The back pain patch is a transdermal agent for the treatment of back pain of various etiologies and genesis. The dosage 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 pain-relieving properties enter the systemic bloodstream in 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 diseases of the gastrointestinal tract and genitourinary system, which is why medical consultation and examination is necessary.
Classification of transdermal products
Dorsalgia (back pain) occurs due to a functionally reversible blockage of the intervertebral joints. Pathological conditions often precede spondyloarthrosis or osteochondrosis of the lumbar region. Blockages often arise from increased static or dynamic stress, antiphysiological postures and microtraumas. Neuropathologists and rheumatologists warn about the need for complete treatment of dorsalgia, since tissue damage in one area of the spine leads to functional changes in adjacent areas. Compensatory hypermobility gradually develops, which impairs the affected person's quality of life.
Lower back pain occurs in 76% of the population. Severe symptoms are diagnosed in 7% of cases. Back pain resulted in disability for more than 9% of people.
In the treatment of diseases of the musculoskeletal systemPlasters are used to relieve pain, reduce inflammation and swelling. Clinical studies have proven the high effectiveness of transdermal active ingredients for local use with analgesic effects. Therapeutic patches for back pain are classified as follows:
| Group of patches | Characteristics |
|---|---|
| Warm up | The active ingredients of external preparations are extracts from hot peppers or mustard seeds. The mechanism of action of the patches is to improve blood flow to damaged tissues and accelerate their regeneration |
| Heat reflective | The patch contains rare earth metal nanoparticles that 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 plasters is effective in the treatment of dorsalgia of any localization |
| Phytoplastics | Chinese manufacturers offer products for local use that contain extracts of medicinal plants, essential oils and other natural ingredients. Plasters are used not only for therapy, but also for the prevention of diseases of the lumbar spine |
In medical practice, pain lasting 1–1. 5 months is considered acute, and pain lasting 12 weeks is considered chronic. The prescription of patches with analgesic effect is practiced to eliminate discomfort at any stage of 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 tissues of the musculoskeletal system. Such patches are rarely included in the treatment plans of patients with lumbosacral osteochondrosis or radiculitisdue to low effectiveness in quickly eliminating pain of any intensity. The main task of chondroprotective patches is to restore tissue affected by inflammation, which can take several months and sometimes years. Many traumatologists and neurologists are skeptical about this type of drugs for local use, since there is no evidence of 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 country, pain in the lumbosacral region was the main cause of discomfort in 24. 9% of 1300 patients.
Warming plasters with red pepper extract
Pepper patch for back pain is the most popular transdermal agent for treating back pain of any severity. The active ingredients are extracts of red pepper and belladonna, dimethyl sulfoxide and eucalyptus essential oil. Thanks to lanolin (animal wax obtained by boiling sheep's wool) and pine resin, the active ingredients are easily absorbed into the skin and penetrate into inflammatory areas. The following therapeutic effects are characteristic of the pepper patch:
- Painkiller;
- distracting;
- locally irritating.
Capsicum extract has the ability to dilate the 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 extract (Belladonna) is characterized by a pronounced antispasmodic effect, which is achieved due to the alkaloid atropine contained in the plant. Manufacturers have added dimethyl sulfoxide to the patch to relieve inflammatory processes that often accompany back pain. The organic compound inactivates hydroxyl radicals and accelerates metabolic processes in pathological areas.
In people with sensitive skin, using a transdermal product results in severe burning, itching, and blockage of blood vessels at the application site. 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 to treat patients under 14 years of age, pregnant or breastfeeding 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 warming patch with a high content of capsaicin is used. This transdermal product is not intended for use at home as certain requirements must be met when using it.
Capsaicin is a highly selective agonist of vanilloid receptors, 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 area of the adhesive, which is 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. However, when a person is exposed to mechanical stimuli and vibrations, the 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 the patch is applied, only 1% of the active ingredient penetrates the damaged tissue.
The area of application of the external drug is determined by the attending physician, and the procedure is carried out by medical personnel. To reduce the intensity of the discomfort, the patient's skin is first treated with a product with a pronounced anesthetic effect. The patch is applied using 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 and radiculitis, a plaster with nanopowder has proven itself effective against back and lower back pain. The composition of the transdermal product represents a fine mixture obtained through the processing of rare earth materials. A nanopowder with the ability to generate infrared radiation is applied to a hypoallergenic polymer base.
The plaster lasts for 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 focus of inflammation increases, which leads to improved microcirculation. Biologically active nutrients begin to flow into damaged tissue and trigger regenerative processes. This leads to a variety of therapeutic effects, among which the following predominate:
- Improvement of local lymph and blood circulation;
- preventing stagnation;
- normalization of venous outflow;
- relief of the inflammatory process;
- reducing the severity of pain;
- acceleration of metabolic processes;
- Relaxation of spasmodic muscles.
The patch has 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, the use of the patch relieves not only the pain, but also extensive hematomas by improving microcirculation in the damaged tissue.
A Polish manufacturer produces a warming 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 of enterosorbent and iron powder leads to an increase in temperature in the focus of inflammation to 45-50 ° C. The body's heat production occurs through the oxidation of alkaline earth metals, the basis of iron powder.
By deeply heating cramped muscles, the blood supply to damaged tissue is increased and the tone of the skeletal muscles is reduced. The warming effect lasts for 12 hours, then the patch should be removed and any moisturizer rubbed into the area of application.To prevent skin burns, the treatment can be carried out no more than three 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. An absolute contraindication is also the presence of cracks, wounds or scratches on the skin. If the patch is applied to areas of the body whose blood vessels are close to the surface of the skin (e. g. in the groin), the likelihood of burns and irritation increases significantly.
Non-steroidal anti-inflammatory drug patches
When patients ask which patch is better for back pain, 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 enzyme cyclooxygenase. This leads to reduced production of the most important pain and inflammatory mediators, prostaglandins. Most often, in the treatment of radiculitis and lumbar osteochondrosis, a patch containing an active ingredient from the group of phenylacetic acid derivatives is used. The external active ingredient 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 adsorbed from a similar dose of a 1% gel. The transdermal product has many advantages: convenience and low frequency of use, no greasy stains on clothes and bedding after use.
About 5-6% of the phenylacetic acid derivative can enter 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 mainly excreted via the urinary system (65–70%), 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 pharmacy shelves, the active ingredient of which is a non-steroidal anti-inflammatory drug from the group of propionic acid derivatives. Its analgesic effect is also based on blocking prostaglandin synthesis 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 liver failure. Regardless of the stage of pathology, the metabolism of NSAIDs in liver cells does not change, which explains the lack of accumulation.
5–8 hours after the patch is applied, 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 through urine.
The transdermal drug is used as a symptomatic agent for the treatment of neuralgia, lumbago, osteochondrosis and radiculitis in patients over 15 years old. The external agent has a pain-relieving and anti-inflammatory effect and effectively relieves swelling. To increase effectiveness, the note recommends applying the patch to painful areas of the body twice a day. The duration of the course of therapy depends on the severity of the diagnosed disease, but should not exceed 6 days.
Chinese pain patches
Chinese plaster for osteochondrosis is a transdermal product containing extracts of medicinal plants and biologically active substances with chondroprotective properties. After applying the transdermal medication to the area of pain and inflammation, acupuncture points in the spine are activated. The result of this effect is improved blood circulation, the supply of nutrients and biologically active substances to damaged tissue and an acceleration of metabolic processes.
There is not a large selection of Chinese plasters for joints and spine on pharmacy shelves, and doctors rarely include them in patients' therapy plans. Manufacturers do not conduct clinical studies whose results 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 plasters are used:
- A topical remedy containing scorpion powder, bee venom, myrrh, cinnamon, angelica, borneol and about 30 other ingredients;
- A patch containing 88 biologically active substances, including of plant origin: angelica, comfrey and licorice root, Sichuan flower pepper and buffalo horn extract, myrrh, turmeric, orange peel, powder that produces infrared radiation, and others;
- Transdermal agent, which includes saffron, musk, ginger, menthol, myrrh, peach and angelica root extracts, salicylic acid methyl ester, which belongs to the group of non-steroidal anti-inflammatory drugs;
- A preparation containing extracts of aconite, belladonna, cinnamon, parsnip, ginger, chilibuha seeds, myrrh and pine resin, clove bark extract and galangal root.
All herbal components of Chinese plasters have a cumulative effect, so that the pain-relieving effect occurs after several hours and sometimes days. Before use, 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.