Patch for back pain is a transdermal agent used in the treatment of back pain of various etiologies and origins. The dosage form is characterized by the gradual release of active substances, which has a long-term therapeutic effect. The active substances of all patches with analgesic properties penetrate into the systemic circulation in low concentrations, so the list of contraindications for transdermal drugs 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 a medical consultation and examination is necessary.
Classification of transdermal products
Dorsalgia (back pain) develops as a result of functionally reversible blockade of the 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 necessity of complete treatment of dorsalgia, because tissue damage in one area of the spine will cause functional changes in adjacent areas. Gradually, compensatory hypermobility will develop, which reduces the quality of life of a person.
Low back pain occurs in 76% of the population. Severe anxiety 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 efficiency of transdermal agents for local use with analgesic effect. Therapeutic patches for back pain are classified as follows:
| A group of patches | Features |
|---|---|
| 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 recovery. |
| Heat reflective | The patch contains nanoparticles of rare earth metals, which have the ability to increase body temperature in inflamed areas 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 |
| Phytoplastics | Chinese manufacturers offer 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 back pathologies |
In medical practice, pain lasting 1-1, 5 months is considered acute, and pain lasting 12 weeks is considered chronic. Patches with analgesic effect are used to relieve discomfort at any stage of the pathology.
Relatively recently, transdermal products with chondroprotectors appeared on pharmacy shelves. They contain hyaluronic acid with chondroitin, glucosamine, and sometimes B vitamins, which 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 therapeutic regimens of patients with lumbosacral osteochondrosis or radiculitis.due 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 of these types of drugs for local use due to the lack of an 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 the leading clinics of the countries, pain in the back was the main cause of complaints in 24. 9% of 1300 patients.
Hot patches with red pepper extract
Pepper patch for back pain is the most popular transdermal remedy for back pain treatment of any severity. Active ingredients are red hot pepper and belladonna extracts, dimethyl sulfoxide, eucalyptus essential oil. Thanks to lanolin (animal wax obtained by boiling sheep's wool) and pine rosin, the active ingredients are easily absorbed by the skin and penetrate into inflamed areas. The following therapeutic actions are characteristic of pepper patch:
- painkiller;
- distracting;
- locally irritating.
Pepper extract has the ability to expand blood vessels localized in the pain area. The analgesic effect is also manifested by a decrease in muscle tone and an improvement in tissue trophism. Belladonna (belladonna) extract is characterized by a clear antispasmodic effect provided by atropine alkaloid, which is part of the plant. Manufacturers added dimethyl sulfoxide to the patch to eliminate the inflammatory processes that often accompany dorsalgia. The organic compound neutralizes hydroxyl radicals and accelerates metabolic processes in pathological areas.
For people with sensitive skin, the use of a transdermal product will cause severe burning, itching and blockage of the blood vessels located at the application site. If any of the listed side effects occur, wipe the affected area of the body with a cotton swab soaked in sunflower oil.
Pepper patch is not used in the treatment of patients under 14 years of age, pregnant or lactating women. Absolute contraindications are varicose veins and damage to the integrity of the skin.
A warming patch with a high amount of capsaicin is used to relieve peripheral neuropathic pain that occurs when the peripheral nervous system is damaged (from the roots to the nerve endings). This transdermal product is not intended for home use, as certain conditions must be met when applying it.
Capsaicin is a highly selective agonist of vanilloid receptors, the transient receptor potential belongs to type 1. Skin pain receptors expressing TRPV1 are activated immediately after local application of the patch. The patient feels a burning sensation and redness occurs in the adhesive area caused by the release of vasoactive neuropeptides. The foreign drug is characterized by the following pharmacodynamic effects:
- Capsaicin significantly reduces the sensitivity of skin pain receptors to mediators. However, when exposed to mechanical and vibrational stimuli, a person's ability to feel pain remains unchanged;
- under the active influence of capsaicin, the changes occurring in the skin pain receptors are reversed and occur 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 applying the patch, only 1% of the active substance penetrates the damaged tissue.
The field of application of foreign medicine is determined by the attending physician, and the procedure is performed by medical personnel. The patient's skin is first treated with a product with overt anesthetic activity to reduce the intensity of the discomfort. The patch is applied with 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, the patch with nanopowder for back pain has shown itself well. The composition of the transdermal product is represented by a fine mixture obtained as a result of the processing of rare earth materials. Nanodust capable of generating infrared radiation is applied to the hypoallergenic polymer base.
The duration of exposure to the patch is 12 hours. The local application below can only be used after 6 hours.
The pharmacological action mechanism of the drug consists of the combined effect of infrared radiation and the magnetic field created by rare earth materials.. The temperature rises in the focus of inflammation, which leads to the improvement of microcirculation. Biologically active and nutrients begin to flow to the damaged tissues, starting regenerative processes. This leads to multifaceted therapeutic effects, among which the following are predominant:
- improvement of local lymph and blood circulation;
- prevention of stagnation;
- normalization of venous flow;
- elimination of the inflammatory process;
- reduce the intensity of pain;
- acceleration of metabolic processes;
- relaxation of spasmodic muscles.
The patch has an analgesic, anti-inflammatory and anti-edema effect. Under the influence of infrared rays, the striated skeletal muscles relax and the optimal transmission of nerve impulses to the central nervous system is restored. Use of the transdermal preparation 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 the patch will eliminate not only pain, but also extensive hematomas by improving microcirculation in the 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 of the patch is iron powder.Activated carbon acts as a catalyst for biochemical reactions.
The interaction of enterosorbent and iron powder causes an increase in the temperature in the inflammatory site to 45-50 ° C. Heat production by the body occurs through the oxidation of alkaline earth metals that form the basis of iron powder.
Deep heating of spasmodic muscles helps to increase blood supply to damaged tissues and reduce skeletal muscle tone. The warming effect lasts for 12 hours, after which the patch should be peeled off and applied to any moisturizing application area.To prevent skin burns, the treatment procedure can be performed no more than 3 times every 7 days.. The absence of substances entering the systemic circulation in the patch ensures a small number of side effects. Transdermal agent is not prescribed to patients during pregnancy, lactation and menstruation. An absolute contraindication is 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 possibility of burning and irritation increases significantly.
Non-steroidal anti-inflammatory drug patches
When patients ask which patch is better for back pain, 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 provokes them by blocking the cyclooxygenase enzyme. This leads to a decrease in the production of prostaglandins, the main mediators of pain and inflammation. A patch with an active ingredient from the group of phenylacetic acid derivatives is often used in the treatment of radiculitis and lumbar osteochondrosis. The external agent also includes levomenthol, which has the following effects:
- local irritant;
- painkiller;
- 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 many advantages: convenience and low frequency of use, absence of greasy marks on clothes and bedding after use.
About 5-6% of the phenylacetic acid derivative can penetrate into the bloodstream, but this amount is not enough for the development of 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 primarily excreted 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 its use in the treatment of patients with chronic kidney and liver failure. Regardless of the stage of pathology, the metabolism of NSAIDs in liver cells does not change, which explains its non-accumulation.
5-8 hours after applying 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 in the urine.
Transdermal preparation is used as a symptomatic agent in the treatment of neuralgia, lumbago, osteochondrosis and radiculitis in patients over 15 years old. The external agent has analgesic and anti-inflammatory activity and effectively removes 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 should not exceed 6 days.
Chinese pain relief patches
Chinese patch for osteochondrosis is a transdermal product containing extracts of medicinal plants and biologically active substances with chondroprotective properties. After sticking the transdermal drug to the area of pain and inflammation, the acupuncture points located on the spine are activated. The result of this effect is the improvement of blood circulation, the delivery of nutrients and biologically active substances to damaged tissues, and the acceleration of metabolic processes.
Pharmacy shelves do not have a wide variety of Chinese plasters for joints and spine, and doctors rarely include them in the therapeutic regimen of patients. Manufacturers do not conduct clinical trials, the results of which create an evidence base for the therapeutic effectiveness of transdermal drugs.
The following Chinese patches are used to reduce the severity of pain, eliminate inflammation and swelling:
- An external remedy consisting of scorpion powder, bee venom, myrrh, cinnamon, angelica, borneol and about 30 other components;
- It contains 88 biologically active ingredients, including herbal patch: angelica, bilberry and licorice root, Sichuan pepper and buffalo horn extract, myrrh, turmeric, orange peel, infrared radiation powder, etc. ;
- Transdermal agent containing saffron, musk, ginger, menthol, myrrh, peach and angelica root extracts, salicylic acid methyl ester, which is included in the group of non-steroidal anti-inflammatory drugs;
- A preparation containing aconite, belladonna, cinnamon, parsley, ginger, chilibucha seeds, myrrh and pine resins, clove bark extract and pileus root extracts.
All plant 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 they contain many biologically active substances that can cause a serious allergic reaction. Chinese patches are not intended for the treatment of children, pregnant or lactating women.