Tired of going to your doctor for repeat trigger point injections to relieve your nagging neck, shoulder, and back pain?  As an alternative to injections or just putting up with a regional pain, ask your doctor about Lidoderm.  It’s a patch that you place on the sore area and it delivers lidocaine anesthetic into your painful muscles.

Lidoderm patches are available by prescription only.  They are formulated to slowly release lidocaine into the tissues over a 12-hour period.  The patches have their own gentle surface adhesive (simply peel off the surface wrapping like you do for a band-aide) and each sheet is 4″ by 5 1/2″ in size.  They can be cut to any size needed for the job.  For example, if your physician routinely injects the muscle junction at the base of your neck (one on each side of your spine), you might cut the patch into fourths and apply two small patches nightly to keep the pain away.  If the tension at the base of your neck leads to frequent headaches during the day from tilting your head forward to work, you might apply the patch in the morning before your tension headaches have a chance to develop.  Alternatively, applying the patch to your most troublesome area at bedtime may prevent a particularly sensitive muscle from generating unbearable pain.  Of course, if you often experience diffuse low back pain, you may need to use an entire patch everyday–at least during the work week.

Your options with Lidoderm are numerous, but can these patches actually take the place of trigger point injections?  And, can they really keep your most nagging pain at bay while you work or sleep?  One published case report using Lidoderm patches to treat the regional (myofascial) pain problems of a fibromyalgia patient shows promise.  Although the indicated use of Lidoderm is for treating the intense regional pain of postherpetic neuralgia, pain specialist Charles Argoff, M.D., of Bethpage, NY, suggests that the use of this patch be broadened “to treat patients with complaints of chronic low back pain, cervical spine pain (neck region), and myofascial pain.”  Backing up his recommendation, he references a small study by Arthur Lipman, Pharm.D., of the University of Utah, which successfully demonstrated that this topical analgesic is effective for myofascial pain.

Studies show that Lidoderm delivers lidocaine only to the tissues beneath the patch and does so without complications that might occur when this anesthetic is administered systemically.  It works as a sodium channel blocker to inhibit pain transmission in the treated area and doesn’t build up in the bloodstream.  The only side effect appears to be mild skin irritation for those patients who must use this patch on a continuous basis.

1.  Dalpaiz AS, Dodds TA.  J Pain & Pall Care Pharm 2002; 16(1):99-104.

2.  Argoff CE. S Med J 2002; 95(7):781.

3.  Argoff CE. Cur Pain Headache Rep 2002; 6(5):375-378.

4.  Lipman A, et. al. J Pain 2002; 3(2 supple 1):abs#782.

5.  Comer AM, Lamb HA. Drugs 2000; 59(2):245-249.

6.  Gammaitoni AR, Davis MW.  Ann Pharmacother 2002; 36:236-40.

Posted on November 3rd, 2008 by cher
Filed under: Front Page