Get Your Lower Back Pain under Control—and Get on with Life by Anthony H. Guarino

Author:Anthony H. Guarino
Language: eng
Format: epub
Publisher: Johns Hopkins University Press

Topicals | Pain medication applied to the skin

The main pain reliever in the class of topical medications is a Lidocaine patch 5 percent, or Lidoderm. This 10 × 14 cm patch releases a local anesthetic continuously. The patient applies it in the morning and removes it in the evening. Its only FDA indication is for postherpetic neuralgia (herpes-related nerve pain). In practice, people try this medication for many different pains. It is very well tolerated and its most common side effect is local skin irritation. An early study showed some promise for its use in patients with low back pain. If a back pain area can be covered with your two hands, then this may be an agent to try.

Flector Patch, available only by prescription, releases a nonsteroidal anti-inflammatory medication through the skin. The patch may be used to treat acute and local inflammatory conditions such as minor sprains, strains, and bruises, but it is not indicated for treatment of chronic low back pain.

There are many formulations of topical compounds that can be produced, such as: clonidine, capsaicin, ketamine, amitriptyline, gabapentin, and nonsteroidals. However, these medications have not been studied or examined in enough patients to be widely accepted as topicals and used in the pain management arena.

Patches are prescribed by a doctor. Creams are available over the counter in pharmacies or in compounding pharmacies (whose pharmacists will compound custom medications for the needs of the specific patient).

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