Table of ContentsView AllTable of ContentsWhat Is a Lidocaine Patch?Safely Using Lidocaine PatchesHow Fast Does It Work?Side Effects and PrecautionsAlternative Treatment Options
Table of ContentsView All
View All
Table of Contents
What Is a Lidocaine Patch?
Safely Using Lidocaine Patches
How Fast Does It Work?
Side Effects and Precautions
Alternative Treatment Options
The Food and Drug Administration (FDA) approved lidocaine 5% or 1.8% patches for relievingpostherpetic neuralgia(PHN) pain.PHN is long-term nerve pain, which is a common complication ofshingles. These lidocaine patches are prescription-only.
OTC lidocaine 4% patches can be used to relieve minor aches and pains, including back pain.
However, there isn’t enough evidence to recommend the use of lidocaine patches as an effective method of pain relief.
This article discusses what you should know about lidocaine patches for back pain, including how well they work, side effects, how to use them, and more.
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The lidocaine patch is in the local anesthetic drug class.It is available in prescription and OTC forms.
OTC forms of lidocaine patches come as a 4% patch in various brand names such as:
Prescription-only lidocaine patches come in 5% or 1.8% patches. Zlido is a brand name for a 1.8% lidocaine patch. Five percent lidocaine patches are available generically.
The prescription-only lidocaine patches are approved to relieve long-term nerve pain from shingles in adults.
The safety and effectiveness of lidocaine patches in children are unknown.
Other Forms of LidocaineLidocaine as a local anesthetic is available in several other dosage forms, including:CreamLiquid (solution)LotionSprayEye gelEar dropsInjectionLidocaine is also available as an acute (short-term) intravenous (into the vein) infusion forabnormal heart rhythm.
Other Forms of Lidocaine
Lidocaine as a local anesthetic is available in several other dosage forms, including:CreamLiquid (solution)LotionSprayEye gelEar dropsInjectionLidocaine is also available as an acute (short-term) intravenous (into the vein) infusion forabnormal heart rhythm.
Lidocaine as a local anesthetic is available in several other dosage forms, including:
Lidocaine is also available as an acute (short-term) intravenous (into the vein) infusion forabnormal heart rhythm.
How Does a Lidocaine Patch Work?
Are Lidocaine Patches Effective?
Several clinical trials suggest that lidocaine patches are effective for relieving chronic (long-term) low back pain.
However, these studies were nonrandomized and didn’t include a control group to compare against the treatment group using lidocaine patches.This means the results may be subject to potential biases.
For this reason, there isn’t enough evidence to support lidocaine patches' effectiveness in reducing low back pain.
Further high-quality randomized and controlled clinical trials are necessary to study the effectiveness of lidocaine patches for low back pain.
How to Safely Use Lidocaine Patches
In general, keep the following in mind about lidocaine patches:
Since specific directions might vary per person, use lidocaine patches according to the healthcare provider’s recommendations. The following, however, are some typical steps on how to use lidocaine patches:
How Quickly Will a Lidocaine Patch Work?
The amount of lidocaine medication absorbed into the bloodstream will depend on how long the patch is placed on the body and how much of the body is covered with the patch. Repeated use with three patches only once for 12 hours per day, however, doesn’t increase the lidocaine level in the bloodstream.
In one study, healthy participants wore three lidocaine patches on their backs for 12 hours on and 12 hours off during a 24-hour period. They had the highest lidocaine level in the bloodstream at 11 hours. Then, at the end of the 24 hours, there was still some lidocaine left in the bloodstream.
People with PHN may start noticing a difference in pain intensity after four hours of using the lidocaine patch.
Experts may suggest using lidocaine patches for four weeks if you experience pain after your shingles rash disappears. However, if you still experience pain after these four weeks, it is recommended to see a pain specialist.
Common side effects of lidocaine patches are typically mild skin reactions where the patch is on the body.
These skin reactions are usually temporary and will go away within a few minutes or hours. Examples include:
Potentially serious side effects of lidocaine patches may include:
If you use too many lidocaine patches to cover large parts of your body or use the patches longer than 12 hours within a 24-hour period, side effects may include heart-related effects, such asslow heart rateandlow blood pressure.You may also experience the following side effects:
A Word From VerywellSkin reactions to lidocaine patches are common. You may experience burning or other irritation where the patch is put on. If this happens, remove the patch and wait until the irritation subsides before applying it again. Most of the time, the reaction goes away within a couple of hours.—FEMI AREMU, PHARMD, MEDICAL EXPERT BOARD
A Word From Verywell
Skin reactions to lidocaine patches are common. You may experience burning or other irritation where the patch is put on. If this happens, remove the patch and wait until the irritation subsides before applying it again. Most of the time, the reaction goes away within a couple of hours.—FEMI AREMU, PHARMD, MEDICAL EXPERT BOARD
Skin reactions to lidocaine patches are common. You may experience burning or other irritation where the patch is put on. If this happens, remove the patch and wait until the irritation subsides before applying it again. Most of the time, the reaction goes away within a couple of hours.
—FEMI AREMU, PHARMD, MEDICAL EXPERT BOARD
Other than lidocaine patches, an alternative treatment option is a topical medication calledcapsaicin, which comes from thecapsicumor pepper plant.
Experts recommend capsaicin as first-line and lidocaine patches as second-line treatment if you still experience pain after your shingles rash goes away.
As for low back pain, guidelines are conflicting.According to some experts, there isn’t enough evidence to support or rule against the use of topical medications — like lidocaine patches and capsaicin — for low back pain.
Other experts, however, recommend topical capsicum for the short-term treatment of low back pain for up to three months.
Summary
The Food and Drug Administration (FDA) approved lidocaine patches for relieving postherpetic neuralgia (PHN) pain. However, lidocaine patches are also commonly used for low back pain.
If you’re experiencing pain after your shingles rash goes away, experts recommend lidocaine patches as a second-line treatment to capsaicin. People with PHN may feel a difference in pain intensity four hours after using the lidocaine patch. As for lidocaine patches for low back pain, there isn’t enough evidence to support or rule against this use.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Lidocaine transdermal patch.Food and Drug Administration.Lidoderm label.Department of Veterans Affairs/Department of Defense.VA/DoD clinical practice guideline for the diagnosis and treatment of low back pain.North American Spine Society.Evidence-based clinical guidelines for multidisciplinary spine care: diagnosis and treatment of low back pain.DailyMed.Label: lidocaine patch.Food and Drug Administration.Ztlido label.DailyMed.Label: Lidocaine- lidocaine hydrochloride injection, solution.Santana JA, Klass S, Felix ER.The efficacy, effectiveness and safety of 5% transdermal lidocaine patch for chronic low back pain: a narrative review.PM R. 2020;2(12):1260-1267. doi:10.1002/pmrj.12366Rowbotham MC, Davies PS, Verkempinck C, Galer BS.Lidocaine patch: double-blind controlled study of a new treatment method for post-herpetic neuralgia.Pain. 1996;65(1):39-44. doi:10.1016/0304-3959(95)00146-8Gross GE, Eisert L, Doerr HW, et al.S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia.JDDG. 2020;18(1):55-78. doi:10.1111/ddg.14013
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Lidocaine transdermal patch.Food and Drug Administration.Lidoderm label.Department of Veterans Affairs/Department of Defense.VA/DoD clinical practice guideline for the diagnosis and treatment of low back pain.North American Spine Society.Evidence-based clinical guidelines for multidisciplinary spine care: diagnosis and treatment of low back pain.DailyMed.Label: lidocaine patch.Food and Drug Administration.Ztlido label.DailyMed.Label: Lidocaine- lidocaine hydrochloride injection, solution.Santana JA, Klass S, Felix ER.The efficacy, effectiveness and safety of 5% transdermal lidocaine patch for chronic low back pain: a narrative review.PM R. 2020;2(12):1260-1267. doi:10.1002/pmrj.12366Rowbotham MC, Davies PS, Verkempinck C, Galer BS.Lidocaine patch: double-blind controlled study of a new treatment method for post-herpetic neuralgia.Pain. 1996;65(1):39-44. doi:10.1016/0304-3959(95)00146-8Gross GE, Eisert L, Doerr HW, et al.S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia.JDDG. 2020;18(1):55-78. doi:10.1111/ddg.14013
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Lidocaine transdermal patch.Food and Drug Administration.Lidoderm label.Department of Veterans Affairs/Department of Defense.VA/DoD clinical practice guideline for the diagnosis and treatment of low back pain.North American Spine Society.Evidence-based clinical guidelines for multidisciplinary spine care: diagnosis and treatment of low back pain.DailyMed.Label: lidocaine patch.Food and Drug Administration.Ztlido label.DailyMed.Label: Lidocaine- lidocaine hydrochloride injection, solution.Santana JA, Klass S, Felix ER.The efficacy, effectiveness and safety of 5% transdermal lidocaine patch for chronic low back pain: a narrative review.PM R. 2020;2(12):1260-1267. doi:10.1002/pmrj.12366Rowbotham MC, Davies PS, Verkempinck C, Galer BS.Lidocaine patch: double-blind controlled study of a new treatment method for post-herpetic neuralgia.Pain. 1996;65(1):39-44. doi:10.1016/0304-3959(95)00146-8Gross GE, Eisert L, Doerr HW, et al.S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia.JDDG. 2020;18(1):55-78. doi:10.1111/ddg.14013
MedlinePlus.Lidocaine transdermal patch.
Food and Drug Administration.Lidoderm label.
Department of Veterans Affairs/Department of Defense.VA/DoD clinical practice guideline for the diagnosis and treatment of low back pain.
North American Spine Society.Evidence-based clinical guidelines for multidisciplinary spine care: diagnosis and treatment of low back pain.
DailyMed.Label: lidocaine patch.
Food and Drug Administration.Ztlido label.
DailyMed.Label: Lidocaine- lidocaine hydrochloride injection, solution.
Santana JA, Klass S, Felix ER.The efficacy, effectiveness and safety of 5% transdermal lidocaine patch for chronic low back pain: a narrative review.PM R. 2020;2(12):1260-1267. doi:10.1002/pmrj.12366
Rowbotham MC, Davies PS, Verkempinck C, Galer BS.Lidocaine patch: double-blind controlled study of a new treatment method for post-herpetic neuralgia.Pain. 1996;65(1):39-44. doi:10.1016/0304-3959(95)00146-8
Gross GE, Eisert L, Doerr HW, et al.S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia.JDDG. 2020;18(1):55-78. doi:10.1111/ddg.14013
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