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Lidocaine Patch: Effective Pain Relief Options

Lidocaine Patch: Effective Pain Relief Options

by | Lower Back Pain, Sciatica

For individuals experiencing lower back pain and sciatica symptoms, can using a lidocaine patch help?

Lidocaine Patch: Effective Pain Relief Options

Lidocaine Patch

Lidocaine patches are in a drug class called local anesthetics (MedlinePlus, 2025) (Food and Drug Administration, 2022). They relieve pain in small body areas by blocking the nerves from sending pain signals. The Food and Drug Administration approved lidocaine 5% or 1.8% patches for relieving postherpetic neuralgia (PHN) pain. These lidocaine patches are prescription-only (Food and Drug Administration, 2022). They are available either by prescription or over the counter and are commonly used for back pain and other areas. Over-the-counter lidocaine, 4% patches, can be used to relieve minor aches and pains, including back pain. However, further research is needed to recommend the use of lidocaine patches as an effective method of pain relief. (Department of Veterans Affairs/Department of Defense, 2022) (North American Spine Society, 2020)

The Patch

They are available in prescription and over-the-counter forms. Over-the-counter forms come as a 4% patch in various brands, such as (MedlinePlus, 2025)

  • Aspercreme
  • Lidocare
  • Salonpas

Prescription-only patches come in 5% or 1.8% patches and are approved to relieve long-term nerve pain from shingles in adults. Zlido is a brand name for a 1.8% lidocaine patch. Five percent lidocaine patches are available generically. (DailyMed, 2018) (Food and Drug Administration, 2021) The safety and effectiveness in children are unknown. (Food and Drug Administration, 2022)

Other Lidocaine Forms

As a local anesthetic, it is available in several other forms, including:

  • Spray
  • Topical cream
  • Lotion
  • Liquid
  • Ear drops
  • Eye gel
  • Injection
  • It is also available as a short-term intravenous infusion for abnormal heart rhythm. (DailyMed, 2025)

Effectiveness

Clinical trials have shown that the patches effectively relieve chronic low back pain. However, these studies were nonrandomized and did not include a control group to compare against the treatment group. (Santana J. A., Klass S., & Felix E. R. 2020) The results may be subject to potential biases. For this reason, further evidence is needed to support lidocaine patches’ effectiveness in reducing low back pain. (North American Spine Society, 2020) High-quality randomized and controlled clinical trials are necessary to study the effectiveness. (North American Spine Society, 2020) (Santana J. A., Klass S., & Felix E. R. 2020)

How to Use Safely

In general, keep the following in mind (MedlinePlus, 2025)

  • Use according to the directions on the box and the healthcare provider’s recommendations.
  • Do not use on broken or inflamed, swollen skin.
  • Do not apply heat like heating pads or electric blankets over patches.
  • Avoid getting water on or around the patch.
  • Avoid letting a patch near your eyes to limit eye irritation.
  • Fold the sticky sides of the used lidocaine patches together and safely throw them away, keeping them away from children and pets.

How to use (MedlinePlus, 2025)

  • Clean and dry the affected area before placing the patch.
  • Apply to the affected body area as directed.
  • Wash your hands after touching the patch.
  • Remove the patch after what is usually recommended after eight hours.

How Quickly Does It Work?

The amount of medication absorbed into the blood depends on how long the patch is placed on the body and how much is covered with the patch. In a study, healthy participants wore three lidocaine patches on their backs for 12 hours on and 12 hours off during 24 hours. Lidocaine levels were highest at 11 hours. At the end of the 24 hours, there was still some lidocaine left in the bloodstream. (Food and Drug Administration, 2022)

Individuals with PHN may notice a difference in pain intensity after four hours of using the patch. (Rowbotham, M. C. et al., 1996) (Food and Drug Administration, 2022) Experts may suggest using patches for four weeks for those who experience pain after their shingles rash disappears. However, if there is still pain after these four weeks, it is recommended to see a pain specialist. (Gross, G. E. et al., 2020)

Side Effects

Common side effects are typically mild skin reactions where the patch is. These reactions are usually temporary and will disappear within a few minutes or hours. Examples include: (Food and Drug Administration, 2022)

  • Irritation
  • Itchiness
  • Abnormal or burning sensation
  • Redness
  • Swelling
  • Blisters
  • Bruises
  • Skin bumps
  • Skin color changes
  • Skin peeling

Potentially serious side effects include: (Food and Drug Administration, 2022)

Serious Allergic Reaction

  • Severe allergic reactions are rare, but it is possible.
  • Symptoms include breathing problems, itchiness, and rash.

Methemoglobinemia

  • Methemoglobinemia is a condition that makes it hard for red blood cells to carry oxygen.
  • Individuals may experience symptoms of blue-looking skin, headache, lightheadedness, shortness of breath, abnormal heart rhythm, or seizures.

Using too many lidocaine patches to cover large parts of the body or using the patches longer than 12 hours within 24 hours may cause side effects that may include heart-related effects, such as a slow heart rate and low blood pressure. Individuals may also experience the following side effects (Food and Drug Administration, 2022)

  • Hot or cold sensation
  • Numbness
  • Dizziness
  • Ringing ears
  • Lightheadedness
  • Mood changes
  • Drowsiness to unconsciousness
  • Vision changes
  • Seizures
  • Tremors
  • Vomiting

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Sciatica Causes and Treatments

References

National Library of Medicine. MedlinePlus. (2025). Lidocaine transdermal patch. Retrieved from https://medlineplus.gov/druginfo/meds/a603026.html

Food and Drug Administration. (2022). Lidoderm label. Retrieved from https://www.accessdata.fda.gov/spl/data/eedfe43b-1019-19a0-e053-2995a90a7696/eedfe43b-1019-19a0-e053-2995a90a7696.xml

Department of Veterans Affairs/Department of Defense. (2022). VA/DoD clinical practice guideline for the diagnosis and treatment of low back pain. Retrieved from https://www.healthquality.va.gov/guidelines/Pain/lbp/VADoDLBPCPGFinal508.pdf

North American Spine Society. (2020). Evidence-based clinical guidelines for multidisciplinary spine care: diagnosis and treatment of low back pain. https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf

National Library of Medicine. DailyMed. (2018). Label: lidocaine patch. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c66f3b9-6e04-47ab-8d94-21e89ceec154

Food and Drug Administration. (2021). Ztlido label. Retrieved from https://www.ztlido.com/wp-content/uploads/2022/12/ZTlido-LABEL.pdf

National Library of Medicine. DailyMed. (2025). Lidocaine-lidocaine hydrochloride injection, solution. Retrieved from https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=f1b26274-a55e-4321-b96c-ce0df830f205

Santana, J. A., Klass, S., & Felix, E. R. (2020). The Efficacy, Effectiveness and Safety of 5% Transdermal Lidocaine Patch for Chronic Low Back Pain: A Narrative Review. PM & R: the journal of injury, function, and rehabilitation, 12(12), 1260–1267. https://doi.org/10.1002/pmrj.12366

Rowbotham, M. C., Davies, P. S., Verkempinck, C., & Galer, B. S. (1996). Lidocaine patch: double-blind controlled study of a new treatment method for post-herpetic neuralgia. Pain, 65(1), 39–44. https://doi.org/10.1016/0304-3959(95)00146-8

Gross, G. E., Eisert, L., Doerr, H. W., Fickenscher, H., Knuf, M., Maier, P., Maschke, M., Müller, R., Pleyer, U., Schäfer, M., Sunderkötter, C., Werner, R. N., Wutzler, P., & Nast, A. (2020). S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology: JDDG, 18(1), 55–78. https://doi.org/10.1111/ddg.14013

How Topical Medications Alleviate Back/Neck Pain El Paso, TX.

How Topical Medications Alleviate Back/Neck Pain El Paso, TX.

by | Lower Back Pain, Neck Pain

There are different types of topical medications, different ways of delivery and are available for patients with back and neck pain. A physician may combine one or more types of medication for maximum relief or as a way of�limiting the side effects of larger doses of only one medication. Strong dose compounds and controlled drugs are�only�available with a doctor’s prescription.

Medicines that help control/reduce pain include:

  • Narcotics
  • Anti-inflammatories
  • Muscle relaxants
  • Antidepressants
  • Anti-anxiety medications
  • Topical anesthetics

 

11860 Vista Del Sol, Ste. 126 How Topical Medications Alleviate Back/Neck Pain El Paso, TX.

 

Medicines with a low potency and low risk of side effects are available at stores and local pharmacies over-the-counter. But remember medications sold over the counter without a prescription doesn’t mean they are safe to use as much as possible. Please read the label and follow the instructions. Taking higher doses, even acetaminophen e.g. Tylenol can cause liver damage. Discussing these medications with a doctor or pharmacist before purchase would be wise. Your physician should know if you plan to continue using over-the-counter medications.

Medicines with a low potency and low risk of side effects are available at stores and local pharmacies over-the-counter. But remember medications sold over the counter without a prescription doesn’t mean they are safe to use as much as possible. Please read the label and follow the instructions. Taking higher doses, even acetaminophen e.g. Tylenol can cause liver damage. Discussing these medications with a doctor or pharmacist before purchase would be wise. Your physician should know if you plan to continue using over-the-counter medications.

Inform your physician about all the products you take including herbal remedies to decrease the risk of side effects or potential severe drug interactions. When acute pain is present, injections either intravenous or intramuscular injected into the muscles are used. For chronic pain, medications are used and are typically in pill form. Both methods have limitations and different�delivery�approaches may be considered. This includes inhalation or topical on top of the skin applications.

Topical Pain Alleviators

These type of medications come prepared and are applied to the skin via:

Topical medications aim to reduce inflammation and soothe nerve and muscle pain. Some are available with a doctor’s prescription and others are over-the-counter. Medication administered�through the skin is becoming more popular.

Skin Cells

The skin is the largest organ of the body. It serves as�water barrier protection, it regulates body temperature, controls fluid loss, and is important to homeostasis/healthy internal balance.

It is made up of many layers and is supported by a complex blood supply. The blood vessels are in a framework of connective tissue including fat and fascia that holds the tissues together. Below that layer is the bone and muscle. There are also nerve endings that relay touch, temperature, and pain signals from the skin to the spinal cord, to the brain.

 

11860 Vista Del Sol, Ste. 126 How Topical Medications Alleviate Back/Neck Pain El Paso, TX.

 

Compounds�have been developed to safely carry the various medicines through the skin into the blood. These compound enhancers are able to penetrate the skin by opening normally closed channels for a quick time to help the skin absorb the medication/s and then close back up.

Spine Pain

Spine physicians and pain specialists often first recommend topical pain-relievers to help relieve the symptoms of back and neck pain/conditions.

Topical medicines may be used to treat the pain associated with:

  • Neck strain
  • Low back strain
  • Whiplash
  • Muscle inflammation
  • Spasms
  • Osteoarthritis
  • Rheumatoid arthritis
  • Certain types of nerve pain

Topical Advantages

  • Bases like creams, ointments, gels, and sprays make application easy.
  • Symptom relief is faster than oral medicines.
  • Symptoms reduce at a steady rate.
  • Relief can last longer.
  • Not as much medicine is needed when applied in topical form.

As the medication is diffused through the skin and enters the bloodstream, it bypasses the digestive system reducing any unwanted�side effects, like an irritated stomach.

 

Topical Disadvantages

  • Blood flows in different ways to different parts of the body. Education about the product is essential to know where to apply the product like the arm or abdomen and how often.
  • Blood flow to certain parts of the body can change over time. For example, when it’s cold the blood vessels in the skin contract which decreases the absorption of the medicine, while sweating can open the pores too much and allow too much medication to be absorbed too quickly or wash it away completely.
  • The skin could present a negative reaction. Therefore patients need to know what to do if an allergic or other reaction takes place.
  • The skin nerves are different from the spinal nerves, so certain types of neck/back pain may not respond well to topical treatment.
  • Spinal conditions/disorders deep in the body will not respond well to topical therapy.

 

11860 Vista Del Sol, Ste. 128 Sciatica in Cold Weather Can Worsen Symptoms El Paso, TX.

Is it right

Are topical pain-alleviating medications the right for you? The best person to ask is your doctor or healthcare provider. Upon a final diagnosis and medical history, your doctor should offer various treatments/therapies for pain management.

 

Conclusion

Patches and creams can be used to deliver a wide variety of medications. These topicals are becoming popular because of their convenience and, reduction of negative side-effects.

  • For individuals with muscle or tendon inflammation, applying a topical to the affected area limits the amount of medication going to other areas of the body that do not need it.
  • For those that have stomach problems and find it difficult to digest anti-inflammatories, these topicals could be all they need to stay active.
  • Individuals with chronic neck or back pain should discuss these medications with their pain specialist, physician or chiropractor to see if one of these topicals might work for them.

 

El Paso, TX Neck Pain Chiropractic Treatment

 

 

NCBI Resources

Everyone needs to take care of their back/spine because it is what holds us up as long as we keep it straight and strong.�Strengthening the core�can help prevent�a weak and misaligned spine from getting worse�and helps to eliminate pain.

Back safety should be priority one, as it affects all aspects of your life. Not only are you protecting your back, but are preventing future injury. We all need to pay attention to proper body positioning and�body mechanics, as it will pay off in the long run.

 

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