Lidocaine patches can help temporarily relieve some types of lower back pain. You can buy these patches over the counter or talk with a doctor about prescription-strength options.

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Lidocaine patches are a treatment option for lower back pain. Your doctor can prescribe higher-strength lidocaine, or you can purchase a lower-strength patch over the counter (OTC).

There’s evidence that lidocaine patches work to relieve back pain, but it’s possible those results are from the placebo effect.

It’s important to use patches as directed to avoid overdose or side effects.

Here’s what to know about how lidocaine patches work, how to use them, and what types of pain they help with. Plus, learn about alternatives to lidocaine patches that can also provide symptom relief.

Lidocaine is a local anesthetic, which means it temporarily reduces sensitivity to pain in specific areas of your body.

While it has a few other uses, one of the most common is as a topical anesthetic applied directly to your skin. Topical lidocaine comes in different strengths and different formulations, like creams, ointments, and transdermal (skin) patches.

You apply lidocaine patches to your skin, directly over the area that hurts. While you wear the patch, the lidocaine is continuously absorbed through your skin. It works directly on nearby pain fibers, interfering with their ability to send pain signals to and from your brain.

The benefit of lidocaine patches is that the medication continues working longer than it does after a single application of a cream or lotion.

In general, prescription strength 5% lidocaine patches can stay on for 12 hours, but after removing it, you need to wait 12 hours before putting on a new one (12 hours on, 12 hours off). OTC 4% patches can stay on for up to 8 hours at a time.

It’s important to understand that lidocaine isn’t effective for all types of pain and its effects can vary, which means it may not work the same for you as it did for someone else. But research has shown that it’s an effective pain reliever, used alone or in combination with other treatments, for several different types of pain.

Lidocaine patches have shown promise in treating several types of back pain, including chronic lower back pain, disk-related pain, and arthritis pain. However, there’s not yet enough research to support its use in general practice.

According to the North American Spine Society’s (NASS) 2020 clinical guidelines for practitioners, there’s not enough evidence to make a recommendation for or against lidocaine patches for lower back pain.

The research supporting its use in chronic lower back pain is positive but of low quality. A 2020 narrative review found there was evidence that 5% lidocaine patches relieved pain, but that evidence was based on studies without important controls in place. As a result, the placebo effect may be at play in these results.

Although weak, evidence from past studies shows that 5% lidocaine may reduce pain and improve quality of life for some people. It may be particularly helpful for people with pain in a specific area or people who have increased pain sensitivity (hyperalgesia).

Researchers have also studied the potential of topical lidocaine to treat:

Your healthcare professional may recommend lidocaine patches as an additional treatment alongside other therapies for back pain.

Where do you get lidocaine patches?

OTC lidocaine patches are available without a prescription at pharmacies and online retailers. They come under a variety of brand names. Higher-strength lidocaine patches require a doctor’s prescription.

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You should apply lidocaine patches according to your doctor’s instructions or the instructions on the package of your OTC brand. But generally, applying patches involves the following steps:

  1. Trim excess hair on your back.
  2. Check your skin to make sure it’s free of scratches, spots, or lesions.
  3. Wash and dry your skin at the application site.
  4. Wash your hands.
  5. Remove a patch from its pouch.
  6. Peel off the protective backing, taking care not to touch the medicated area.
  7. Apply the patch to the affected area.

Lidocaine patches can be cut into smaller pieces before application, if necessary. But be sure to keep the protective liner in place while you cut the patch. And remember not to apply more than one at a time unless instructed to do so by a healthcare professional.

Using your lidocaine patches will depend on the brand you choose and dosage strength:

  • Prescription 5% lidocaine patches: These are worn for no more than 12 hours at a time. After you take off one 5% patch, you should wait at least 12 hours before applying a new one.
  • OTC 4% lidocaine patches: These are worn for no more than 8 hours at a time, no more than three times per day.

Avoid reusing patches and mixing patches with other topical pain relievers such as gels or creams.

It’s also recommended not to use a heating pad while wearing a lidocaine patch.

Safe disposal of lidocaine patches

Lidocaine patches can be harmful to both children and pets. Take care to dispose of them someplace safe, where they won’t be accidentally eaten or touched.

Throw out used patches by folding them in half so that the medicated side is covered. You may also want to place them back in their pouch before throwing them away.

Lidocaine patches can have side effects even when you use them as directed. If you experience burning, redness, or swelling where you apply the patch, remove it. If the symptoms don’t go away, call your doctor.

If you experience any of these uncommon symptoms after using a lidocaine patch, call your doctor:

  • hives, blisters, itching, or rashes
  • bruising
  • weakness, dizziness, fainting, or confusion
  • swelling of any part of the body
  • nausea or vomiting
  • hoarseness
  • trouble breathing or swallowing
  • lightheadedness, fatigue, change in skin color
  • fast pulse (tachycardia) or rapid breathing
  • unusual thirst

Lidocaine overdose

You can overdose on lidocaine if you wear a patch for too long or wear too many patches at once. Symptoms of a lidocaine overdose include:

  • lightheadedness
  • confusion
  • euphoria
  • nervousness
  • dizziness
  • drowsiness
  • sensory changes, like ringing in the ears or blurry vision
  • vomiting
  • temperature changes
  • twitching, shaking, or seizures

If you have signs of an overdose, call 911 or poison control.

There are a number of alternatives to lidocaine patches that can help reduce your lower back pain. There are even other types of patches that may work for you.

  • Capsaicin patch: NASS recommends topical capsaicin for the treatment of lower back pain. Capsaicin is made with a compound found in chili peppers. You can find OTC creams and patches at pharmacies and other retailers. There is also a prescription-strength capsaicin patch called Qutenza.
  • CBD patch: CBD patches provide a continuous dose of pain-relieving CBD directly to the painful area in your lower back. Patches can be worn for several days and may help relieve several types of back pain.
  • Heat therapy patch: Heat patches work like a heating pad to warm up your muscles and provide pain relief. They are convenient to wear when you’re on the go and don’t have access to an electric heating pad.
  • Menthol patch: Menthol patches, along with creams and ointments, can produce a numbing sensation that may help reduce pain and soothe sore muscles.
  • TENS machine patch: TENS machines provide electrical stimulation that can help reduce pain for some people. Some options, like Aleve Direct Therapy, are applied like a patch to wear on the go.
  • Other prescription patches: You can talk with a doctor about other medicated patches that might help relieve your back pain. These may include patches containing nonsteroidal anti-inflammatory drugs (NSAIDs) like the Flector patch (diclofenac epolamine 1.3%).

Lidocaine patches are a generally safe and effective therapy for lower back pain. To avoid overdose or other harm, it is important to use as directed and to stop using the patches if you experience side effects.