The patch for back pain is a transdermal remedy used for the treatment of dorsalgia of different etiology and genesis. The medicinal form is characterized by a gradual release of the active ingredients, which ensures a long-lasting therapeutic effect. The active ingredients of all patches with analgesic properties penetrate into the systemic bloodstream in low concentrations, so the list of contraindications for the transdermal drug is significantly shorter than for oral and parenteral drugs. 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 functional 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, anti-physiological postures and microtraumas. Neuropathologists and rheumatologists warn of the need for complete treatment of dorsalgia, since tissue damage in one area of the spine will lead to functional changes in adjacent areas. Compensatory hypermobility will gradually form, which reduces the quality of life of the person.
Lower back pain occurs in 76% of the population. Intense discomfort is diagnosed in 7% of cases. In more than 9% of people, back pain has caused disability.
In the treatment of pathologies of the musculoskeletal systempatches are used to minimize pain, relieve inflammation and swelling. Clinical studies prove the high efficiency of transdermal means for local application, which have an analgesic effect. Therapeutic patches for back pain are classified as follows:
| A group of stickers | Characteristics |
|---|---|
| I'm warming up | The active ingredients of external preparations are hot pepper or mustard seed extracts. 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 that have the ability to raise body temperature in areas of inflammation 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 location |
| Phytoplastics | Chinese manufacturers supply topical products containing medicinal plant extracts, essential oils and other natural ingredients. Patches are used not only for treatment, but also for 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. 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 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, bone and joint tissue of the musculoskeletal system.Such patches are rarely included in the therapeutic regimens of patients with lumbosacral osteochondrosis or radiculitisdue to the low efficiency of the rapid 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 about this type of topical medication due to the lack of 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 leading clinics of the countries, out of 1300 patients in 24. 9% the main cause of complaints was pain in the lumbosacral region.
Red pepper extract warming patches
Pepper patch for back pain is the most popular transdermal drug for the treatment of dorsalgia of any severity. The active ingredients are red hot pepper and belladonna extracts, dimethylsulfoxide, 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 the inflammatory areas. The following therapeutic actions are characteristic of a black patch:
- pain reliever;
- distracting;
- locally irritating.
Cayenne pepper extract has the ability to dilate 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 (belladonna) is characterized by a pronounced antispasmodic effect, which is provided by the alkaloid atropine, which is part of the plant. Manufacturers have added dimethylsulfoxide to the patch to relieve inflammatory processes that often accompany dorsalgia. The organic compound inactivates hydroxyl radicals and accelerates metabolic processes in the areas of pathology.
In people with sensitive skin, the use of a transdermal product will cause severe burning, itching and blockage of the blood vessels located at the site of application. If any of the listed side effects occur, wipe the affected area of the body with a cotton pad soaked in sunflower oil.
Pepper patch is not used in the treatment of patients under 14 years of age, pregnant and lactating women. Absolute contraindications are varicose veins and impaired skin integrity.
To eliminate peripheral neuropathic pain, which occurs with damage to the peripheral nervous system (from the roots to the nerve endings), a warming patch with a high capsaicin content is used. This transdermal product is not intended for home use, as certain conditions must be observed when applying it.
Capsaicin is a highly selective agonist of vanilloid receptors whose transient receptor potential belongs to type 1. Immediately after topical application of the patch, skin pain receptors expressing TRPV1 are activated. The patient feels burning and redness appears in the area of the glue 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 feel pain remains unchanged;
- changes in pain receptors in the skin under the active influence of capsaicin are reversible, which happens after some time. The reaction to painful stimuli is restored after 2-4 weeks.
The patch is characterized by slow transepidermal and transdermal absorption. One hour after sticking the patch, only 1% of the active ingredient penetrates the damaged tissue.
The field of application of the external medicine is determined by the attending physician, with the procedure being performed 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 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, a patch with nanopowder for back and low back pain has proven itself well. The composition of the transdermal product is represented by 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 of the patch is 12 hours. The following topical application can be used only after 6 hours.
The mechanism of pharmacological action of the drug consists in the combined effect 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 substances begin to flow to the damaged tissues, triggering regenerative processes. This leads to multifaceted therapeutic effects, among which the following predominate:
- improvement of local lymphatic and blood circulation;
- prevention of stagnation;
- normalization of venous outflow;
- relief of the inflammatory process;
- reducing the severity of pain;
- acceleration of metabolic processes;
- relaxing spasmodic muscles.
The patch exhibits analgesic, anti-inflammatory and anti-edematous effects. 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 dorsalgia is a fall or a severe bruise, then the use of the patch will relieve 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 leads to an increase in the temperature in the focus of inflammation to 45-50 ° C. The production of heat by the body occurs through the oxidation of alkaline earth metals, the basis of iron powder.
Deep heating of spasmed muscles helps 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 any moisturizer rubbed into the application area. To prevent skin burns, the treatment procedure can be performed no more than 3 times every 7 days.. The lack 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, lactation and menstruation. The presence of cracks, wounds or scratches on the skin is also an absolute contraindication. 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 likelihood of burns and irritation increases significantly.
Patches with non-steroidal anti-inflammatory drugs
When asked by patients which plaster for back pain 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 provokes 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 by a similar dose of 1% gel. The transdermal product has many advantages: convenience and low frequency of use, no greasy marks on clothes 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 nonsteroidal anti-inflammatory drugs - within 1-3 hours. After glucuronidation in hepatocytes, the phenylacetic acid derivative is mostly evacuated from 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 the shelves of 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 derivative of propionic acid is the possibility of use in the treatment of patients with a history of chronic kidney and liver failure. Regardless of the stage of the pathology, the metabolism of NSAIDs in liver cells does not change, which explains the absence of its accumulation.
5-8 hours after sticking the patch, its biological concentration in the 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.
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 an analgesic and anti-inflammatory effect 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 patches for pain relief
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 in the area of pain and inflammation, acupuncture points located in the spine are activated. The result of this effect is the improvement of blood circulation, delivery of nutrients and biologically active substances to damaged tissues and acceleration of metabolic processes.
There is not a wide range of Chinese patches 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 the severity of pain, relieve inflammation and swelling, the following Chinese patches are used:
- An external remedy that contains scorpion dust, bee venom, myrrh, cinnamon, angelica, borneol and about 30 other components;
- Patch containing 88 biologically active substances, including herbal origin: angelica, black wormwood and licorice root, extract of Sichuan multi-colored pepper and buffalo horn, myrrh, turmeric, orange peel, powder producing infrared radiation and others;
- A transdermal agent that includes extracts of saffron, musk, ginger, menthol, myrrh, peach and angelica root, 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, seeds of chili pepper, resins of myrrh and pine, extract of clove bark and galangal root.
All plant components of Chinese plasters have a cumulative effect, so the analgesic effect occurs after several hours and sometimes days. Before using them, it should be borne in mind 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 and lactating women.