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 the gradual release of the active ingredient, 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 transdermal drugs is much shorter than drugs for oral administration and parenteral administration. The cause of back pain is often pathology of the gastrointestinal tract and genitourinary system, so medical consultation and examination are required.
Classification of transdermal products
Dorsalgia (back pain) develops due to reversible blocking 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 microtrauma. Neuropathologists and rheumatologists warn about the need for full treatment of dorsalgia, because tissue damage in one area of the spine 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. Severe discomfort was diagnosed in 7% of cases. In more than 9% of people, dorsalgia causes disability.
In the treatment of pathologies of the musculoskeletal systemThe patch is used to reduce 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:
| Patch group | Characteristics |
|---|---|
| Warm up | The active ingredient of the external preparation is hot pepper extract or mustard seeds. The mechanism of action of the patch 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 the area of inflammation using the body's own resources |
| Anti-inflammatory | The active ingredient of the transdermal drug is a non-steroidal anti-inflammatory drug. This patch group is effective in the treatment of dorsalgia of any localization |
| Phytoplasty | Chinese manufacturers supply products for local application that contain medicinal plant extracts, essential oils and other natural ingredients. Plaster is used not only for therapy, but also for the prevention of lumbar spine pathology |
In medical practice, pain that lasts for 1-1. 5 months is considered acute, and pain that lasts for 12 weeks is considered chronic. Prescription of patches with analgesic effect is practiced to eliminate discomfort at any stage of pathology.
Recently, transdermal products with chondroprotectors appeared on pharmacy shelves. It contains chondroitin, glucosamine, and sometimes hyaluronic acid with B vitamins that can improve conservation. This biologically active substance is the structural unit of cartilage, bone, and joint tissue of the musculoskeletal system.Such spots are rarely included in the therapeutic regimen of patients with lumbosacral osteochondrosis or radiculitisbecause of its low effectiveness quickly eliminates pain of any intensity. The main task of the chondroprotective patch is to restore tissue affected by inflammation, which can take months and sometimes years. Many traumatologists and neurologists are skeptical about this type of drug for local use due to the lack of evidence base for its therapeutic effectiveness.
Dorsalgia occupies one of the first places in the structure of people seeking medical help. According to the results of an epidemiological study conducted at the country's leading clinic, out of 1300 patients, in 24. 9% the main cause of complaints was pain in the lumbosacral area.
Warming patch with red pepper extract
Pepper paste 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's wool) and pine rosin, the active ingredient is easily absorbed by the skin and penetrates the inflamed area. The following therapeutic actions are characteristic of the pepper patch:
- pain reliever;
- disturbing;
- annoying local.
Capsicum extract has the ability to dilate the blood vessels located in the area of pain. The analgesic effect also manifests itself in a decrease in muscle tone and an increase in tissue trophism. Belladonna extract (belladonna) is characterized by a significant antispasmodic effect, which is provided by the alkaloid atropine, which is part of the plant. The manufacturer has added dimethyl sulfoxide to the patch to relieve the inflammatory process, a frequent accompaniment of dorsalgia. Organic compounds deactivate hydroxyl radicals and accelerate metabolic processes in pathological areas.
For people with sensitive skin, the use of transdermal products 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 body part with a cotton pad 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 compromised skin integrity.
To eliminate peripheral neuropathic pain that occurs when the peripheral nervous system is damaged (from the root to the tip of the nerve), 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 when applying.
Capsaicin is a highly selective agonist of the vanilloid receptor, a transient receptor potential belonging to type 1. Immediately after application of the local patch, skin 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. External drugs are characterized by the following pharmacodynamic effects:
- Capsaicin significantly reduces the sensitivity of skin pain receptors to mediators. But when exposed to mechanical stimulation and vibration, a person's ability to experience pain remains unchanged;
- changes in skin pain receptors under the active influence of capsaicin can be reversed, which occurs after some time. The response to painful stimuli is restored after 2-4 weeks.
This patch is characterized by slow transepidermal and transdermal absorption. An hour after sticking the patch, only 1% of the active substance penetrates into the damaged tissue.
The area of external drug use is determined by the attending physician, and procedures are carried out by medical personnel. The patient's skin is first treated with a product with pronounced anesthetic activity to reduce the intensity of the discomfort. The patch is applied using gloves and safety glasses. Such precautions are necessary to avoid redness of the epidermis and irritation of the mucous membrane.
Heat reflective patches
In the treatment of lumbar osteochondrosis, intervertebral hernia, radiculitis, patches with nano powder for back and lower back pain have proven themselves well. The composition of the transdermal product is represented by a fine mixture obtained by processing rare earth materials. Nano powder with the ability to produce infrared radiation is used 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 magnetic fields formed by rare earth substances. The temperature in the focus of inflammation increases, which leads to better microcirculation. Biologically active and nutrients begin to flow to the damaged tissue, triggering the regenerative process. This leads to various therapeutic effects, among which the following dominate:
- increased local lymph and blood circulation;
- prevention of stagnation;
- normalization of venous outflow;
- relieves the inflammatory process;
- reduce the severity of pain;
- acceleration of metabolic processes;
- spasmodic muscle relaxation.
The patch exhibits analgesic, anti-inflammatory and anti-edema 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 transdermal drugs for 5-7 weeks helps to improve 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 the pain, but also the extensive hematoma by improving microcirculation in the damaged tissue.
A Polish manufacturer produces a patch that warms and relieves pain. This 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 enterosorbent and iron powder leads to an increase in temperature in the focus of inflammation 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 the cramping muscles helps increase blood supply to the damaged tissue and reduces skeletal muscle tone. The warming effect lasts for 12 hours, then the patch should be peeled off and any moisturizer should be applied to the application area.To avoid burning the skin, the treatment procedure can be carried out no more than 3 times every 7 days.. The absence of substances in the patch that are absorbed into the systemic circulation ensures a small number of side effects. Transdermal agents are 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 a part 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 asked by patients which patch for back pain is better, neurologists and rheumatologists give a clear answer - transdermal agents 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 the main mediator of pain and inflammation, prostaglandins. Often, in the treatment of radiculitis and lumbar osteochondrosis, patches with active ingredients from the group of phenylacetic acid derivatives are used. External agents also include levomenthol, which has the following effects:
- local irritants;
- pain reliever;
- weak antiseptic.
The amount of phenylacetic acid derivative released from the patch during the day corresponds to the volume absorbed from a similar dose of 1% gel. Transdermal products have many advantages: convenience and low frequency of use, no greasy effect on clothes and bedding after use.
About 5-6% of phenylacetic acid derivatives can penetrate into the bloodstream, but this amount is not enough to develop significant systemic side effects. T1/2 inactive metabolites of nonsteroidal anti-inflammatory drugs - within 1-3 hours. After glucuronidation in hepatocytes, phenylacetic acid derivatives are cleared mainly by the urinary system (65-70%), and the rest is excreted in the feces. 1% of the active substance leaves the body unmetabolized.
Recently, a patch from a Korean manufacturer appeared on pharmacy shelves, the active ingredient is a non-steroidal anti-inflammatory drug from the group of propionic acid derivatives. Its analgesic activity 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 pathological stage, the metabolism of NSAIDs in liver cells does not change, which explains their lack of accumulation.
5-8 hours after sticking the patch, its biological concentration in the blood serum reaches 0. 08-0. 15 μg/ml. Propionic acid derivatives are 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. External agents have analgesic and anti-inflammatory activity and effectively relieve swelling. To increase effectiveness, the annotation recommends sticking the patch 2 times a day on the painful part 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 patch
Chinese patch for osteochondrosis is a transdermal product containing medicinal plant extracts and biologically active ingredients that have chondroprotective properties. After sticking the transdermal medicine to the area of pain and inflammation, the acupuncture points located in the spine are activated. The result of this effect is better blood circulation, delivery of nutrients and biologically active substances to damaged tissues, and acceleration of metabolic processes.
There are no different types of Chinese plasters for joints and spine on pharmacy shelves, and doctors rarely include them in the patient's therapeutic regimen. The manufacturer has not conducted clinical trials, the results of which would establish the evidence base for the therapeutic efficacy of the transdermal drug.
To reduce the severity 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 ingredients, including herbal origin: angelica, comfrey and licorice root, extracts of Sichuan multi-flower pepper and buffalo horn, myrrh, turmeric, orange peel, powder that produces infrared radiation, etc. ;
- Transdermal agents, which include turmeric, 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 containing extracts of aconite, belladonna, cinnamon, parsnip, ginger, cilibuha seeds, myrrh and pine resin, clove bark extract and galangal root.
All components of Chinese patch herbs have a cumulative effect, so the analgesic effect occurs after several hours and sometimes days. Before using it, it should be taken into account that the composition contains many biologically active substances that can trigger a severe allergic reaction. Chinese spots are not intended for the treatment of children, pregnant or lactating women.