For those of you who have used lidocaine patches, how long till you know if they're going to help? My son's been using them for two days and hasn't found them particularly helpful. He gets more relief from the heating pad, but they said not to use the heating pad with the patch on.

The doctor's office said to give it a few days, but it seems like something topical would have pretty immediate results if it was going to help.

Thanks.

I used the Lidoderm for 2 weeks on my Lateral femoral nerve pain. It worked in about 3 days. Then after 2 weeks, the nerve stopped firing so much and I got a remission.

The patches have to be placed in a "sweet spot"...and I found that over a main nerve path was best. Placed over an end point where you "feel" the pain, is not going to work, IMO.
I use anatomy charts to determine my placement now for my feet.

The Lidoderm website says some people experience relief right away but that it can take up to two weeks for effectiveness in some individuals. It does seem like they would work pretty quickly for cutaneous pain.

I use a similar tactic as Mrs. D with my compounded cream, I put it on both the fussy area and over the nerve tract.

Lidoderm patches were one of the few things that gave me relief and were particularly helpful in areas where things were touching my skin like on my ankle where my shoes would rub against the skin and cause pain or (after my spread) under my bra straps. I would give them the maximum time and try out in a few locations to see where they help most. Remember that you can cut the patches into different sizes and shapes so that they work best. I usually cut then in half or thirds and would use in multiple locations at once. I DID use them in conjuction with heating pads for greater relief during flares...but it's not recommended.

I actually prefer the Watson brand and notice they seem to not only stick better but give greater pain relief.

The worst of his pain is on the top of his foot, just where the ankle bends and also a little below the bend. (Right below where two of the biggest screws are.) I'm not sure what nerve tract that would be. I'm having him wear the patch at night while he's sleeping, so that he can still use the heating pad during the day. Then, when (and if) they start to be effective, he can switch to daytime wear.

Pain on the dorsum of the foot can be referred from both the superficial peroneal (runs in between the big tendons at the front of the ankle) and the saphenous nerve which runs in front of the malleolus (find the big saphenous vein at the inside ankle knob and the nerve runs anterior to that). There are two major curtaneous nerves on the dorsal foot, the lateral dorsal cutaneous nerve and the medial dorsal cutaneous. The lateral is palpable beneath the skin at the bend at the front of the ankle, very easy to put cream on. Look them up online, you can actually see the dorsal cutaneous on some people and find it easily where it rolls across the big tendon at the left front of the ankle where the "bend" is.

Or you can avoid the anatomy lesson and just put the patch across the front of the ankle from one malleolus to the other and you will pretty much hit all of them! FYI, swelling at the anterior ankle takes a long time to resolve and those nerves are pretty sensitive to pressure. Mine were quite sore for months and are now improving, pain at the dorsal cutaneous is gone and I thought I was going to have that forever. Careful with the compression socks, some of them really put pressure on that area and can inadvertently contribute.

Good luck! I am sending more healing love, Littlepaw

Yes, I agree... across the front of the ankle is a good spot.

I also use 1/2 patch behind the knee, just below the bend.
This however may numb the foot... so be careful with it, placed around the knee area.

I often use 1/2 patch on the top of the foot too, at times.
Lots of nerves there. If the foot is swollen, or discolored, I'd put the patches higher up. Pulling them off can do damage.

I had a patient who pulled off her Lidoderm too hastily and it bruised her whole upper arm.

I do not have RSD so I have not experienced that myself.

Feet and ankles must be problematical at times to stick Lidocaine patches on due to topography. I know Littlepaw mentions cream, but do you all know you can get liquid Lidocaine for external use? When having radiotherapy I suffered 2nd degree burns on and between my legs and this was an easy method of maximum application to a very lumpy area.
For me, in that condition, it dulled the pain for a few hours.

Dave.

I used them on my belly right below my breast for internal burning. You can get 5% Lido ointment somewhat like Neosporin by script. You can get topical pain creams at compounding pharmacies too. I found ketamine and lidocaine together worked better. Lidocaine ointment actually gave me weird warming sensations when I first got RSD. Never use Caspian cream for RSD (pepper creams). You can get pain meds in compounds with lidocaine too.