The patch for back pain is a transdermal agent used in the treatment of dorsalgia of various etiologies and genesis. The dosage form is characterized by a gradual release of active ingredients, which provides a long-lasting therapeutic effect. The active ingredients of all patches with analgesic properties penetrate the systemic bloodstream in low concentrations, so the list of contraindications for the transdermal drug is significantly shorter than for drugs for oral administration and parenteral administration. The causes of back pain are often pathologies of the gastrointestinal tract and genitourinary system, so medical consultation and examination are necessary.
Classification of transdermal products
Dorsalgia (back pain) develops as a result of functionally reversible blocking of intervertebral joints. Pathological conditions often precede spondyloarthrosis or osteochondrosis of the lumbar region. Blocking often occurs as a result of increased static or dynamic loads, antiphysiological postures and microtraumas. Neuropathologists and rheumatologists warn about the need for full treatment of dorsalgia, since tissue damage in one area of the spinal column will lead to functional changes in adjacent areas. Gradually, compensatory hypermobility will form, reducing a person’s quality of life.
Lower back pain occurs in 76% of the population. Intense discomfort is diagnosed in 7% of cases. In more than 9% of people, dorsalgia caused disability.
In the treatment of pathologies of the musculoskeletal systempatches are used to minimize pain, relieve inflammation and swelling. Clinical studies have proven the high effectiveness of transdermal agents for local use, which have an analgesic effect. Therapeutic patches for back pain are classified as follows:
| Group of patches | Characteristics |
|---|---|
| Warming up | The active ingredients of external preparations are extracts of hot pepper or mustard seeds. The mechanism of action of the patches is to improve blood circulation in damaged tissues and accelerate their regeneration |
| Heat reflective | The patch contains nanoparticles of rare earth metals, which have the ability to increase body temperature in areas of inflammation using the body’s own resources |
| Anti-inflammatory | The active ingredients of transdermal drugs are non-steroidal anti-inflammatory drugs. This group of patches is effective in the treatment of dorsalgia of any localization |
| Phytoplasties | Chinese manufacturers supply products for local application containing extracts of medicinal plants, essential oils and other natural ingredients. Plasters are used not only for therapy, but also for the prevention of pathologies of the lumbar spine |
In medical practice, pain that lasts 1-1. 5 months is considered acute, and pain that lasts for 12 weeks is considered chronic. The prescription of patches with an analgesic effect is practiced to eliminate discomfort at any stage of the pathology.
Relatively recently, transdermal products with chondroprotectors appeared on pharmacy shelves. They contain chondroitin, glucosamine, and sometimes hyaluronic acid with B vitamins that can improve innervation. These biologically active substances are structural units of cartilage, bone, and joint tissues of the musculoskeletal system.Such patches are rarely included in the therapeutic regimens of patients with lumbosacral osteochondrosis or radiculitisdue to the low effectiveness of quickly eliminating pain of any intensity. The main task of chondroprotective patches is to restore tissues affected by inflammation, which can take several months and sometimes years. Many traumatologists and neurologists are skeptical about this type of drugs for local use due to the lack of evidence base for their therapeutic effectiveness.
Dorsalgia occupies one of the first places in the structure of people seeking medical help. According to the results of epidemiological studies conducted in leading clinics of the countries, out of 1300 patients, in 24. 9% the main cause of complaints was pain in the lumbosacral region.
Warming patches with red pepper extract
Pepper patch for back pain is the most popular transdermal remedy for the treatment of dorsalgia of any severity. The active ingredients are extracts of red hot pepper and belladonna, dimethyl sulfoxide, eucalyptus essential oil. Thanks to lanolin (animal wax obtained by boiling sheep wool) and pine rosin, the active ingredients are easily absorbed by the skin and penetrate into inflammatory areas. The following therapeutic actions are characteristic of the pepper patch:
- pain reliever;
- distracting;
- locally irritating.
Capsicum extract has the ability to dilate blood vessels localized in the area of pain. The analgesic effect also manifests itself in a decrease in muscle tone and improvement in tissue trophism. Belladonna (belladonna) extract is characterized by a pronounced antispasmodic effect, which is provided by the alkaloid atropine, which is part of the plant. Manufacturers have added dimethyl sulfoxide to the patch to relieve inflammatory processes, a frequent accompaniment of dorsalgia. The organic compound inactivates hydroxyl radicals and accelerates metabolic processes in areas of pathology.
For people with sensitive skin, the use of a transdermal product will cause severe burning, itching, and congestion of blood vessels located at the site of application. If any of the listed side effects occur, wipe the affected area of the body with a cotton pad soaked in sunflower oil.
Pepper patch is not used in the treatment of patients under 14 years of age, pregnant or breastfeeding women. Absolute contraindications are varicose veins and impaired integrity of the skin.
To eliminate peripheral neuropathic pain that occurs when the peripheral nervous system is damaged (from the roots to the nerve endings), a warming patch with a high content of capsaicin is used. This transdermal product is not intended for use at home, as certain conditions must be met when applying it.
Capsaicin is a highly selective agonist of vanilloid receptors, the transient receptor potential of which belongs to type 1. Immediately after local application of the patch, cutaneous pain receptors expressing TRPV1 are activated. The patient feels a burning sensation and redness occurs in the area of the adhesive caused by the release of vasoactive neuropeptides. The external drug is characterized by the following pharmacodynamic effects:
- Capsaicin significantly reduces the sensitivity of skin pain receptors to mediators. But when exposed to mechanical and vibrational stimuli, a person's ability to experience pain remains unchanged;
- changes in skin pain receptors under the active influence of capsaicin are reversible, which occurs after some time. The response to painful stimuli is restored after 2-4 weeks.
The patch is characterized by slow transepidermal and transdermal absorption. An hour after gluing the patch, only 1% of the active ingredient penetrates into the damaged tissue.
The area of application of the external drug is determined by the attending physician, and the procedure is carried out by medical personnel. The patient's skin is first treated with a product with pronounced anesthetic activity to reduce the intensity of discomfort. The patch is applied using gloves and safety glasses. Such precautions are necessary to prevent redness of the epidermis and irritation of the mucous membranes.
Heat reflective patches
In the treatment of lumbar osteochondrosis, intervertebral hernia, radiculitis, a patch with nanopowder for back and lower back pain has proven itself well. The composition of the transdermal product is represented by a fine mixture obtained by processing rare earth materials. A nanopowder with the ability to produce infrared radiation is applied to a hypoallergenic polymer base.
The duration of exposure to the patch is 12 hours. The following topical application can only be used after 6 hours.
The mechanism of pharmacological action of the drug lies in the combined influence of infrared radiation and the magnetic field formed by rare earth materials. The temperature in the inflammatory focus rises, which leads to improved microcirculation. Biologically active and nutrients begin to flow to damaged tissues, triggering regenerative processes. This leads to multifaceted therapeutic effects, among which the following predominate:
- improvement of local lymph and blood circulation;
- prevention of stagnation;
- normalization of venous outflow;
- relief of the inflammatory process;
- reducing the severity of pain;
- acceleration of metabolic processes;
- relaxation of spasmodic muscles.
The patch exhibits analgesic, anti-inflammatory and anti-edematous activity. Under the influence of infrared rays, striated skeletal muscles relax, and the optimal transmission of nerve impulses to the central nervous system is restored. The use of a transdermal drug for 5-7 weeks helps to increase the functional activity of the musculoskeletal system and normalize range of motion. If the cause of dorsalgia is a fall or a severe bruise, then the use of the patch will relieve not only pain, but also extensive hematomas by improving microcirculation in damaged tissues.
A Polish manufacturer produces a warming and pain-relieving patch. The drug does not contain non-steroidal anti-inflammatory drugs.The active ingredient in the patch is iron powder.Activated carbon acts as a catalyst for biochemical reactions.
The interaction of enterosorbent and iron powder leads to a rise in temperature in the inflammatory focus to 45-50 °C. Heat production by the body occurs through the oxidation of alkaline earth metals, the basis of iron powder.
Deep heating of spasmed muscles helps to increase blood supply to damaged tissues and reduce the tone of skeletal muscles. The warming effect lasts for 12 hours, then the patch should be peeled off and any moisturizer should be rubbed into the area of application. In order to prevent skin burns, the treatment procedure can be carried out no more than 3 times every 7 days.. The absence of ingredients in the patch that are absorbed into the systemic circulation ensures a small number of side effects. The transdermal agent is not prescribed to patients during pregnancy, lactation and menstruation. An absolute contraindication is also the presence of cracks, wounds, or scratches on the skin. When the patch is applied to areas of the body with blood vessels located close to the surface of the skin (for example, the groin area), the likelihood of burns and irritation increases significantly.
Non-steroidal anti-inflammatory drug patches
When asked by patients which patch for back pain is better, neurologists and rheumatologists give a clear answer - a transdermal agent with non-steroidal anti-inflammatory drugs. NSAIDs reduce the severity of clinical manifestations and eliminate the pathology that provoked them by blocking the enzyme cyclooxygenase. This leads to a decrease in the production of the main mediators of pain and inflammation, prostaglandins. Most often, in the treatment of radiculitis and lumbar osteochondrosis, a patch with an active ingredient from the group of phenylacetic acid derivatives is used. The external agent also includes levomenthol, which has the following effects:
- local irritant;
- pain reliever;
- weak antiseptic.
The amount of phenylacetic acid derivative released from the patch during the day corresponds to the volume that was adsorbed from a similar dose of 1% gel. The transdermal product has many advantages: convenience and low frequency of use, no greasy marks on clothes and bedding after use.
About 5-6% of the phenylacetic acid derivative is able to penetrate into the bloodstream, but this amount is not enough to develop significant systemic side effects. T1/2 of inactive metabolites of non-steroidal anti-inflammatory drugs - within 1-3 hours. After glucuronidation in hepatocytes, the phenylacetic acid derivative is evacuated primarily by the urinary system (65-70%), and the rest is excreted in the feces. 1% of the active ingredient leaves the body unmetabolized.
Relatively recently, a patch from a Korean manufacturer appeared on pharmacy shelves, the active ingredient of which is a non-steroidal anti-inflammatory drug from the group of propionic acid derivatives. Its analgesic activity is also based on blocking the synthesis of prostaglandins by inhibiting cyclooxygenase.
The undoubted advantage of the propionic acid derivative is the possibility of use in the treatment of patients with a history of chronic renal and liver failure. Regardless of the stage of pathology, the metabolism of NSAIDs in liver cells does not change, which explains the lack of its accumulation.
5-8 hours after gluing the patch, its biological concentration in the blood serum reaches 0. 08–0. 15 μg/ml. The propionic acid derivative is metabolized by hepatocytes during the glucuronidation reaction, and the conjugates are excreted from the human body mainly in the urine.
The transdermal drug is used as a symptomatic agent in the treatment of neuralgia, lumbago, osteochondrosis, and radiculitis in patients over 15 years of age. The external agent has analgesic and anti-inflammatory activity and effectively relieves swelling. To increase effectiveness, the annotation recommends sticking the patch 2 times a day on painful areas of the body. The duration of the therapeutic course depends on the severity of the diagnosed disease, but it should not exceed 6 days.
Chinese pain relief patches
The Chinese patch for osteochondrosis is a transdermal product that contains extracts of medicinal plants and biologically active substances that have chondroprotective properties. After gluing the transdermal drug to the area of pain and inflammation, acupuncture points located in the spinal column are activated. The result of this effect is improved blood circulation, delivery of nutrients and biologically active substances to damaged tissues, and acceleration of metabolic processes.
There is no wide range of Chinese plasters for joints and spine on pharmacy shelves, and doctors rarely include them in patients’ therapeutic regimens. Manufacturers do not conduct clinical trials, the results of which would create an evidence base for the therapeutic effectiveness of transdermal drugs.
To reduce the severity of pain, relieve inflammation and swelling, the following Chinese patches are used:
- An external remedy that contains scorpion powder, bee venom, myrrh, cinnamon, angelica, borneol and about 30 other components;
- A patch containing 88 biologically active substances, including herbal origin: angelica, comfrey and licorice root, extract of Sichuan multifloral pepper and buffalo horn, myrrh, turmeric, orange peel, powder producing infrared radiation, and others;
- Transdermal agent, which includes saffron, musk, ginger, menthol, myrrh, peach and angelica root extracts, salicylic acid methyl ester, which is part of the group of non-steroidal anti-inflammatory drugs;
- A preparation that contains extracts of aconite, belladonna, cinnamon, parsnip, ginger, chilibuha seeds, myrrh and pine resins, clove bark extract and galangal root.
All herbal components of Chinese patches have a cumulative effect, so the analgesic effect occurs after several hours and sometimes days. Before using them, it should be taken into account that the composition contains many biologically active substances that can provoke a severe allergic reaction. Chinese patches are not intended for the treatment of children, pregnant or breastfeeding women.