The patch for back pain is a transdermal agent used in the treatment of dorsalgia of various etiology and genesis. The dosage form is characterized by the gradual release of active ingredients, which ensures a long-lasting therapeutic effect. The active ingredients of all plasters with analgesic properties penetrate into the systemic bloodstream in low concentrations, so the list of contraindications for the transdermal drug is much shorter than for drugs for oral and parenteral administration. The causes of back pain are often pathologies of the gastrointestinal tract and genitourinary system, so a medical consultation and examination is necessary.
Classification of transdermal products
Dorsalgia (back pain) occurs as a result of functionally reversible blocking of the intervertebral joints. Pathological conditions are often preceded by spondyloarthrosis or osteochondrosis of the lumbar region. Blocking often occurs as a result of increased static or dynamic loads, anti-physiological positions and microtrauma. Neuropathologists and rheumatologists warn of the need for complete treatment of dorsalgia, because tissue damage in one part of the spinal column will lead to functional changes in neighboring areas. Compensatory hypermobility will gradually form, reducing the person's quality of life.
Pain in the lower back 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 reduce pain, relieve inflammation and swelling. Clinical studies have proven the high efficiency of transdermal means for local use, which have an analgesic effect. Therapeutic back pain patches are classified as follows:
| Patch group | Characteristics |
|---|---|
| Warming up | Active ingredients of external preparations are extracts of hot pepper or mustard seeds. The mechanism of action of the patch is to improve blood circulation in damaged tissues and accelerate their regeneration |
| Reflective heat | The patch contains nanoparticles of rare earth metals, which have the ability to increase body temperature in areas of inflammation using their own resources |
| Anti-inflammatory | The active ingredients of transdermal drugs are nonsteroidal anti-inflammatory drugs. This group of patches is effective in the treatment of dorsalgia of any localization |
| Phytoplastics | Chinese manufacturers supply topical products containing herbal extracts, essential oils and other natural ingredients. Patches 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 12 weeks is considered chronic. Prescribing plasters with an analgesic effect is practiced in order 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 tissue, bones and joints of the musculoskeletal system.Such patches are rarely included in the therapeutic regimens of patients with lumbosacral osteochondrosis or radiculitisdue to low efficiency of quick removal of 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 of this type of drugs for local use due to the lack of evidence base on 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 the 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 drug for the treatment of dorsalgia of any severity. Active ingredients are red hot pepper and belladonna extracts, dimethyl sulfoxide, eucalyptus essential oil. Thanks to lanolin (animal wax obtained by cooking sheep's wool) and pine rosin, the active ingredients are easily absorbed into the skin and penetrate into inflamed areas. The pepper patch is characterized by the following therapeutic effects:
- pain reliever;
- interference;
- locally irritating.
Pepper extract has the ability to expand blood vessels localized in the area of pain. The analgesic effect is also manifested in the reduction of muscle tone and improvement of tissue trophism. Belladonna extract is characterized by a pronounced antispasmodic effect provided by the alkaloid atropine, which is part of the plant. The manufacturers added dimethyl sulfoxide to the patch to alleviate inflammatory processes, which is a frequent accompaniment of dorsalgia. The organic compound inactivates hydroxyl radicals and accelerates metabolic processes in areas of pathology.
In people with sensitive skin, the use of the transdermal product will cause severe burning, itching and blockage of blood vessels at the application site. If any of the listed side effects occur, wipe the affected area of the body with a cotton ball soaked in sunflower oil.
Pepper patch is not used in the treatment of patients under the age of 14, pregnant or lactating women. Absolute contraindications are varicose veins and damaged skin integrity.
To relieve peripheral neuropathic pain that occurs when the peripheral nervous system is damaged (from the root to the nerve endings), a heating patch with a high capsaicin content is used. This transdermal product is not intended for home use, as certain conditions must be met during application.
Capsaicin is a highly selective agonist of vanilloid receptors, whose transient receptor potential belongs to type 1. Immediately after local application of the patch, skin pain receptors expressing TRPV1 are activated. The patient feels burning and redness in the adhesive area 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 sticking the patch, only 1% of the active ingredient penetrates the damaged tissue.
The field of application of the external medicine is determined by the doctor, and the procedure is performed by medical personnel. The patient's skin is first treated with a product with pronounced anesthetic action 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 membrane.
Heat reflective patches
In the treatment of lumbar osteochondrosis, intervertebral hernia, radiculitis, a patch with nanopowder for pain in the back and lower back performed well. The composition of the transdermal product is a fine mixture obtained by processing rare earth materials. 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 next local application can be used only 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 focus of inflammation rises, which leads to the improvement of microcirculation. Biologically active and nutritious ingredients begin to flow into damaged tissues, triggering regenerative processes. This leads to multiple therapeutic effects, among which the following predominate:
- improvement of local lymph and blood circulation;
- preventing stagnation;
- normalization of venous outflow;
- alleviation of the inflammatory process;
- reduction of pain intensity;
- acceleration of metabolic processes;
- relaxation of spasmodic muscles.
The patch exhibits analgesic, anti-inflammatory and anti-edematous effects. Under the influence of infrared rays, the striated skeletal muscles relax and optimal transmission of nerve impulses to the central nervous system is established. The use of the transdermal drug for 5-7 weeks helps to increase the functional activity of the musculoskeletal system and normalize the range of motion. If the cause of dorsalgia is a fall or a severe bruise, then the use of a patch will relieve not only pain, but also extensive hematomas by improving microcirculation in the damaged tissues.
The Polish manufacturer produces a patch for warming and pain relief. The medicine does not contain non-steroidal anti-inflammatory drugs.The active ingredient of the patch is iron powder.Activated carbon acts as a catalyst for biochemical reactions.
The interaction of enterosorbent and iron powder leads to an increase in temperature in the focus of inflammation to 45-50 °C. Heat production by the body is caused by the oxidation of alkaline earth metals, the basis of iron powder.
Deep heating of the stretched muscles helps to increase the blood supply to the damaged tissues and reduce the tone of the skeletal muscles. The warming effect lasts for 12 hours, then the patch should be peeled off and any moisturizing cream should be rubbed into the area of application.In order to prevent skin burns, the treatment can be carried out a maximum of 3 times every 7 days.. The absence of ingredients in the patch that are absorbed into the systemic circulation ensures a low number of side effects. The transdermal agent is not prescribed to patients during pregnancy, breastfeeding and menstruation. The presence of cracks, wounds or scratches on the skin is also an absolute contraindication. When the patch is applied to parts of the body with blood vessels close to the surface of the skin (for example, the groin area), the likelihood of burns and irritation increases significantly.
Patches with non-steroidal anti-inflammatory drugs
When asked by patients which back pain patch 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 caused them by blocking the cyclooxygenase enzyme. 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 adsorbed from a similar dose of 1% gel. The transdermal product has numerous advantages: practicality and low frequency of use, no greasy marks on clothes and bedding after use.
About 5-6% of phenylacetic acid derivatives can penetrate into the bloodstream, but this amount is not sufficient for the development of significant systemic side effects. T1/2 inactive metabolites of nonsteroidal anti-inflammatory drugs - within 1-3 hours. After glucuronidation in hepatocytes, the phenylacetic acid derivative is evacuated primarily through the urinary system (65-70), and the rest is excreted in 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 action is also based on blocking prostaglandin synthesis by inhibiting cyclooxygenase.
The undoubted advantage of propionic acid derivatives is the possibility of use in the treatment of patients with a history of chronic kidney 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 sticking the patch, its biological concentration in 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 through urine.
The transdermal drug is used as a symptomatic agent in the treatment of neuralgia, lumbago, osteochondrosis and radiculitis in patients older than 15 years. The external agent has an analgesic and anti-inflammatory effect and effectively reduces swelling. In order to increase the effectiveness, the note recommends sticking the patch 2 times a day on the painful parts of the body. The duration of the therapeutic course depends on the severity of the diagnosed disease, but it should not be longer than 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 sticking the transdermal drug to the area of pain and inflammation, the acupuncture points located in the spine 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 not a wide variety of Chinese plasters for joints and spine on the shelves of pharmacies, and doctors rarely include them in the therapeutic regimens of patients. Manufacturers do not conduct clinical trials, the results of which would create an evidence base for the therapeutic effectiveness of transdermal drugs.
To reduce pain, relieve inflammation and swelling, the following Chinese plasters are used:
- External remedy containing scorpion powder, bee venom, myrrh, cinnamon, angelica, borneol and about 30 other components;
- Patch containing 88 biologically active substances, including plant origin: angelica, comfrey and licorice root, extract of Sichuan multifloral pepper and buffalo horn, myrrh, turmeric, orange peel, powder that produces infrared radiation, etc.
- Transdermal agent, which includes saffron, musk, ginger, menthol, extracts of myrrh, peach and angelica, methyl ester of salicylic acid, 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 resin, extract of clove bark and galangal root.
All herbal components of Chinese plasters have a cumulative effect, so the analgesic effect occurs after several hours and sometimes days. Before use, it should be taken into account that the composition contains many biologically active substances that can cause a severe allergic reaction. Chinese plasters are not intended for the treatment of children, pregnant or lactating women.