Is Capsaicin Patch Safer for Chronic Lower Back Pain Than NSAID or Wintergreen Oil Patches?

Is using capsaicin patches for lower back pain safer than using topical NSAIDs or patches containing wintergreen oil?

Hello, doctor.
I would like to address the issue of long-term application of patches for lower back pain, but I am concerned that patches containing non-steroidal anti-inflammatory drugs (NSAIDs) and those with wintergreen oil might harm my kidneys.
Regarding the capsaicin patches, which compete with pain substances, would it be safer to apply them for no more than 6 hours a day for a duration of 1-2 years? P.S.: I accidentally submitted a very dissatisfied rating on the satisfaction survey for article #165770, and I wanted to change it to very satisfied but couldn't go back to modify it.
I apologize for the inconvenience.

Mr. Li, 20~29 year old female. Ask Date: 2021/03/30

Dr. Yin Xinbei reply Rehabilitation

Transdermal patches containing non-steroidal anti-inflammatory drugs (NSAIDs) are absorbed through the skin and enter the bloodstream in small amounts, which are then metabolized by the kidneys.
Unless multiple patches are applied simultaneously, there is generally no risk of kidney damage for individuals with normal kidney function.
However, unless dealing with severe pain that is difficult to treat, the use of analgesics is not recommended on a daily basis for extended periods, such as several months or even 1-2 years.
Instead, treatment should focus on addressing the underlying causes of pain.
For lower back pain, strengthening exercises for the lumbar muscles and local heat therapy are preferable to long-term use of medicated patches.
For information on the application of capsaicin in pain management, please refer to this article: http://www.pain-manage.org.tw/professional/a18.htm.

Reply Date: 2021/03/30

More Info

When considering the treatment options for chronic lower back pain, particularly the use of topical patches, it is essential to weigh the safety and efficacy of different ingredients. In your case, you are comparing capsaicin patches with NSAID patches and wintergreen oil patches, particularly concerning their long-term use and potential side effects.

Capsaicin, derived from chili peppers, works by depleting substance P, a neuropeptide associated with pain transmission. When applied topically, capsaicin can provide relief from pain by reducing the amount of substance P in the affected area. It is generally considered safe for long-term use, especially when applied in moderation (not exceeding six hours a day, as you mentioned). Studies have shown that capsaicin patches can be effective for various types of pain, including neuropathic pain and musculoskeletal pain, making them a viable option for chronic lower back pain.

On the other hand, NSAID patches, such as those containing diclofenac or ketoprofen, are effective in reducing inflammation and pain. However, they can pose risks, especially with long-term use. NSAIDs can lead to gastrointestinal issues, cardiovascular problems, and renal impairment, particularly in individuals with pre-existing kidney conditions or those taking other medications that may affect kidney function. Therefore, while NSAID patches can provide significant pain relief, their safety profile is a concern for long-term use.

Wintergreen oil patches, which contain methyl salicylate, also provide pain relief through their anti-inflammatory properties. However, similar to NSAIDs, they can have systemic effects and may pose risks to the kidneys and liver, especially if used excessively or in individuals with underlying health issues.

Given your concerns about kidney safety, capsaicin patches may indeed be a safer alternative for long-term management of chronic lower back pain. They do not carry the same systemic risks associated with NSAIDs and wintergreen oil. However, it is crucial to monitor for any local skin reactions or irritation, as capsaicin can cause a burning sensation upon application, especially in sensitive individuals.

In conclusion, while capsaicin patches can be a safer option for chronic lower back pain compared to NSAID and wintergreen oil patches, it is essential to consult with a healthcare provider before starting any long-term treatment. They can help tailor a pain management plan that considers your specific health conditions, potential drug interactions, and overall treatment goals. Regular follow-ups can also ensure that the chosen treatment remains effective and safe over time.

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