A lidocaine patch is a topical patch designed to deliver medication directly through the skin to a specific area of pain. This non-opioid option contains the local anesthetic lidocaine for managing discomfort without the need for oral medication. It provides temporary relief by acting right at the site of application, making it a focused approach for managing pain in areas like the shoulder.
How the Patch Delivers Pain Relief
The pain-relieving effect of the patch stems from its active ingredient, lidocaine, which functions as a local anesthetic. Lidocaine works by stabilizing the membranes of nerve cells, effectively blocking the generation and conduction of nerve impulses. This action is achieved by inhibiting the influx of sodium ions, which are necessary for nerves to fire and transmit a pain signal to the brain.
When the patch is applied, the medication slowly penetrates the skin to target the peripheral nerve endings just beneath the surface. The pain relief occurs directly in the tissue under the patch. Less than five percent of the lidocaine is absorbed into the bloodstream, which minimizes the risk of systemic side effects. This localized action disrupts the pain signal without causing numbness or a loss of sensation in the affected area.
Proper Application and Usage for Shoulder Pain
The skin must be clean, dry, and free of any irritation, cuts, or open wounds before application. The patch must be placed directly over the most painful area of the shoulder to ensure the medication targets the affected nerve endings. For a contoured area like the shoulder, the patch can be cut into smaller pieces with scissors before removing the protective liner to ensure a snug fit.
Prescription-strength patches (typically five percent lidocaine) are generally applied once daily and worn for a maximum of 12 hours, followed by a 12-hour patch-free period. Over-the-counter patches (usually four percent lidocaine) are often used up to three times per day, with each application lasting no more than eight hours. Remove the patch before bathing or showering, as excessive water exposure can affect adhesion and drug delivery. Always wash your hands after handling a patch to prevent accidental transfer of medication to sensitive areas like the eyes.
Safety Considerations and Potential Side Effects
The most common side effects are mild and temporary application site reactions. These reactions can include redness, burning, discomfort, or itching on the skin directly beneath the patch. If these localized irritations become severe or do not resolve quickly, the patch should be removed.
Rarely, systemic side effects can occur if too much lidocaine is absorbed, particularly when patches are worn longer than recommended or applied to broken skin. Signs of excessive absorption may include dizziness, lightheadedness, or confusion. The patch is contraindicated for individuals with a known allergy to amide-type anesthetics or those with severely damaged skin. Avoid applying external heat sources, such as heating pads, over the patch, as heat can increase the rate of lidocaine absorption into the bloodstream.
When the Lidocaine Patch is Appropriate for Shoulder Pain
Prescription-strength five percent patches are specifically approved for the relief of post-herpetic neuralgia, a chronic, nerve-related pain that can affect the shoulder area. This higher concentration is typically reserved for neuropathic pain, characterized by burning, shooting, or radiating sensations due to damaged nerves.
Over-the-counter four percent patches are indicated for the temporary relief of minor, localized aches and pains, including general musculoskeletal discomfort, muscle strain, or minor injuries. Lidocaine patches are generally less effective for pain caused primarily by deep inflammation, such as certain forms of arthritis, where anti-inflammatory medications may be a better choice. The patch is most appropriate when the pain is well-defined and close to the skin’s surface.