Treatment of localized neuropathic pain after disk herniation with 5% lidocaine medicated plaster

Rudolf Likar,¹ Ingo Kager,¹ Michael Obmann,¹ Wolfgang Pipam,¹ Reinhard Sittl<sup>2

1</sup>Department of Anesthesiology and Intensive Care, Klagenfurt Hospital, Klagenfurt, Austria; ²Department of Anesthesiology, Interdisciplinary Pain Center, University Hospital Erlangen, Erlangen, Germany

Objective: To assess treatment with the 5% lidocaine medicated plaster for peripheral neuropathic pain after disk herniation.
Study design: Case series, single center, retrospective data.
Patients and methods: Data of 23 patients treated for neuropathic pain with the lidocaine plaster for up to 24 months after a protrusion or prolapse of the cervical, thoracic, or lumbar vertebral disks were retrospectively analyzed. Changes in overall pain intensity, in intensity of different pain qualities and of allodynia and hyperalgesia were evaluated.
Results: Patients (14 female/nine male, mean age 53.5 ± 10.4 years) presented with radiating pain into the abdomen, back, neck, shoulder, or legs and feet with a mean pain intensity of 8.3 ± 1.5 on the 11-point Likert scale. Mean treatment duration was 7.6 months; 52% of the patients received lidocaine plaster as monotherapy. At the end of the observation, mean overall pain intensity had been reduced to 3.1 ± 1.8. All other parameters also improved. The treatment was well tolerated.
Conclusion: These results point to a safe and effective treatment approach with 5% lidocaine medicated plaster for localized neuropathic pain related to disk herniation. However, owing to the small sample size, further investigation in a larger-scale controlled trial is warranted.

Keywords: peripheral neuropathic pain, radiating pain, topical analgesic