Lidocaine Patches for Knee Pain
Yes, lidocaine patches can be safely and effectively applied to the knees for pain relief, particularly for localized knee pain in elderly patients. 1
Application Guidelines
- Apply lidocaine patches directly to the most painful area of the knee
- Use up to 3 patches simultaneously (do not exceed this number)
- Apply for 12 hours, then remove for 12 hours (follow this on/off cycle)
- Continue for at least 4 weeks to properly assess efficacy 1
- For adults and children 2 years and older, patches can be applied externally to the affected area up to 3-4 times daily 2
Evidence Supporting Use
Lidocaine patches work by blocking sodium ion channels required for the initiation and conduction of neuronal impulses, resulting in local anesthesia after topical application 1. They are particularly beneficial for:
- Localized knee pain, especially with neuropathic components
- Elderly patients who may not tolerate systemic medications well
- Patients with contraindications to oral medications
- Those with nocturnal knee pain 1
Research has demonstrated that lidocaine patches can effectively reduce pain in osteoarthritis of the knee. A 2-week study showed significant improvements in pain qualities as measured by the Neuropathic Pain Scale in patients with moderate-to-severe OA of the knee 3. Another study specifically examining post-knee surgery neuropathic pain found that lidocaine patches reduced dynamic mechanical allodynia by ≥30% over 3 months in 96% of patients 4.
Advantages Over Other Treatments
Lidocaine patches offer several advantages:
- Minimal systemic absorption with few drug interactions
- Excellent tolerability with primarily mild local reactions
- Avoidance of risks associated with NSAIDs and opioids 1
The Centers for Disease Control and Prevention and the American Academy of Orthopaedic Surgeons recommend topical treatments like lidocaine patches over oral NSAIDs in older adults (≥75 years) to minimize systemic effects 1.
Precautions and Contraindications
- Do not use on broken or irritated skin
- Remove old patches before applying new ones
- Wash hands after handling patches
- Do not use lidocaine patches within 4 hours of receiving nerve blocks or other local anesthetic interventions 1
- For children under 2 years of age, consult a physician before use 2
Integration with Other Therapies
Lidocaine patches can be effectively used as part of a multimodal pain management approach. They can be combined with:
- Physical therapy and exercise programs, which have been shown to reduce pain in various conditions 5
- Other non-opioid analgesics when needed
- Behavioral therapies and psychosocial interventions 5
Safety Profile
A 2024 systematic review and meta-analysis found that the risk of adverse events with lidocaine patches was similar to placebo (risk ratio: 0.90; 95% CI: 0.48-1.67) 6, confirming their excellent safety profile.
For optimal results, cut patches to fit the painful area if needed, and ensure proper adherence to the recommended application schedule 1.