The 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 the systemic bloodstream at low concentrations, so the list of contraindications for the transdermal drug is significantly shorter than for drugs for oral and parenteral administration. The causes of back pain are often pathologies of the gastrointestinal tract and genitourinary system, so medical consultation and examination are 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. Blockage often occurs due to increased static or dynamic loads, antiphysiological postures, and microtrauma. Neuropathologists and rheumatologists warn of the need for comprehensive treatment of dorsalgia, since 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.
Low 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 have demonstrated 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 |
|---|---|
| Heating | The active ingredients of external preparations are extracts of chili 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 treating back pain of any location |
| Phytoplasties | Chinese manufacturers provide products for local use containing medicinal plant extracts, essential oils and other natural ingredients. The patches are used not only for therapy, but also for the prevention of pathologies of the lumbar spine |
In medical practice, pain that lasts 1-1. 5 months is considered acute, while pain that lasts 12 weeks is considered chronic. The prescription of patches with analgesic effect is practiced to eliminate discomfort at any stage of the pathology.
Relatively recently, transdermal products with chondroprotectors have 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 tissues of the musculoskeletal system. Such patches are rarely included in the treatment regimens of patients with lumbosacral osteochondrosis or radiculitisdue to poor 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 about these types of drugs for local use due to the lack of basic evidence on their therapeutic efficacy.
Back pain 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 disorders was pain in the lumbosacral region.
Heating patches with chili pepper extract
Pepper patch for back pain is the most popular transdermal remedy for treating back pain of any severity. The active ingredients are chili pepper and nightshade extracts, dimethyl sulfoxide, 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 into the inflammatory areas. The following therapeutic actions are characteristic of the pepper patch:
- painkiller;
- distraction;
- locally irritating.
Pepper extract has the ability to dilate blood vessels located in the pain area. The analgesic effect is also manifested by a decrease in muscle tone and an improvement in tissue trophism. Belladonna (nightshade) extract is characterized by a pronounced antispasmodic effect, provided by the alkaloid atropine, which is part of the plant. The manufacturers added dimethyl sulfoxide to the patch to relieve inflammatory processes, a frequent accompaniment of back pain. The organic compound inactivates hydroxyl radicals and accelerates metabolic processes in pathological areas.
In people with sensitive skin, use of a transdermal product will cause severe burning, itching and congestion of blood vessels located at the application site. If you experience any of the listed side effects, 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 breastfeeding 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 roots to nerve endings), a heating patch with a high content of capsaicin is used. This transdermal product is not intended for home use, as certain conditions must be met during application.
Capsaicin is a highly selective agonist of vanilloid receptors, the transient receptor potential of which belongs to type 1. Immediately after local application of the patch, skin pain receptors expressing TRPV1 are activated. The patient feels a burning sensation and redness occurs in the area of the adhesive 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 skin pain receptors under the active influence of capsaicin are reversible, and occur after some time. The response to painful stimuli is restored after 2-4 weeks.
The patch is characterized by slow transepidermal and transdermal absorption. One hour after gluing the patch, only 1% of the active ingredient penetrates the damaged tissue.
The area of application of the external drug is determined by the attending physicianand the procedure is performed by medical personnel. The patient's skin is first treated with a product with strong anesthetic activity to reduce the intensity of discomfort. The patch is applied using 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, radiculitis, a patch with nanopowder for back and lower back pain has proven itself effectively. The composition of the transdermal product is represented by a fine mixture obtained from the processing of rare earth materials. A nanopowder with the ability to produce infrared radiation is applied to 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 the 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 leads to improved microcirculation. Biologically active and nutrients begin to flow towards damaged tissues, triggering regenerative processes. This leads to multiple 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;
- 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, striated skeletal muscles relax and 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 mobility. If the cause of back pain is a fall or severe bruise, the use of the patch will relieve not only pain, but also extensive hematomas by improving microcirculation in damaged tissues.
A Polish manufacturer produces a heating and pain-relieving plaster. The drug 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 between enterosorbent and iron powder leads to an increase in temperature in the inflammatory focus up to 45-50 °C. The body's production of heat occurs through the oxidation of alkaline earth metals, the basis of iron powder.
Deep warming of spasmed muscles helps increase blood flow to damaged tissues and reduce skeletal muscle tone. The warming effect lasts 12 hours, then the patch should be removed and any moisturizer should be rubbed into the application area.To prevent skin burns, the treatment procedure can be performed no more than 3 times every 7 days.. The absence of ingredients in the patch that are absorbed into the systemic circulation ensures a limited number of side effects. The transdermal agent is not prescribed to patients during pregnancy, breastfeeding 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 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 patch is best for back pain, neurologists and rheumatologists give a clear answer: a transdermal agent with nonsteroidal 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. Very 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;
- painkiller;
- 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. The transdermal product has numerous advantages: convenience and low frequency of use, absence of greasy stains on clothes and bed linen after use.
Approximately 5-6% of the phenylacetic acid derivative is able to enter 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 mainly evacuated from the urinary system (65-70%) and the remainder is excreted in the feces. 1% of the active ingredient leaves the body unmetabolised.
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 propionic acid derivative is the possibility of use in the treatment of patients with a history of chronic renal and hepatic failure. Regardless of the stage of the pathology, the metabolism of NSAIDs in liver cells does not change, which explains the absence of their accumulation.
5-8 hours after gluing 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 analgesic and anti-inflammatory activity and effectively relieves swelling. To increase effectiveness, the annotation recommends applying the patch 2 times a day to 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 painkiller patches
Chinese patch for osteochondrosis is a transdermal product that contains extracts of medicinal plants and biologically active substances that have chondroprotective properties. After pasting the transdermal drug to the area of \u200b\u200bpain and inflammation, the acupuncture points located in the spine are activated. The result of this effect is the improvement of blood circulation, the supply of nutrients and biologically active substances to damaged tissues and the acceleration of metabolic processes.
There is no wide range of Chinese joint and spine patches on pharmacy shelves, and doctors rarely include them in patients' treatment regimens. Manufacturers do not conduct clinical studies, the results of which would create an evidence base for the therapeutic efficacy of transdermal drugs.
To reduce the severity of pain, relieve inflammation and swelling, the following Chinese plasters are used:
- An external remedy that contains scorpion powder, bee venom, myrrh, cinnamon, angelica, borneol and about 30 other components;
- A patch containing 88 biologically active substances, including those 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 other;
- Transdermal agent, which includes extracts of saffron, musk, ginger, menthol, myrrh, peach and angelica root, salicylic acid methyl ester, which is part of the group of nonsteroidal anti-inflammatory drugs;
- A preparation that contains extracts of aconite, nightshade, cinnamon, parsnip, ginger, chili seeds, myrrh and pine resins, clove bark extract and galangal root.
All plant components of Chinese plasters have a cumulative effect, so the analgesic effect manifests itself 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 patches are not intended for the treatment of children, pregnant or breastfeeding women.