#Lidocaine cream for pain skin

In primary care in the UK the incidences, per 100,000 person‐years observation, have been reported as 28 (95% confidence interval (CI) 27 to 30) for postherpetic neuralgia, 27 (95% CI 26 to 29) for trigeminal neuralgia, 0.8 (95% CI 0.6 to 1.1) for phantom limb pain and 21 (95% CI 20 to 22) for painful diabetic neuropathy ( Hall 2008). Many people with these conditions are significantly disabled, with moderate or severe pain for many years.Ĭhronic painful conditions comprised five of the 11 top‐ranking conditions for years lived with disability in 2010 ( Vos 2012), and are responsible for considerable loss of quality of life, employment, and increased health costs ( Moore 2014a).

It is complex ( Apkarian 2011 Tracey 2011), and neuropathic pain features can be found in patients with joint pain ( Soni 2013). Neuropathic pain may be caused by nerve damage, but is often followed by changes in the central nervous system (CNS) ( Moisset 2007). The 2011 International Association of the Study of Pain definition of neuropathic pain is 'pain caused by a lesion or disease of the somatosensory system' ( Jensen 2011), based on an earlier consensus meeting ( Treede 2008). They will be of great help in working out the benefits of topical lidocaine when they are completed and results can be incorporated in this review. There was no clear evidence of an effect of lidocaine on the incidence of adverse events or withdrawals (very low quality evidence).Ī number of studies of topical lidocaine in neuropathic pain are ongoing. There was some indication that topical lidocaine was beneficial in these studies (very low quality evidence). The 508 people in the studies had different types of neuropathic pain, with pain after herpes zoster infection the most common. One study also tested a cream containing amitriptyline, which is an antidepressant. We found 12 small studies of modest quality that tested topical lidocaine against topical placebo for a number of weeks. In July 2014 we performed searches to look for clinical trials where topical lidocaine was used to treat neuropathic pain. Treatment with plasters usually involves applying one, two, or three plasters for up to 12 hours a day.

#Lidocaine cream for pain skin

These contain high concentrations of lidocaine because it crosses the skin poorly. It is available in plasters (or patches), sprays, and creams, as topical lidocaine. Other possible treatments include the use of local anaesthetic applied to the skin. Medicines like paracetamol or ibuprofen are usually not effective in neuropathic pain, while medicines that are sometimes used to treat epilepsy or depression can be very effective in some people with neuropathic pain. Neuropathic pain is treated by different medicines than pain from damaged tissue. It differs from pain messages carried along healthy nerves from damaged tissue (a fall, or cut, or arthritic knee). Neuropathic pain is pain coming from damaged nerves. Topical lidocaine for neuropathic pain in adults Pooling multiple‐dose studies across conditions demonstrated no clear evidence of an effect of lidocaine on the incidence of adverse events or withdrawals, but there were few events and the withdrawal phase of enriched enrolment designs is not suitable to assess the true impact of adverse events (very low quality evidence).

In all but one study, third tier (very low quality) evidence indicated that lidocaine was better than placebo for some measure of pain relief. The two enriched enrolment, randomised withdrawal studies reported time to loss of efficacy. Three single‐dose studies reported participants who were pain‐free at a particular time point, or had a 2‐point (of 10) reduction in pain intensity. Only one multiple‐dose study reported our primary outcome of participants with ≥ 50% or ≥ 30% pain intensity reduction. There was no first or second tier evidence, and no pooling of data was possible for efficacy outcomes. We judged all of the studies at high risk of bias because of small size or incomplete outcome assessment, or both. Seven studies used multiple doses, with one to four‐week treatment periods, and five used single applications. Two studies used enriched enrolment with randomised withdrawal. Most studies used a cross‐over design, and two used a parallel‐group design. Four different formulations were used: 5% medicated patch, 5% cream, 5% gel, and 8% spray. Six studies enrolled participants with moderate or severe postherpetic neuralgia, and the remaining studies enrolled different, or mixed, neuropathic pain conditions, including trigeminal neuralgia and postsurgical or post‐traumatic neuralgia. We included 12 studies (508 participants) in comparisons with placebo or an active control.