One of the most common reasons for patients to consult health professionals is pain. Evaluation Evaluation of newer pain remedies and pain medications has ha been stressed by health authorities like NHS to lower the risk of opioid addictions. (1) Taking oral medication on in the long term has also been associated with increased risk for side effects like gastrointestinal disturbances and renal and hepatic events. (2) This is why greater attention is not being diverted toward alternate forms of painkillers, which include Pain Relief Patches. These FDA FDA-approved patches have gained popularity over recent years due to their effectiveness in treating both chronic and acute forms of pain.
What are Pain Relief Patches?
Pain relief patches, which are also referred to as analgesic patches, are medicated adhesive patches that are required to be applied to the skin surface. These may either be prescription-based or may be purchased over the counter. The active ingredients commonly included in these patches include anti-inflammatory drugs like NSAIDSNSAIDs, opioids, Capsaicin, Lidocaine, and numerous others. These may treat pain with an intensity varying between mild, moderate, and severe. These may either be used on their own for pain relief or provide local analgesia before administration of injection or minor surgical procedures. On their own, the pain patches may be used for mild strains, sprains, contusions, and even pain disorders like postherpetic neuralgia. Severe pain may often require the prescription of opioid analgesics. (3)
When recommending a patch system to an individual for analgesic purposes, health professionals evaluate the active ingredients, the type of pain, the cause of pain, and the pain receptors that are to be targeted. This helps them determine the type of analgesics which will be best suited for the individual.
How To Use a Pain Relief Patch?
Pain Relief patches are now found to be effective for pains of various types, including muscle and backache. However, in order to achieve good analgesics, the individual must be aware of how to use the pain relief patch correctly. The individual should start by washing their hands properly to prevent the contamination of the product. Next, the patch’s sticky side should be placed firmly against the skin’s surface. The individual may administer these patches themselves or take the help of a healthcare provider, especially if it is their first time using a patch. The patch should only be placed on the affected area and is not recommended to be applied to other parts of the body. The patches should only be applied to areas of the skin that are not broken, cut, or injured. The used patch should then be carefully disposed of in a bin to keep it out of reach of children and pets.
What are the Types of Pain Relief Patches?
Over the recent years, many new technologies and active ingredients have been introduced to provide the individual with maximum pain relief. The two most common pain-relief patches are topical pain-relief patches and transdermal pain-relief patches.
Topical Patch System
The type of analgesics that are delivered through the topics analgesic patch system includes Capsaicin. Diclofenac and Lidocaine. Due to their topical nature, they are designed to administer the drug to only the affected area, which reduces its access to the systemic circulation. A popular example of this includes the Salonpas Pain Relieving Patch, which is found to be particularly effective for back pain, neck pain, knee pain, and muscle sores.
- Topical Lidocaine Patches
The topical lidocaine patches work by blocking the sodium-gated channels in the body, which prevent the progression of the action potential. These patches commonly targeted pain fibers include the A Delta and C Fibers mostly found just under the skin. (4) These patches are commonly prescribed to an individual diagnosed with Post Herpetic Neuralgia to provide pain relief due to their effectiveness proven in many studies. (5)
- Topical Capsaicin Patches
Topical Capsaicin Patches, which are often referred to as heat patches, are another popular form of analgesic patch system. The active ingredient Capsaicin found in these patches is derived from hot chili peppers, which mainly work by affecting the Calcium channels. These pain patches are often recommended to individuals with minor aches and pain disorders, as seen in osteoarthritis, backache, and sprain. (6)
- Topical Diclofenac Patches
Topical Diclofenac patches contain the active ingredient Diclofenac, which is an effective NSAID. Even though it was previously more commonly used as an oral drug, the popularity of diclofenac patches has increased rapidly over the past few years. The majority of these patches contain 180 mg of Diclofenac, which is recommended for acute pain from muscle sprains, strains, and contusions.
Transdermal Patch System
Unlike the Topical patch system, the transdermal pain relief patches work by delivering the drug to the systemic circulation. These analgesic patches may contain active ingredients like Opioids like Buprenorphine and Fentanyl.
- Fentanyl Transdermal Patch
Fentanyl is an opioid that works as an effective pain-relieving agent. Its lipophilic nature and low molecular weight make it a very efficient pain killer as it can reach systemic circulation much faster.
- Buprenorphine Transdermal Patch
Buprenorphine is a long-acting partial mu-opioid agonist. It is one of the most studied opioids for pain relief and has several advantages over the conventional Mu opioid systems. Similar to Fentanyl, its lipophilic nature and low molecular weight allows it to travel to systemic circulation in a much shorter time, making it highly efficient.
The Effectiveness of Pain Relief Patches
Numerous studies have shown pain relief patches to be effective for muscle pain, neck pain, and even joint pain relief. However, the pain-relieving potential of the skin patches depends on their active ingredient and their dosage.
For mild injuries, including strains and muscle sprains, the healthcare professional may recommend a diclofenac patch. This is an NSAIDs similar to Ibuprofen and Aspirin. An example of a brand name containing these patches includes Flector; however, it must only be applied to unbroken skin. This was also investigated in a study conducted in 2010, where individuals who received the diclofenac pain patches had improvement in the pain and discomfort associated with their soft tissue injuries. These injuries include sprains, bruises, and strains. (7)
It is also found to be highly effective for back pain. This was further proven in a non-randomized study conducted over six weeks. The study includes patients with moderate to severe lower back pain who were given patches of 5% Lidocaine. They were asked to apply four patches once every day to the area with the highest lower back pain levels. The study results showed that individuals who consistently used these were found to be very satisfied with this treatment form. The majority also tolerated the lidocaine patches, with only a few reporting rashes and dizziness. (8)
A patient affected with postherpetic neuralgia may also be prescribed Lidoderm pain relief patches with brand names like Lidoderm. Other forms of chronic pain, which are more severe, may require a more potent active ingredient. Individuals may be recommended Fentanyl patches, which are available under the brand name Duragesic. These are only recommended to individuals with severe pain after a doctor’s assessment, which determines if they will be able to tolerate the opioids. Studies have also found these patches to be more effective than conventional oral morphine pain relief pills, as they are fewer side effects like Vomiting and Nausea. (9)
What Are the Precautions for Taking a Pain Relief Patch?
While Pain Relief Patches are generally considered safe, there are several precautions that one should take while starting a new patch. This is particularly important for females who are expecting or breastfeeding. It should also be kept out of reach of children. The way to ensure greater safety while using the pain relief patch may start by:
- Consult your healthcare professionals and get pretested for any allergies you might have to the contents of the patch. You should also inform the doctor about any other medicine or supplements you may be taking that can interact with the pain patch. It is always advisable to check the product’s expiry before putting it on.
- Inform the healthcare professional about the contents of the patch, and allow them to evaluate if it may be the best option for you based on your unique health status. For example, certain medical conditions might not allow you to use certain active ingredients as they may have an increased risk of side effects. For example, Fentanyl is a strong opioid and may not be ideal for every individual. It also has a strong addictive potential, so individuals who have a previous history of addiction should never be recommended to use Fentanyl patches. Moreover, it may also not be recommended for individuals with Asthma or other breathing disorders as it may worsen the symptoms.
Common Side Effects of Pain Relief Patches
Pain Relief patches may sometime present with side effects, which may vary according to their type and the active ingredient found in them. Therefore, it is recommended to consult a healthcare provider about the type of pain patches that may be safe for you and present with the minimum side effects. In the majority of the cases, the side effects associated with pain relief patches are mild, and they may include skin irritation, redness, a feeling of burning, and blisters. However, these are temporary and go away in a few hours. The more serious side effects of pain relief patches may be classified on the basis of the active ingredient found in them.
Patches contain NSAIDs
The serious side effects associated with NSAIDs patches may include bleeding, stroke, and heart attack. The signs like shortness of breath, nausea, slurring of speech, indigestion, vomiting, and swelling in the body after administration of NSAIDs patches are classified as a state of emergency. Patients with these signs should be immediately taken to a healthcare setup and given medical intervention.
Patches Containing Lidocaine
The serious side effects associated with Lidocaine patches include allergic reactions. This may present itself in the form of rashes, hives, swallowing difficulty, swelling in the body, breathing difficulty, confusion, dizziness, and even fainting. These side effects are not common and, if encountered, require immediate medical intervention.
Patches Containing Fentanyl
While starting Fentanyl patches, most individuals are educated about a rescue medication known as Naloxone, which may be taken in case of a Fentanyl overdose. The symptoms of this overdose may present in the form of sweating, confusion, nervousness, increased heart rate, hoarseness of voice, and difficulty in breathing. Severe side effects may also lead to seizures and coma.
Other treatment options
Prolotherapy:
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to relieve pain.
Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to repair the damage and help with pain.
As prolotherapy is helping to treat the root cause of pain, it is deemed to be a permanent fix, preventing the symptoms from returning.
Frequently Asked Questions
What Patch is Good for Pain?
The two types of patches known as topical and transdermal are both effective at pain relieving. While the topical patches have a more localized more of action, the transdermal patches help deliver the drug to the bloodstream- exhibiting a more systemic effect. In order to find out the type of patch that may be more effective for you according to your unique health condition, a consultation with a health expert is highly recommended. (10)
Which Pain Patch is the Strongest?
Opioid patches are considered the stronger form of pain relief patches. Amongst the opioid patches, the active ingredient which is found to be the most effective at pain relief and improving individual quality of life is Fentanyl Patches. They are also associated with a lower risk for constipation, which is amongst the most common side effects experienced by opioid users.
Do Patches Work for Pain?
Patches are effective for relieving pain either on their own or before the administration of injection and minor surgical procedures. In addition, they may be used for pain associated with muscle sprains, strains, osteoarthritis, and other pain disorders like postherpetic neuralgia and postherpetic neuralgia.
What Patch is Good for Nerve Pain?
Lidocaine patches with 5% lidocaine are found to be particularly effective for nerve pains. This is why it is currently recommended to treat postherpetic neuralgia. (11)
Who Should Not Use Lidocaine Patches?
Lidocaine patches are often not recommended for individuals with a lung infection, ongoing seizures, large open wounds, liver diseases, blood disorders, anemia, heart blocks, and sepsis.
Is There an Anti-Inflammatory Patch?
There are numerous anti-inflammatory patches available on the market that contain NSAIDs in varying concentrations. An example of this is the Flector patch, which is a topical patch containing diclofenac epolamine. It may be effective as a pain medication along with its anti-inflammatory effects on the body.
References
Goldberg, D. S., & McGee, S. J. (2011). Pain as a global public health priority. BMC public health, 11, 770. https://doi.org/10.1186/1471-2458-11-770
Argoff, C. E., Albrecht, P., Irving, G., & Rice, F. (2009). Multimodal analgesia for chronic pain: rationale and future directions. Pain medicine (Malden, Mass.), 10 Suppl 2, S53–S66. https://doi.org/10.1111/j.1526-4637.2009.00669.x
Nalamachu S, Gudin J. Characteristics of Analgesic Patch Formulations. J Pain Res. 2020;13:2343-2354. Published 2020 Sep 22. doi:10.2147/JPR.S270169
Sheets, M. F., & Hanck, D. A. (2007). Outward stabilization of the S4 segments in domains III and IV enhances lidocaine block of sodium channels. The Journal of physiology, 582(Pt 1), 317–334. https://doi.org/10.1113/jphysiol.2007.134262
Galer, B. S., Rowbotham, M. C., Perander, J., & Friedman, E. (1999). Topical lidocaine patch relieves postherpetic neuralgia more effectively than a vehicle topical patch: results of an enriched enrollment study. Pain, 80(3), 533–538. https://doi.org/10.1016/S0304-3959(98)00244-9
Baranidharan, G., Das, S., & Bhaskar, A. (2013). A review of the high-concentration capsaicin patch and experience in its use in the management of neuropathic pain. Therapeutic advances in neurological disorders, 6(5), 287–297. https://doi.org/10.1177/1756285613496862
Kuehl K. S. (2010). Review of the efficacy and tolerability of the Diclofenac epolamine topical patch 1.3% in patients with acute pain due to soft tissue injuries. Clinical therapeutics, 32(6), 1001–1014. https://doi.org/10.1016/j.clinthera.2010.06.001
Gimbel, J., Linn, R., Hale, M., & Nicholson, B. (2005). Lidocaine patch treatment in patients with low back pain: results of an open-label, non-randomized pilot study. American journal of Therapeutics, 12(4), 311–319. https://doi.org/10.1097/01.mjt.0000164828.57392.ba
Wang, D. D., Ma, T. T., Zhu, H. D., & Peng, C. B. (2018). Transdermal Fentanyl for cancer pain: A trial sequential analysis of 3406 patients from 35 randomized controlled trials. Journal of cancer research and Therapeutics, 14(Supplement), S14–S21. https://doi.org/10.4103/0973-1482.171368
Tanner, T., & Marks, R. (2008). Delivering drugs by the transdermal route: review and comment. Skin research and technology: official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI), 14(3), 249–260. https://doi.org/10.1111/j.1600-0846.2008.00316.x
Hans G, Robert D, Verhulst J, Vercauteren M. Lidocaine 5% patch for localized neuropathic pain: progress for the patient, a new approach for the physician. Clin Pharmacol. 2010;2:65-70. doi:10.2147/CPAA.S9795