From the Guidelines
Efficacy of Lidocaine Patches for Lower Back Pain
Lidocaine patches are not effective for widespread lower back pain, but may be useful for localized pain.
- The patches can be used for up to 12 hours in a 24-hour period 1, 2.
- Studies have shown limited data supporting the use of lidocaine patches for lower back pain, and they are not recommended for more widespread distribution of pain 1, 2.
- However, lidocaine patches may be of use in individuals with nocturnal neuropathic foot pain or localized pain 1, 2.
- A study comparing lidocaine patch to pregabalin showed that lidocaine was as effective as pregabalin in reducing pain and was free of side effects 3.
- The recommended dose is one to three patches applied to the affected area for 12 hours, followed by a 12-hour patch-free period, for a duration of up to 4 weeks.
- Each patch contains 700mg of lidocaine, which is released over a 12-hour period, providing localized pain relief without significant systemic absorption.
- It is essential to note that lidocaine patches are not a first-line treatment for lower back pain, and other treatments such as exercise, NSAIDs, and duloxetine may be more effective 4.
From the Research
Efficacy of Lidocaine Patches for Lower Back Pain
- The lidocaine patch 5% has been found to be effective in relieving lower back pain in several studies 5, 6, 7.
- A retrospective case series found that the addition of the lidocaine patch 5% to the analgesic regimen helped relieve varying characteristics of pain, including general pain, shooting pain, burning pain, and allodynia, and had a significant impact on the quality of life of all patients 5.
- A multicenter pilot trial found that the lidocaine patch 5% significantly improved pain intensity and pain relief in patients with low back pain, as well as pain interference with general activity, mood, walking ability, normal work, relationships with others, sleep, and enjoyment of life 6.
- Another study found that the lidocaine patch 5% effectively reduced the intensity of all common pain qualities in patients with moderate-to-severe chronic pain resulting from low back pain, and was well tolerated in combination with other analgesic regimens 7.
Safety and Tolerability
- The lidocaine patch 5% has been found to be safe and well tolerated in several studies, with minimal risk of systemic adverse effects or drug-drug interactions 5, 6, 8, 7.
- Most adverse events reported were at patch application sites, and no clinically significant systemic adverse effects were noted, including when used long term or in an elderly population 8.
- The lidocaine patch 5% has been recommended as a first-line therapy for the treatment of neuropathic pain, including lower back pain, due to its proven efficacy and safety profile 8.
Comparison with Other Treatments
- The lidocaine patch 5% has been compared to other treatments, including gabapentin, and has been found to be effective in combination with these treatments 6, 7.
- The use of topical lidocaine formulations, including the lidocaine patch 5%, has been supported by clinical practice guidelines, including first-line treatment by the American Academy of Neurology and the European Federation of Neurological Societies 9.