Okay... this a good time to explain patches, I guess!

There are several types.

1) Fentanyl (Duragesic) --this is a very potent narcotic and effective but has alot of warnings with it to NOT use in people who are not already using high doses of another narcotic.
(the term is opiate naive). There can be severe side effects and even death if it is improperly prescribed and monitored.
But for severe pain...it is effective.

2) Lidoderm patches -- these contain lidocaine which is a numbing agent. They were designed specifically for post herpetic neuralgia, but they have been shown to work very well for other chronic pain issues. I started these right when they came out.. and really like them. They help me tremendously.
(placement can be tricky, and failure with them may reflect where they are placed).

3) Salonpas-- These are over the counter pain patches with different formulas. I use the ones with methyl salicylate in them. They are more effective than BenGay or IcyHot patches which only have menthol in them.

4) Flector-- these are new in USA, and I am trying to get some. It looks like I will have to wait until September, since my doctor is leary of new things...
These have the NSAID diclofenac in them. I expect them to work like the Salonpas. However the Salonpas cost pennies each and Flector costs mega DOLLARS!
They have been in Europe for about 15 years, and have just been approved for "short term pain" here around January 08.

5) There is an antidepressant in patch form, called Emsam.
However, as of now, the company that makes it is not targeting it for pain. That might change in the future, as many drugs become commonly prescribed off label.

I personally like the patch idea. I use both Salonpas and Lidoderm with great success. (Lidoderms are expensive if your insurance does not cover them). Salonpas are extremely INexpensive.