Lidocaine patches for back pain?

Please comment on the use of lidocaine patches for back pain.
—Felix N. Chien, DO, Rowland Heights, Calif.

At this point, there are no large, randomized, placebo-controlled trials examining the use of lidocaine patches for back pain. Current studies have focused on these patches as adjunctive therapy to more traditional modes of treatment, such as nonsteroidal anti-inflammatory drugs.

Although the studies have been small, mostly open-label, and nonrandomized, results do show promise. For example, Argoff et al found statistically significant pain relief in 41 patients with low back pain using the lidocaine patch (5%) over two weeks (Curr Med Res Opin. 2004;20 Suppl 2:S21-S28). A study presented at the July 2003 meeting of the American Academy of Nurse Practitioners found that approximately 40% of 131 patients with acute or chronic low back pain experienced ≥30% improvement in subjective pain scores. Doses were limited to four patches over 24 hours in each of these studies, and the most common adverse reaction was local skin irritation.
— Christopher Ruser, MD (101-19)

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