is a problem with information submitted for this request. Sign up for free, and stay up-to-date on research advancements, health tips and current health topics, like COVID, plus expert advice on managing your health.
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All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Muscle relaxants are actually sedative—hypnotic drugs that do not have direct activity on the muscle and are thought by many pain authorities not to possess analgesic properties [15,16].
If a neuropathic component is believed to be present in a patient with LBP, then those drugs often prescribed for the treatment of neuropathic pain, e.
Tricyclic antidepressants may have mechanisms related to the endogenous central nervous pain-modulating system or may have sodium-channel-blocking activity. Some anticonvulsants also possess a sodium-channel-antagonistic mechanism, whereas others, such as gabapentin, have unknown analgesic mechanisms [17]. It is frequently found that patients with chronic LBP have little response to, or great difficulty in tolerating, treatment with these analgesics [18,19].
Results from controlled clinical trials have demonstrated that the lidocaine patch is effective for the treatment of neuropathic pain associated with PHN [10—12]. Recent clinical experience indicates that the lidocaine patch may also be effective for the treatment of other neuropathic and non-neuropathic pain states [10,13,20].
Most recently, Dalpiaz et al. In the treatment of neuropathic pain, e. In myofascial pain, however, the mechanism of action is less clear. It can be hypothesized that a similar mechanism of action is occurring, i. In patient 3, a multimodal treatment regimen, including the lidocaine patch, was shown to help reduce swelling.
A recent study demonstrated the immunoregulatory effects of lidocaine on T cells in patients with allergic asthma [21].
The lidocaine patch may, therefore, also possess anti-inflammatory actions. In patient 4, the combination of the lidocaine patch and gabapentin was successful in managing burning pain and allodynia of the lower back.
In regard to allodynia, there are four theoretical mechanisms to explain the possible beneficial effects of the lidocaine patch in this patient. First, blockade of abnormally functioning sodium channels on damaged peripheral nerves may decrease ectopic nociceptive pain signals transmitted to the dorsal horn of the spinal cord. Second, the lidocaine patch may act as a mechanical barrier to the area of allodynia, thus preventing stimulation [10].
The fourth possibility is interruption of the proposed mechanism of antidromic neurogenic inflammation. Efferent stimulation of injured nerves via antidromic signals traveling back down afferent nociceptors is speculated to cause inflammation that does not respond to NSAIDs or cyclo-oxygenase-2 inhibitors. Release of histamines, substance P, and calcitonin-gene-related peptide causes recruitment of non-nociceptors.
It is possible that the lidocaine patch interrupts this cycle [22—24]. In comparison with other drugs currently being prescribed to treat LBP, the lidocaine patch has several important clinical advantages in the management of pain syndromes.
Thus, there are no significant pharmacokinetic or pharmacologic interactions with other drugs [25]. Although three of the patients had the lidocaine patch added as part of a multimodal intervention, patient 2 had the patch added as the sole intervention.
The use of a combination of interventions is reflective of general clinical practice and, therefore, we recognize that the successful pain relief observed in patients 1, 3, and 4 cannot be solely attributed to the lidocaine patch.
Further controlled trials are needed to fully examine the effect of the lidocaine patch in LBP. One such trial, in which the authors are participating investigators, is ongoing [26]. Prospective, controlled trials should be conducted to further evaluate the utility of the lidocaine patch for the treatment of this condition.
We would also like to express thanks to Adelphi Inc. The labor productivity effects of chronic backache in the United States. Med Care ; 36 : — Google Scholar. Low back pain: risk factors for chronicity. Rev Rheum Engl Ed ; 64 : — Efficacy of transverse tripolar stimulation for relief of chronic low back pain: Results of a single center. Stereotact Funct Neurosurg ; 73 : — Using gabapentin to treat failed back surgery syndrome caused by epidural fibrosis: A report of 2 cases.
Arch Phys Med Rehabil ; 82 : — 3. Deyo RA. Drug therapy for back pain. Which drugs help which patients? Spine ; 21 : — Borenstein DG. Epidemiology, etiology, diagnostic evaluation, and treatment of low back pain. Curr Opin Rheumatol ; 11 : — 7. Spinal drug delivery.
Curr Pain Headache Rep ; 5 : — 6. Gill K Blumenthal SL. Functional results after anterior lumbar fusion at L5—S1 in patients with normal and abnormal MRI scans. Spine ; 17 : — 2. Pongratz D Spath M. Guideline for symptomatic therapy.
Argoff CE. New analgesics for neuropathic pain: The lidocaine patch. Clin J Pain ; 16 : S62 — 6. Lidocaine patch: Double-blind controlled study of a new treatment method for post-herpetic neuralgia. Pain ; 65 : 39 — Topical lidocaine patch relieves postherpetic neuralgia more effectively than a vehicle topical patch: Results of an enriched enrollment study.
Pain ; 80 : — 8. Initial efficacy trial of topical lidocaine patches in the management of chronic myofascial pain. Can a pharmacological pain analysis in patients with chronic low back pain predict the outcome of lumbar fusion? Instead, the best way to dispose of your medication is through a medicine take-back program.
If you wear too many lidocaine transdermal patches or topical systems or wear them for too long, too much lidocaine may be absorbed into your blood. In that case, you may experience symptoms of an overdose. In case of overdose, call the poison control helpline at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at Do not let anyone else use your medication.
Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital.
It is also important information to carry with you in case of emergencies. Lidocaine Transdermal Patch pronounced as lye' doe kane. Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow? What special dietary instructions should I follow? What should I do if I forget a dose? What side effects can this medication cause? What should I know about storage and disposal of this medication?
Brand names. Wash your hands after handling lidocaine patches or topical system. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. Other uses for this medicine. What special precautions should I follow? Before using lidocaine transdermal, tell your doctor and pharmacist if you are allergic to lidocaine; other medications such as benzocaine.
Ask your pharmacist for a list of the ingredients. Be sure to mention any of the following: acetaminophen Tylenol , chloroquine, dapsone Aczone , disopyramide Norpace , flecainide Tambocor , medications applied to the skin or mouth to treat pain, metoclopramide Reglan , mexiletine Mexitil , moricizine Ethmozine , nitrofurantoin Furadantin , nitroglycerin Nitro-Dur , nitroprusside Nitropress , phenobarbital, phenytoin Dilantin , primaquine, procainamide Procanabid, Pronestyl , propafenone Rhythmol , quinidine Quinidex , quinine Qualaquin , sulfasalazine Azulfidine , and tocainide Tonocard.
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