I have been prescribed 700 mg lidocaine patches. As I understand it, there is NO systemic value of these patches... the medication is delivered only to the local tissues. The package insert says you can wear up to 4 at a time, 12 hours on, 12 hours off. I believe that the rotation is because of the potential skin reaction to the adhesive, but I would not try to wear them more than the 12 on/12 off without discussing it with my doctor. In the year to two that I've been using them, I've never been motivated to ask. (my pain is not constant... it's on and off. Sadly, for me, most days include hours of very high pain levels, but I also get some number of good hours on most days.
The patches DO help my pains... cervical, thoracic, lumbar (or SI?) Obviously, these are not intended to deal with nerve pain.
Maria, I would not presume to know what tests are in order to help focus the diagnoses. We've all seen people with relatively benign looking imaging who have pain that seems too severe based on what is seen. Some of us have little insulation around the nerve roots, making chemical irritation of the nerve roots possible even with minor disc tears. Conversely, someone with more insulating fat around the nerve roots can have much worse looking disc herniations and tears and experience less severe symptoms.
I would ask your doc about other or non-spine related causes of your pain. It is a good question, but I would not borrow trouble and horriblize about potential problems. Take a step back and rule out other obvious problems based on how likely they may be (and how easy to rule out.)
All the best,
Mark
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