A back pain patch is a transdermal drug used in the treatment of dorsalgia of various etiologies and genesis. The dosage form is characterized by a gradual release of the active ingredients, which provides a long therapeutic effect. The active substances of all patches with analgesic properties penetrate into the systemic circulation in an insignificant concentration, therefore the list of contraindications for a transdermal agent is significantly shorter than for drugs for oral administration and parenteral administration. The causes of back pain are often pathologies of the gastrointestinal tract and organs of the genitourinary system, therefore, medical consultation and examination are necessary.
Dorsalgia (back pain) develop as a result of functionally reversible blocking of the intervertebral joints. Pathological conditions often precede spondylarthrosis or osteochondrosis of the lumbar spine. Blocking often occurs as a result of increased static or dynamic loads, anti-physiological postures and microtrauma. Neurologists and rheumatologists warn of the need for a full treatment of dorsalgia, since tissue damage in one area of the spinal column will lead to functional changes in adjacent areas. Compensatory hypermobility is gradually forming, which reduces the quality of human life.
Pain in the lower back and back occurs in 76% of the population. Intense discomfort is diagnosed in 7% of cases. In more than 9% of people, dorsalgia has caused disability.
In the treatment of pathologies of the musculoskeletal system, patches are used to minimize pain, relieve the inflammatory process and swelling. In clinical trials, the high efficacy of transdermal preparations for local use, which have an analgesic effect, has been proven. Therapeutic patches for back pain are classified as follows:
|Warming up||The active ingredients of external preparations are extracts of hot pepper or mustard seeds. The mechanism of action of the patches is to improve blood circulation in damaged tissues, accelerate their regeneration|
|Reflective heat||The patch consists of rare-earth metal nanoparticles with the ability to increase body temperature in the foci of inflammation due to the body’s own resources|
|Anti-inflammatory||The active substances of transdermal drugs are non-steroidal anti-inflammatory drugs. This group of patches is effective in the treatment of dorsalgia of any location.|
|Herbal Adhesives||Chinese manufacturers supply topical products containing medicinal plant extracts, essential oils and other natural ingredients. Patches are used not only for therapy, but also for the prevention of pathologies of the lumbar spine|
In medical practice, pain lasting 1-1,5 months is considered acute, and lasting for 12 weeks is considered chronic. The appointment of patches with an analgesic effect is practiced to eliminate discomfort at any stage of the pathology.
Relatively recently, transdermal drugs with chondroprotectors appeared on the pharmacy shelves. They include chondroitin, glucosamine, sometimes hyaluronic acid with B vitamins that can improve innervation. These biologically active substances are the structural units of cartilage, bone, articular tissues of the musculoskeletal system. Such patches are rarely included in therapeutic regimens of patients with lumbosacral osteochondrosis or radiculitis due to the low efficiency of the rapid elimination of pain syndrome of any intensity. The main task of chondroprotective patches is the restoration of tissues affected by inflammation, which can take several months, and sometimes years. Many traumatologists and neuropathologists are skeptical of this type of drug for local use due to the lack of evidence of their therapeutic effectiveness.
Dorsalgia is one of the first places in the structure of medical treatment. According to the results of epidemiological studies conducted in leading clinics of the country, out of 1300 patients in 24,9%, the main cause of complaints was pain in the lumbosacral region.
Red Pepper Warming Adhesive
Pepper patch for back pain is the most popular transdermal treatment for dorsalgia of any severity. The active ingredients are extracts of red hot pepper and belladonna, dimexide, eucalyptus essential oil. Thanks to lanolin (animal wax obtained by digestion of sheep’s wool) and pine rosin, active substances are easily absorbed by the skin and penetrate into inflammatory foci. For a pepper patch (from 25 rubles), the following therapeutic actions are characteristic:
- locally irritating.
Capsicum extract has the ability to dilate blood vessels localized in the area of pain. The analgesic effect is also manifested in a decrease in muscle tone and an improvement in trophic tissue. The belladonna extract (belladonna) is characterized by a pronounced antispasmodic effect, which provides the atropine alkaloid that is part of the plant. Manufacturers added dimexide to the patch to stop inflammatory processes – frequent companions of dorsalgia. The organic compound inactivates hydroxyl radicals and accelerates the course of metabolic processes in the foci of pathology.
In people with sensitive skin, the use of a transdermal product will cause severe burning, skin itching, and blood vessels overflowing at the place of sticking. If any of these side effects occur, you should wipe the affected area of the body with a cotton pad dipped in sunflower oil.
Pepper patch is not used in the treatment of patients under 14 years of age, pregnant and breast-feeding women. Absolute contraindications are varicose veins and impaired skin integrity.
To eliminate the peripheral neuropathic pain that occurs when the peripheral nervous system is damaged (from the roots to the nerve endings), a warming patch with a high content of capsaicin – Kutenza (from 17000 rubles) is used. This transdermal product is not intended for use at home, since when it is glued, certain conditions must be met.
Capsaicin is a highly selective vanilloid receptor agonist whose transient receptor potential is of type 1. Immediately after local application of Kutenza, skin pain receptors expressing TRPV1 are activated. The patient feels a burning sensation, and in the area of gluing, redness occurs due to the release of vasoactive neuropeptides. For the external drug, the following pharmacodynamic effects are characteristic:
- Capsaicin significantly reduces the sensitivity of skin pain receptors to mediators. But under the influence of mechanical and vibrational stimuli, a person’s ability to experience pain remains unchanged;
- changes in skin pain receptors under the active influence of capsaicin are reversible, which happens after some time. The response to pain stimuli is restored after 2-4 weeks.
Kutenza is characterized by slow transepidermal and transdermal absorption. One hour after gluing the patch, only 1% of the active ingredient penetrates into 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. Previously, the patient’s skin is treated with a means with a pronounced anesthetic activity, for example, Emla, to reduce the intensity of discomfort. The patch is glued on with gloves and goggles. Such precautions are necessary to prevent redness of the epidermis and irritation of the mucous membranes.
Heat Reflecting Adhesives
In the treatment of lumbar osteochondrosis, intervertebral hernia, radiculitis, the patch for pain in the back and lower back Nanoplast Forte has proven itself (from 119 rubles). The composition of the transdermal agent is represented by a finely divided mixture obtained from the processing of rare-earth materials. A nanopowder with the ability to produce infrared radiation is deposited on a hypoallergenic polymer base.
The duration of exposure to Nanoplast Forte is 12 hours. The following topical application can be used only after 6 hours.
Even “neglected” joint problems can be cured at home! Just remember to smear it once a day.
The mechanism of the pharmacological action of the drug is the combined effect of infrared radiation and the magnetic field generated by rare-earth materials. In the inflammatory focus, the temperature rises, which leads to an improvement in microcirculation. Biologically active and nutrients begin to come to damaged tissues, starting regenerative processes. This leads to multifaceted therapeutic effects, among which the following prevail:
- improvement of local lymph and blood circulation;
- prevention of stagnation;
- normalization of venous outflow;
- relief of the inflammatory process;
- a decrease in the severity of pain;
- acceleration of metabolic processes;
- relaxation of spasmodic muscle muscles.
Nanoplast Forte exhibits analgesic, anti-inflammatory and decongestant activity. Under the influence of infrared rays, striated skeletal muscles relax, optimal transmission of nerve impulses to the central nervous system is restored. The use of a transdermal preparation for 5-7 weeks helps to increase the functional activity of the musculoskeletal system, to normalize the range of motion. If the cause of dorsalgia is a fall or a severe bruise, then the use of Nanoplast Forte will relieve not only pain, but also extensive hematomas due to improved microcirculation in damaged tissues.
The Polish manufacturer Master Farm produces a heating and analgesic patch Ketonal Thermo (about 800 rubles for 10 pieces). Despite the immediate association with ketoprofen, the drug does not contain non-steroidal anti-inflammatory drugs. The active ingredient of Ketonal Thermo is a glandular powder. Activated carbon acts as a catalyst for biochemical reactions.
The interaction of enterosorbent and glandular powder leads to a rise in temperature in the inflammatory focus to 45-50 ° C. The production of heat by the body occurs during the oxidation of alkaline earth metals – the basis of glandular powder.
Deep warming of spasmodic muscles helps to increase blood supply to damaged tissues, reduce the tone of skeletal muscles. The warming effect persists for 12 hours, then the patch should be peeled off, and any moisturizer should be rubbed into the application area. In order to prevent skin burns, the treatment procedure can be carried out no more than 3 times in 7 days. The absence of ingredients absorbed into the systemic circulation in Ketonal Thermo provides a small number of side effects. A transdermal drug is not prescribed to patients during the bearing of a child, during lactation and menstruation. The presence of cracks, wounds, and scratches on the skin also becomes an absolute contraindication. When a patch is applied to areas of the body with blood vessels located close to the skin surface (for example, the inguinal region), the likelihood of burns and irritation increases significantly.
Non-steroidal anti-inflammatory adhesives
To patients’ question about which patch for back pain is better, neuropathologists and rheumatologists give a definite answer – a transdermal drug with non-steroidal anti-inflammatory drugs. NSAIDs reduce the severity of clinical manifestations, eliminate the pathology that provoked them by blocking the cyclooxygenase enzyme. This leads to a decrease in the production of major mediators of pain and inflammation of prostaglandins. Most often, in the treatment of radiculitis and lumbar osteochondrosis, the Voltaren patch (from 149 rubles) with the active ingredient diclofenac is used. The composition of the external agent also includes levomenthol, which has the following actions:
- local irritant;
- weak antiseptic.
The amount of diclofenac released from the Voltaren patch during the day corresponds to the amount that was adsorbed from a similar dose of 1% Voltaren gel. The transdermal product has many advantages: convenience and low frequency of use, the absence of greasy marks on clothes and bedding after application.
About 5-6% of diclofenac is able to penetrate the bloodstream, however, this amount is not enough for the development of pronounced systemic side effects. T1 / 2 of inactive metabolites of a non-steroidal anti-inflammatory drug – within 1-3 hours. After glucuronidation in hepatocytes, diclofenac is evacuated mainly by the urinary system (65-70%), and the rest is excreted in feces. 1% of the active ingredient leaves the body in a non-metabolized form.
Relatively recently, the Ketotop patch (from 370 rubles) from the Korean manufacturer, the active ingredient of which is the non-steroidal anti-inflammatory drug ketoprofen, appeared on the shelves of pharmacies. Its analgesic activity is also based on blocking the synthesis of prostaglandins by inhibiting cyclooxygenase.
The undoubted advantage of ketoprofen is the possibility of using in therapy patients with a history of chronic renal and hepatic insufficiency. Regardless of the stage of the pathology, the NSAID metabolism in the liver cells does not change, which explains the lack of its cumulation.
5-8 hours after gluing the Ketotop patch, its biological concentration in the blood serum reaches 0,08–0,15 μg / ml. Ketoprofen is metabolized by hepatocytes during the glucuronidation reaction, and conjugates are excreted from the human body mainly with urine.
A transdermal drug is used as a symptomatic agent in the treatment of neuralgia, lumbago, osteochondrosis, radiculitis in patients older than 15 years. An external agent has analgesic, anti-inflammatory activity, effectively relieves swelling. To increase efficiency in the annotation, it is recommended to stick 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 it should not exceed 6 days.
Chinese painkillers patches
Chinese patch for osteochondrosis is a transdermal drug that contains extracts of medicinal plants and biologically active substances with the properties of chondroprotectors. After gluing the transdermal preparation on the area of pain and inflammation, the acupuncture points located in the spinal column are activated. The result of this effect is the improvement of blood circulation, the delivery of nutrient and biologically active substances to damaged tissues, and the acceleration of metabolic processes.
On the shelves of pharmacies there is no wide range of Chinese plasters for joints and spine, and doctors rarely include them in therapeutic regimens of patients. Manufacturers do not conduct clinical trials, the results of which would form the 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:
- “Black jade” (from 250 rubles). The composition of the external product includes scorpion powder, bee venom, myrrh, cinnamon, angelica, borneol and about 30 other components;
- “Lao Gaoyao” (from 550 rubles). Contains 88 biologically active substances, including those of plant origin: angelica, comfrey and licorice root, extract of Sichuan multi-flowered pepper and buffalo horn, myrrh, turmeric, orange peel, infrared radiation-producing powder, and others;
- “Red Tiger” (from 450 rubles). The composition of the transdermal product includes saffron, musk, ginger, menthol, myrrh, peach and angelica root extracts, methyl salicylate, which is part of the group of non-steroidal anti-inflammatory drugs;
- “Shangshi Zhitong Gao” (from 180 rubles). The preparation contains extracts of aconite, belladonna, cinnamon, parsnip, ginger, chilibuha seeds, myrrh and pine resins, an extract of clove bark and galanga root.
All plant components of Chinese plasters have a cumulative effect, so the analgesic effect occurs after a few hours, and sometimes days. Before using them, it should be borne in mind that the composition includes many biologically active substances that can provoke a pronounced allergic reaction. Chinese patches are not intended for the treatment of children, pregnant and breastfeeding women.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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