Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie.


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Old 02-11-2009, 06:41 PM #11
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Default oh Dear.....

Well the patches work hands down so testimonials from all of us ...you could take that to your Doctor...hmmm lets see what else....the fact that you may end up taking less medication by mouth to deal with increased pain......you can go about your day with less of a stabbing in your back and your neck can all be more relaxed.....

You need good medical articles to take to this doctor and tell him/her that these patches DO work and work WELL!!! not sure on the literature.....

1: Br J Anaesth. 2007 Feb;98(2):261-2.
Management of complex regional pain syndrome type II using lidoderm 5% patches.

Karmarkar A, Lieberman I.
Department of Anaesthetics, Hope Hospital, Salford M6 8HD, UK. acarrom@yahoo.co.uk
We report a case of a patient developing complex regional pain syndrome of the upper limb after a laceration injury with glass. The pain in his hand was resistant to all conventional modes of treatment. The pain reduced dramatically after a diagnostic lidocaine infusion and the reduction in pain lasted for 3 days. Following this the patient responded well to lidoderm 5% patches and achieved 80% pain relief with an improved range of movement in his hand.

1: Pain Med. 2002 Dec;3(4):361-5.Links
Use of lidocaine patch 5% for chronic low back pain: a report of four cases.

Hines R, Keaney D, Moskowitz MH, Prakken S.
Bay Area Pain Medical Associates, Mill Valley, California 94941, USA.
OBJECTIVE: To describe the use of the lidocaine patch 5% (Lidoderm), a targeted peripheral analgesic, in treatment of patients with chronic low back pain. DESIGN: This retrospective case series examines four patients with pain secondary to spinal degeneration and complications from failed back surgery syndrome, who were prescribed the lidocaine patch as an add-on to their analgesic regimen. SETTING: Bay Area Pain Medical Associates, Mill Valley, California. PATIENTS: Patients (age range: 33-64 years) were all complicated cases in which multiple analgesics had been prescribed with varying degrees of success. Intervention. Lidocaine patch 5%. RESULTS: The addition of the lidocaine patch helped relieve varying characteristics of pain, including general pain, shooting pain, burning pain, and allodynia, and had a significant impact on the quality of life of all patients. Some patients were able to reduce or altogether stop some medications. No adverse events were reported from the lidocaine patch. CONCLUSIONS: Based on our experience with the four cases presented here and with other patients in our clinic, we believe that addition of the lidocaine patch 5% to the analgesic regimen in chronic low back pain may be beneficial. Prospective, controlled clinical trials are planned to further evaluate the efficacy and safety of the lidocaine patch for treatment of chronic low back pain with or without a neuropathic component.

1: Drugs. 2004;64(9):937-47.Links
Review of lidocaine patch 5% studies in the treatment of postherpetic neuralgia.

Davies PS, Galer BS.
Department of Neurology, Seattle Veterans' Medical Center, Seattle, Washington, USA.
Postherpetic neuralgia (PHN) is a chronic pain syndrome that disproportionately affects the elderly; its incidence is anticipated to increase as the population ages. PHN presents as pain (continuous burning or intense paroxysmal), most often with tactile allodynia, which may be severe and disabling, resulting in poor quality of life and depression. Traditional treatments have included tricyclic antidepressants, anticonvulsants and opioids; however, adverse systemic effects associated with these agents have led to the development of a newer and potentially safer agent, the topical lidocaine patch 5% (Lidoderm), a targeted peripheral analgesic.This article reviews the clinical pharmacology of the lidocaine patch 5% for the treatment of PHN and summarises data from clinical trials of its safety, tolerability and efficacy. The Medline search terms "lidocaine" and "patch" were used to search for English-language articles on the pharmacokinetics of the lidocaine patch 5% and its clinical use for the treatment of PHN. Additional published studies not identified by the database search but performed by the authors or their colleagues were also included in the review.The systemic absorption of lidocaine from the patch was minimal in healthy adults when four patches were applied for up to 24 hours/day, and lidocaine absorption was even lower among PHN patients than healthy adults at the currently recommended dose. Vehicle-controlled and open-label trials found the lidocaine patch 5%, either alone or in combination with other agents, to be effective in the treatment of PHN. Most adverse events were at patch application sites; no clinically significant systemic adverse effects were noted, including when used long term or in an elderly population.In patients with PHN, the lidocaine patch 5% has demonstrated relief of pain and tactile allodynia with a minimal risk of systemic adverse effects or drug-drug interactions. Because of its proven efficacy and safety profile, the lidocaine patch 5% has been recommended as a first-line therapy for the treatment of the neuropathic pain of PHN.


Maybe some of that will help???
take care,
love and hugs,
Victoria
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Old 02-11-2009, 07:24 PM #12
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I just asked. I explained to my doc that by numbing the area with the patches i can actually get away with taking less pain pills during the day. she liked that idea!

Quote:
Originally Posted by sandy1955 View Post
How in the world do you people convince your doctors you need patches? My pain management doctor (who lives in a fantasy world), would laugh if I even asked abut them.
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Old 02-11-2009, 11:01 PM #13
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It seems to be that patches would be so much better for your body in the long run... esp if you can reduce the pills needed.
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Old 02-13-2009, 03:59 AM #14
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Default great answers guys...

hey
guess I overshot that one!!! I missed the obvious!!! It does for SURE decrease my pain pill intake unless I do silly things like unload the washer and do more laundry....or scrapbook or you know.....try having a life!!!!

Bottom line....they work!!!!!!!!!!!!!!!!!!!!!!! And well!!!!!!!!!!!!!!!! In fact I put one on 1hr ago to help me sleep well!!

Love and hugs,
Victoria
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Old 02-13-2009, 05:20 PM #15
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Default patches

Quote:
Originally Posted by olecyn View Post
The bestest thing to is find the buring nerve pain. I cut up 3 per day & place along the nerve pain path for me. Using a full patch is a waste on 1 area. Spread the wealth!

Example: 1 on my right BP, 1 posterior upper arm under arm pit, 1 above elbow, 1 posterior Ulnar nerve forearm, 1 right hand, 1 left palm.

Use alcohol to dry areas, place & stretch out patch

As pain days change so do the placement of the patches. Traps, cervical, wrist, bum, foot, toes....
Cyndy,
You've had the rib resections done, right? and you still have this much pain? I'm in a lot of pain, too.
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Old 02-19-2009, 11:18 PM #16
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No rib resection here. Bilateral costaclavicular decompression along with ulnar nerve decompression & right CTR. Dr. J says the surgeon did take 1 scalene out & resected another on the right side.

Quote:
Originally Posted by sandy1955 View Post
Cyndy,
You've had the rib resections done, right? and you still have this much pain? I'm in a lot of pain, too.
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Old 02-19-2009, 11:20 PM #17
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Default Victoria

Do u see how much you r needed & APPRECIATED with ur expertese in researching for others?

Quote:
Originally Posted by gibbrn View Post
Well the patches work hands down so testimonials from all of us ...you could take that to your Doctor...hmmm lets see what else....the fact that you may end up taking less medication by mouth to deal with increased pain......you can go about your day with less of a stabbing in your back and your neck can all be more relaxed.....

You need good medical articles to take to this doctor and tell him/her that these patches DO work and work WELL!!! not sure on the literature.....

1: Br J Anaesth. 2007 Feb;98(2):261-2.
Management of complex regional pain syndrome type II using lidoderm 5% patches.

Karmarkar A, Lieberman I.
Department of Anaesthetics, Hope Hospital, Salford M6 8HD, UK. acarrom@yahoo.co.uk
We report a case of a patient developing complex regional pain syndrome of the upper limb after a laceration injury with glass. The pain in his hand was resistant to all conventional modes of treatment. The pain reduced dramatically after a diagnostic lidocaine infusion and the reduction in pain lasted for 3 days. Following this the patient responded well to lidoderm 5% patches and achieved 80% pain relief with an improved range of movement in his hand.

1: Pain Med. 2002 Dec;3(4):361-5.Links
Use of lidocaine patch 5% for chronic low back pain: a report of four cases.

Hines R, Keaney D, Moskowitz MH, Prakken S.
Bay Area Pain Medical Associates, Mill Valley, California 94941, USA.
OBJECTIVE: To describe the use of the lidocaine patch 5% (Lidoderm), a targeted peripheral analgesic, in treatment of patients with chronic low back pain. DESIGN: This retrospective case series examines four patients with pain secondary to spinal degeneration and complications from failed back surgery syndrome, who were prescribed the lidocaine patch as an add-on to their analgesic regimen. SETTING: Bay Area Pain Medical Associates, Mill Valley, California. PATIENTS: Patients (age range: 33-64 years) were all complicated cases in which multiple analgesics had been prescribed with varying degrees of success. Intervention. Lidocaine patch 5%. RESULTS: The addition of the lidocaine patch helped relieve varying characteristics of pain, including general pain, shooting pain, burning pain, and allodynia, and had a significant impact on the quality of life of all patients. Some patients were able to reduce or altogether stop some medications. No adverse events were reported from the lidocaine patch. CONCLUSIONS: Based on our experience with the four cases presented here and with other patients in our clinic, we believe that addition of the lidocaine patch 5% to the analgesic regimen in chronic low back pain may be beneficial. Prospective, controlled clinical trials are planned to further evaluate the efficacy and safety of the lidocaine patch for treatment of chronic low back pain with or without a neuropathic component.

1: Drugs. 2004;64(9):937-47.Links
Review of lidocaine patch 5% studies in the treatment of postherpetic neuralgia.

Davies PS, Galer BS.
Department of Neurology, Seattle Veterans' Medical Center, Seattle, Washington, USA.
Postherpetic neuralgia (PHN) is a chronic pain syndrome that disproportionately affects the elderly; its incidence is anticipated to increase as the population ages. PHN presents as pain (continuous burning or intense paroxysmal), most often with tactile allodynia, which may be severe and disabling, resulting in poor quality of life and depression. Traditional treatments have included tricyclic antidepressants, anticonvulsants and opioids; however, adverse systemic effects associated with these agents have led to the development of a newer and potentially safer agent, the topical lidocaine patch 5% (Lidoderm), a targeted peripheral analgesic.This article reviews the clinical pharmacology of the lidocaine patch 5% for the treatment of PHN and summarises data from clinical trials of its safety, tolerability and efficacy. The Medline search terms "lidocaine" and "patch" were used to search for English-language articles on the pharmacokinetics of the lidocaine patch 5% and its clinical use for the treatment of PHN. Additional published studies not identified by the database search but performed by the authors or their colleagues were also included in the review.The systemic absorption of lidocaine from the patch was minimal in healthy adults when four patches were applied for up to 24 hours/day, and lidocaine absorption was even lower among PHN patients than healthy adults at the currently recommended dose. Vehicle-controlled and open-label trials found the lidocaine patch 5%, either alone or in combination with other agents, to be effective in the treatment of PHN. Most adverse events were at patch application sites; no clinically significant systemic adverse effects were noted, including when used long term or in an elderly population.In patients with PHN, the lidocaine patch 5% has demonstrated relief of pain and tactile allodynia with a minimal risk of systemic adverse effects or drug-drug interactions. Because of its proven efficacy and safety profile, the lidocaine patch 5% has been recommended as a first-line therapy for the treatment of the neuropathic pain of PHN.


Maybe some of that will help???
take care,
love and hugs,
Victoria
__________________
Cyndy

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color="Black">Slowly I turn, step by step, inch by inch *The 3 Stooges
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Old 02-20-2009, 08:18 AM #18
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Lightbulb

in the past when Lidoderm was new... this doctor problem was
common. Unless doctors get visited by a drug rep/salesperson they won't use a drug these days. It has been my experience that doctors WILL NOT in general research themselves!

But today, there are many using the Lidoderm patches.
The patches are trickey and you have to place them properly, for best effect and even the drug company does not help with this aspect.

Google Lidoderm studies...and print them out and take to your
out of date doctor. That is what I did.
In nursing homes today and rehab institutions, Lidoderms are very heavily used.

If your doctor is that behind the times, I wonder what else he is not doing for YOU!.

http://www.bio-medicine.org/medicine...hritis-3414-1/

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum
Quote:
Pain Med. 2002 Dec;3(4):361-5.Links
Use of lidocaine patch 5% for chronic low back pain: a report of four cases.
Hines R, Keaney D, Moskowitz MH, Prakken S.

Bay Area Pain Medical Associates, Mill Valley, California 94941, USA.

OBJECTIVE: To describe the use of the lidocaine patch 5% (Lidoderm), a targeted peripheral analgesic, in treatment of patients with chronic low back pain. DESIGN: This retrospective case series examines four patients with pain secondary to spinal degeneration and complications from failed back surgery syndrome, who were prescribed the lidocaine patch as an add-on to their analgesic regimen. SETTING: Bay Area Pain Medical Associates, Mill Valley, California. PATIENTS: Patients (age range: 33-64 years) were all complicated cases in which multiple analgesics had been prescribed with varying degrees of success. Intervention. Lidocaine patch 5%. RESULTS: The addition of the lidocaine patch helped relieve varying characteristics of pain, including general pain, shooting pain, burning pain, and allodynia, and had a significant impact on the quality of life of all patients. Some patients were able to reduce or altogether stop some medications. No adverse events were reported from the lidocaine patch. CONCLUSIONS: Based on our experience with the four cases presented here and with other patients in our clinic, we believe that addition of the lidocaine patch 5% to the analgesic regimen in chronic low back pain may be beneficial. Prospective, controlled clinical trials are planned to further evaluate the efficacy and safety of the lidocaine patch for treatment of chronic low back pain with or without a neuropathic component.

PMID: 15099246 [PubMed]
Notice the above study was from 2002!

http://www.ncbi.nlm.nih.gov/pubmed/15563743?ordinalpos=1&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.P ubmed_Discovery_RA&linkpos=2&log$=relatedarticles& logdbfrom=pubmed
Quote:
Curr Med Res Opin. 2004;20 Suppl 2:S21-8.Click here to read Links
Effectiveness of the lidocaine patch 5% on pain qualities in three chronic pain states: assessment with the Neuropathic Pain Scale.
Argoff CE, Galer BS, Jensen MP, Oleka N, Gammaitoni AR.

Cohn Pain Management Center, North Shore University Hospital/NYU School of Medicine, Bethpage, NY 11714, USA. pargoff@optonline.net

OBJECTIVE: To determine the impact of the lidocaine patch 5% on pain qualities associated with chronic pain from postherpetic neuralgia (PHN), painful diabetic neuropathy (DN), and low-back pain (LBP), using the Neuropathic Pain Scale (NPS). PATIENTS AND METHODS: Patients with PHN, painful DN, and LBP were enrolled if they had partial response to gabapentin-containing analgesic regimens and if they reported moderate-to-severe pain on the NPS at study enrollment. Eligible patients were included in an open-label, non-randomized, prospective, 2-week study across 7 clinical trial sites in the United States. The lidocaine patch 5% was applied to the area of maximal pain, using no more than a total of 4 patches changed every 24 h. Patients were maintained on their other analgesic regimens with no dose adjustment or additions allowed. Treatment effect was measured by change from baseline to Week 2 in 4 composite measures of the NPS: NPS-10, NPS-4, NPS-8, and NPS-non-allodynia. Safety was assessed by adverse events (AEs), dermal assessment of application site(s), and skin sensory testing. RESULTS: In the combined patient population (n = 77), 2 weeks of treatment with the lidocaine patch 5% significantly improved all 4 composite measures (p < 0.01). In the subgroup analyses, the lidocaine patch 5% demonstrated numerical advantage for all 4 NPS composite measures for the PHN patients (n = 8), and significantly improved all 4 composite measures for the painful DN patients (n = 41; p < 0.001) and LBP patients (n = 28; p < or = 0.005). Overall, 8 patients (10%) experienced mild-to-moderate treatment-related AEs. CONCLUSIONS: The lidocaine patch 5% effectively reduces the intensity of all common pain qualities in patients with moderate-to-severe chronic pain resulting from PHN, painful DN, or LBP. Treatment is well tolerated in combination with other analgesic regimens, with no reports of serious AEs or adverse drug interactions. Assessment scales such as the NPS may offer the possibility to differentiate between various pain states and to assess treatment outcomes for various pain qualities associated with a given pain state.

PMID: 15563743 [PubMed - indexed for MEDLINE]
I am not sure about the application that was used in the above study.
At this time max of 3 patches a day, and use on the body for 12 hrs on and off 12 hrs
is the recommended method. I have never used more than one a day myself.
1/2 of a patch is still pretty strong if placed correctly for that particular pain spot.

I had a very painful lateral femoral nerve injury in my thigh from a C-section years before.
Nothing worked on it, and it was like 100 bee stings! Using the patch daily for 2 weeks put that nerve to sleep and it is a miracle for me! The pain is GONE! (it twinges now and then if I overexend the leg during exercise, but I never have that original pain anymore). I think that nerve was just firing...."just because"...and once that cycle was interrupted for a while, it stopped. I had it for YEARS...almost a decade!
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