Back pain patch is a transdermal agent used in the treatment of back pain 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 into the systemic bloodstream in low concentrations, therefore the list of contraindications of the transdermal drug is much shorter than that of drugs for oral and parenteral administration. The causes of back pain are usually 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 blockage of the intervertebral joints. Pathological conditions often precede spondyloarthrosis or osteochondrosis of the lumbar region. Locking often occurs as a result of increased static or dynamic loads, antiphysiological postures, and microtrauma. Neuropathologists and rheumatologists warn about the need for complete treatment of back pain, since tissue damage in one area of the spine will cause functional changes in adjacent areas. Little by little, compensatory hypermobility will form, which will reduce the person's quality of life.
Low back pain occurs in 76% of the population. Severe discomfort is diagnosed in 7% of cases. In more than 9% of people, back pain caused disability.
In the treatment of pathologies of the musculoskeletal system.Patches are used to minimize pain, relieve inflammation and swelling.. Clinical studies have shown the high effectiveness of transdermal agents for topical use, which have an analgesic effect. Therapeutic patches for back pain are classified as:
| patch group | 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 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 back pain of any location. |
| Phytoplasties | Chinese manufacturers supply locally applied products containing medicinal plant extracts, essential oils and other natural ingredients. Dressings are used not only for therapy, but also for the prevention of pathologies of the lumbar spine. |
In medical practice, pain lasting 1 to 1. 5 months is considered acute, and pain lasting 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 in pharmacies. They contain chondroitin, glucosamine and sometimes hyaluronic acid with vitamin B that can improve innervation. These biologically active substances are structural units of cartilage, bone and joint tissues of the musculoskeletal system. These patches are rarely included in the therapeutic regimens of patients with lumbosacral osteochondrosis or radiculitis.due to low effectiveness in 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 this type of topical drugs due to the lack of scientific evidence on their therapeutic efficacy.
Dorsalgia occupies one of the first places in the structure of people seeking medical help. According to the results of epidemiological studies carried out in the main clinics in the country, of 1, 300 patients, in 24. 9% the main cause of complaint was pain in the lumbosacral region.
Hot patches with red pepper extract
Pepper patch for back pain is the most popular transdermal remedy for the treatment of back pain of any severity. The active ingredients are extracts of hot red pepper and belladonna, dimethyl sulfoxide and eucalyptus essential oil. Thanks to lanolin (animal wax obtained by boiling sheep's wool) and rosin, the active ingredients are easily absorbed by the skin and penetrate into inflamed areas. The following therapeutic actions are characteristic of the pepper patch:
- analgesic;
- distract;
- locally irritating.
Capsicum extract has the ability to dilate the blood vessels located in the pain area. The analgesic effect is also manifested in a decrease in muscle tone and an improvement in tissue trophism. Belladonna extract (belladonna) is characterized by a pronounced antispasmodic effect, provided by the alkaloid atropine, which is part of the plant. Manufacturers have added dimethyl sulfoxide to the patch to relieve inflammatory processes, a common accompaniment to back pain. The organic compound inactivates hydroxyl radicals and accelerates metabolic processes in pathological areas.
For people with sensitive skin, using a transdermal product will cause severe burning, itching, and congestion 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 ball soaked in sunflower oil.
Pepper patch is not used in the treatment of patients under 14 years of age, pregnant or breast-feeding women. Absolute contraindications are varicose veins and impaired skin integrity.
To eliminate peripheral neuropathic pain that occurs when the peripheral nervous system (from roots to nerve endings) is damaged, a heating patch with a high capsaicin content 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, whose transient receptor potential 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 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 to 4 weeks.
The patch is characterized by slow transepidermal and transdermal absorption. One hour after sticking 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 treating physician., and the procedure is performed by medical personnel. First, the patient's skin is treated with a product with pronounced anesthetic activity to reduce the intensity of discomfort. The patch is applied with gloves and safety glasses. These 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 and radiculitis, a patch with nanopowder for back and lumbar pain has proven effective. 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 on 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 increases, which improves microcirculation. Nutrients and biologically active substances begin to flow into damaged tissues, triggering regenerative processes. This leads to multifaceted therapeutic effects, among which the following predominate:
- improvement of local blood and lymph circulation;
- prevention of stagnation;
- normalization of venous flow;
- relief of the inflammatory process;
- reduce the severity of pain;
- acceleration of metabolic processes;
- relaxation of spasmodic muscles.
The patch has analgesic, anti-inflammatory and anti-edematous activity. 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. The use of a 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 the back pain is a fall or a severe bruise, the use of the patch will relieve not only the pain, but also extensive bruising by improving microcirculation in the damaged tissues.
A Polish manufacturer produces a patch that heats and relieves pain. The medicine 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 the enterosorbent and iron powder causes an increase in temperature in the inflammatory focus up to 45-50 °C. Heat production by the body occurs through the oxidation of alkaline earth metals, the basis of iron powder.
Deep warming of spasmed muscles helps increase blood supply to damaged tissues and reduce skeletal muscle tone. The warming effect lasts 12 hours, then the patch should be removed and any moisturizer rubbed into the application area.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 causes 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 near the surface of the skin (for example, the groin area), the likelihood of burns and irritation increases significantly.
Nonsteroidal anti-inflammatory drug patches
When patients ask which patch for back pain is best, 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;
- analgesic;
- weak antiseptic.
The amount of phenylacetic acid derivative released by the patch during the day corresponds to the volume absorbed from a similar dose of 1% gel. The transdermal product has many advantages: convenience and low frequency of use, no greasy marks on clothing and bedding after use.
About 5-6% of the phenylacetic acid derivative can penetrate 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: in 1 to 3 hours. After glucuronidation in hepatocytes, the phenylacetic acid derivative is mainly evacuated through the urinary system (65-70%) and the rest is excreted with feces. 1% of the active ingredient leaves the body unmetabolized.
Relatively recently, a patch from a Korean manufacturer appeared in pharmacies, 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 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 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 should not exceed 6 days.
Chinese pain relief patches.
The Chinese patch for osteochondrosis is a transdermal product containing 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 on the spine are activated. The result of this effect is better blood circulation, the delivery of nutrients and biologically active substances to damaged tissues and the acceleration of metabolic processes.
There is not a wide range of Chinese joint and spine dressings in pharmacies, and doctors rarely include them in patients' therapeutic regimens. Manufacturers do not conduct clinical trials whose results would create an evidence base for the therapeutic efficacy of transdermal medications.
To reduce the intensity of pain, relieve inflammation and swelling, the following Chinese patches are used:
- An external remedy containing scorpion powder, bee venom, myrrh, cinnamon, angelica, borneol and about 30 other components;
- A patch containing 88 biologically active substances, including of plant origin: angelica, comfrey and licorice root, Sichuan multifloral pepper extract and buffalo horn, myrrh, turmeric, orange peel, powder that produces infrared radiation and others;
- Transdermal agent, which includes extracts of saffron root, musk, ginger, menthol, myrrh, peach and angelica, methyl ester of salicylic acid, which is part of the group of non-steroidal anti-inflammatory drugs;
- Preparation containing 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 use, it must be taken into account that the composition contains many biologically active substances that can cause a severe allergic reaction. Chinese patches are not intended for the treatment of children, pregnant or nursing women.