By Lisa Collier Cool | Posted December 22 2010
Commonly used in Europe and Japan instead of oral analgesics, pain patches offer Americans a convenient treatment, while avoiding some of the side effects of taking aspirin and other pills. Applied to the painful area, patches release medication that’s absorbed through the skin, says Christopher Gharibo, MD, medical director of pain medicine, department of anesthesiology, NYU Langone Hospital for Joint Diseases. “Because the drug doesn’t pass through the stomach or intestines, and very little of it gets into the bloodstream, pain patches have an improved safety profile.”
In June, Dutch researchers reported that non-steroid anti-inflammatory drugs (NSAIDs)—a drug category that includes aspirin, ibuprofen and naproxen—can quadruple risk for GI problems ranging from mild indigestion to hospitalization for serious disorders like digestive tract bleeding, perforation or obstructions. Only four out ten patients at high risk for these complications received appropriate therapies to guard against them, such as combining NSAIDs with GI tract-protecting drugs, the study of more than 50,000 patients found.
While NSAIDs are typically prescribed for moderate discomfort (or to combat inflammation), until recently, doctors had to turn to stronger pills, such as opiates, to treat highly painful conditions, such as postherpetic neuralgia (PHN). After an attack of shingles, PNH can damage nerves, sparking sharp, burning, or shooting pain severe enough to disrupt sleep, mood and daily activities, says Dr. Gharibo. “Some patients develop such extreme sensitivity that they can’t wear clothing comfortably, walk outside in a windy day, or let someone touch them.”
Now, a new FDA-approved pain patch called Qutenza provides a non-narcotic treatment for PHN containing a synthetic form of capsaicin, the “hot” ingredient in chili peppers. The Qutenza patch is applied in a doctor’s office to provide pain relief lasting for up to 12 weeks. “It’s as effective as pills like Vicodin or opiates, without causing drowsiness or disrupting cognitive function,” says Dr. Gharibo, which are common side effects of the powerful oral drugs formerly prescribed for PHN.
Another prescription patch for post-shingles nerve pain contains lidocaine, a type of local anesthetic. Lidocaine patches are worn for up to 12 hours, compared to a one-hour application for Qutenza. Another non-narcotic pain treatment, the Flector Patch, relieves acute pain from muscle or tendon strains, sprains and bruises. Since it contains a NSAID, it shouldn’t be combined with oral NSAIDs to avoid excessive dosages. The Flector Patch is available in more than 40 countries, including the US.
Before considering a prescription patch (or pills), Dr. Gharibo advises patients to treat muscle aches and pains with heat or cold packs or an over-the-counter pain patch. Brands available in the US include Johnson & Johnson’s Bengay and Tylenol Precise, Sanofi-Aventis’ Icy Hot, and Hisamitsu’s Salonpas. Most of these products contain camphor or menthol, which spark a warm sensation that helps block pain receptors. “Home therapies can be beneficial for minor discomfort and should be tried first,” says Dr. Gharibo. Remember to review package information and instructions carefully before beginning any over-the-counter medicine, and consult your primary care doctor if you have questions about whether a product is appropriate for you. Also consult your primary care doctor about pain that’s severe enough to keep you awake or disrupt daily activities, doesn’t respond to home treatment, or persists more than a few days.
CONNECT THE DOTS
For more information on creams, gels and patches for aching joints and postherpetic neuralgia visit the Mayo Clinic website. Also read Patches for Pain Relief Take Hold in the U.S. in the Wall Street Journal.
PREVIOUS POST
