How do you cut Lidoderm patches to fit the pain site? Lengthwise or widthwise or in strips?

How you cut them depends on which nerve you are intercepting.

I use 1/2 patch on the tops of my feet for intercepting most of the nerves in the foot. Also 1/4 across the medial side of the ankle if necessary. 1/2 patch behind the knees if necessary to intercept higher. I use whole patches on my lower back when needed.

Strips on fingers/toes are not really going to do much. The amount of lidocaine reduces with each volume decrease cut.

I do use Salonpas patches in strips on my fingers where swelling is obvious and those do work in small amounts.

Do not use Lidoderms on the bottoms of the feet...the skin is too thick there for them to work... and you need to intercept the nerves when they join into a major axon, and not at the dendrite level.

Welcome davidl588. Others will be along.

Thank you so much! This is very helpful. I have postherpetic neuralgia around my lower back. Should I use half a patch per day, or 1 patch or 2 patches per day?

How long should I use the patches? Daily for 2 or 3 days, or longer? I heard some people use them for 12 hours on and then 12 hours off.

Shingles live in the dorsal roots of the spine. So applying a patch along the spine on the side effected, is the most helpful.

You should use a patch every day, 12 hrs on and 12 hrs off.

I used them for over 2 weeks, on my MP nerve pain in my right thigh, and by using every day, the nerve calmed down after many years of over-firing, and went into remission. They don't work instantly either, but over several days you will notice improvements.

These patches work by slowly releasing lidocaine into the area, which then blocks the sodium channels in the nerve axons to prevent the signals from moving to the brain. Not using every day reduces the lidocaine and may not be strong enough to
get the job done.

Where on the back depends on your shingles presentation.
Dermatome maps show which nerves from the spine go where...
http://www.backpain-guide.com/Chapte...culopathy.html

For shingles pain don't put the patches at the endpoints of the map. For example, the blue gray color from lumbar area, go to the feet. Don't put a patch on the feet (that shows that color), but do put it over the lumbar area of the back. It will work better. Sometimes Lidoderms don't stick well... so you may have to tape it down.

Did the pain come back when you were off for 12 hours during those 2 weeks?

No. I can have a brief twinge if exposed to heat..hot tub
Or heating pad. But the all day pain and lightening bolts
Which stabbed me all day long are gone. I didn't expect
A remission but just some relief. The patches were just new
on the market and it took some experimenting to find
the exact spot where the nerve was to place the patches.

I still use them for my feet occasionally and my knee. But not often and I pulse them for about a week, when I do. They have
worked for me well. I have arthritis as well as PN.

I am fortunate to have the shingles diagnosis on file with
my insurance. So they pay for them partially.

I've used the patches for 5 years now, and they are helpful, though somewhat limited because of where my pain is. I have pain in my right torso, neck, jaw and side of face.

I cut the patches in strips and apply them to the spots around the chest and back that are most painful. But my doctor said not to use strips on my face and to avoid areas on the neck close to major veins, so I can't use them in some very, very painful places.

Recently a generic version of Lidoderm has come out and I tried it, but found it extremely inferior. The generic patches are flimsy and don't stick as well, plus I found the adhesive irritating, which hasn't been the case with Lidoderm. The brand drug costs more (of course), but I've needed to stick with it (ha!).

Interesting about the generic.

Brand Lidoderm is all I use. I haven't needed a refill yet.

Lidoderm's adhesive is aqueous based. If you leave one out like I did by accident (a used one), outside where it can absorb dew (I took one off my knee on vacation once and left one on the dock by accident)...
it will swell up and get viscous(jelly-like) .... I think there is something like a gel that swells up on the patch. Sort of like those Soil Moist bits for gardening that swell up when exposed to water.

I remember when Lidoderms were experimental, I read somewhere that getting a good adhesive base was a big challenge and difficult during development.

We used to get endless calls from the nursing homes from the nurses about proper placement and improving adhesion in the long term care patients.

This RXlist link gives the inactive ingredients:
from http://www.rxlist.com/lidoderm-drug.htm

I've bolded the major ingredients that would react to moisture in that list. Polyvinyl alcohol is in some artificial tears products too.

I don't have access to the ingredients in the generic at this time however, to compare

This link shows the aqueous nature of the adhesive layer patent from 1998:
http://www.drugs.com/availability/generic-lidoderm.html

It is important to keep any cut portions of a whole patch in a waterproof sealed ziploc with its backing still on it and intact. I use the original envelope folded down, and placed then in an airtight (air squeezed out) ziploc to prevent the gel backing layer from drying out on any cut portions that I don't use immediately. I use this part up first next application before opening another whole patch.