The back pain patch is a transdermal agent used to treat back pain of different etiologies and genesis. The pharmaceutical form is characterized by the 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 in low concentrations, so the list of contraindications for the transdermal drug is significantly smaller than for drugs for oral and parenteral administration. The causes of back pain are often pathologies of the gastrointestinal tract and genitourinary system, requiring medical consultations and examinations.
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 as a result of increased static or dynamic loads, antiphysiological postures, and microtraumas. Neuropathologists and rheumatologists warn about the need for complete treatment of back pain, since tissue damage in one area of the spine will lead to functional changes in adjacent areas. Gradually, compensatory hypermobility will form, reducing 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 systempatches are used to minimize pain, relieve inflammation and swelling. Clinical studies have proven the high efficacy of transdermal agents for local use, which have an analgesic effect. Therapeutic patches for back pain are classified as follows:
| Patch group | Characteristics |
|---|---|
| Warming up | The active ingredients of external preparations are extracts of pepper or mustard seeds. The mechanism of action of the patches is to improve blood circulation in damaged tissues and accelerate their regeneration |
| Reflective heat | The patch contains rare earth metal nanoparticles, which have the ability to increase body temperature in areas of inflammation using the body's own resources. |
| Anti-inflammatory | The active ingredients in transdermal medications are nonsteroidal anti-inflammatory drugs. This group of patches is effective in treating back pain of any location. |
| Phytoplasty | Chinese manufacturers provide products for local application containing extracts of medicinal plants, essential oils and other natural ingredients. Plasters are used not only for therapy, but also for the prevention of pathologies of the lumbar spine. |
In medical practice, pain that lasts 1 to 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, bones and joint tissues of the musculoskeletal system.These adhesives 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 about this type of medication for local use due to the lack of evidence of its therapeutic effectiveness.
Back pain 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 of the countries, out of 1, 300 patients, in 24. 9% the main cause of complaints was pain in the lumbosacral region.
Warming Patches with Red Pepper Extract
The pepper patch for back pain is the most popular transdermal remedy for treating back pain of any severity. The active ingredients are extracts of red pepper and belladonna, 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 inflammatory 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 area of pain. The analgesic effect is also manifested in the decrease in muscle tone and the improvement of tissue trophism. Belladonna extract (belladonna) is characterized by a pronounced antispasmodic effect, provided by the alkaloid atropine, which is part of the plant. Manufacturers added dimethyl sulfoxide to the patch to alleviate inflammatory processes, a frequent accompaniment of 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 intense burning, itching and congestion of the blood vessels located at the application site. If any of the listed side effects occur, clean the affected area of the body with a cotton pad dipped in sunflower oil.
The pepper patch is not used to treat patients under 14 years of age, pregnant or lactating women. Absolute contraindications are varicose veins and impaired 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 capsaicin content is used. This transdermal product is not intended for home use as certain conditions must be met at the time of application.
Capsaicin is a highly selective vanilloid receptor agonist, 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 patch area caused by the release of vasoactive neuropeptides. The external medicine is characterized by the following pharmacodynamic effects:
- Capsaicin significantly reduces the sensitivity of cutaneous 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, 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 the patch is applied, only 1% of the active ingredient penetrates the damaged tissue.
The area of application of the external medicine is determined by the attending physician, and the procedure is performed by medical staff. The patient's skin is first treated with a product with pronounced anesthetic activity to reduce the intensity of discomfort. The adhesive is applied with gloves and safety glasses. Such care is necessary to avoid 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 pain in the back and lower back has proven itself well. The composition of the transdermal product is represented by a fine mixture obtained by processing rare earth materials. A nanopowder capable of producing infrared radiation is applied to a hypoallergenic polymeric 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 leads to an improvement in microcirculation. Biologically active substances and nutrients begin to flow into damaged tissues, triggering regenerative processes. This leads to multifaceted therapeutic effects, among which the following predominate:
- improvement of local lymph and blood circulation;
- prevention of stagnation;
- normalization of venous flow;
- relief of the inflammatory process;
- reducing pain intensity;
- acceleration of metabolic processes;
- relaxation of spasmodic muscles.
The patch has analgesic, anti-inflammatory and anti-edematous activity. Under the influence of infrared rays, skeletal striated muscles relax and the optimal transmission of nerve impulses to the central nervous system is restored. Using a transdermal medication for 5 to 7 weeks helps to increase the functional activity of the musculoskeletal system and normalize range of motion. If the cause of back pain is a fall or severe bruise, using the patch will relieve not only pain, but also extensive bruising, improving microcirculation in damaged tissues.
A Polish manufacturer produces a heating and pain relief patch. 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 enterosorbent and iron powder leads to an increase in temperature in the inflammatory focus 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 warming of spasmodic muscles helps to increase blood supply to damaged tissues and reduce the tone of skeletal muscles. The warming effect lasts for 12 hours, then the patch must be removed and any moisturizer must be rubbed into the area of application.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 ensures 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 close to the surface of the skin (for example, in the groin area), the likelihood of burns and irritation increases significantly.
Nonsteroidal anti-inflammatory patches
When asked by patients which patch 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 provoked 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 from the patch during the day corresponds to the volume that was adsorbed from a similar dose of 1% gel. The transdermal product has many advantages: practicality and low frequency of use, without greasy marks on clothes and sheets after use.
About 5-6% of the phenylacetic acid derivative is able to 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 - within 1-3 hours. After glucuronidation in hepatocytes, the phenylacetic acid derivative is evacuated mainly through the urinary system (65-70%) and the remainder is excreted in feces. 1% of the active ingredient leaves the body unmetabolized.
Relatively recently, a patch from a Korean manufacturer appeared on pharmacy shelves, 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 using it in the treatment of patients with a history of chronic renal and hepatic insufficiency. Regardless of the stage of the pathology, the metabolism of NSAIDs in liver cells does not change, which explains the lack of their accumulation.
5-8 hours after gluing 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 in urine.
The transdermal drug is used as a symptomatic agent in the treatment of neuralgia, low back pain, 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 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 adhering the transdermal medication to the area of pain and inflammation, acupuncture points located on 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 not a wide range of Chinese plasters for joints and spine on pharmacy shelves, and doctors rarely include them in patients' treatment regimens. Manufacturers do not conduct clinical trials, the results of which 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:
- External medicine containing scorpion powder, bee venom, myrrh, cinnamon, angelica, borneol and about 30 other components;
- Adhesive 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 producing infrared radiation and others;
- Transdermal agent, which includes extracts of saffron, musk, ginger, menthol, myrrh, peach root and angelica, salicylic acid methyl ester, 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 using them, it must be taken into account that the composition contains many biologically active substances that can provoke a serious allergic reaction. Chinese patches are not intended for the treatment of children, pregnant or lactating women.