Lidocaine patch 5% for carpal tunnel syndrome: How it compares with injections: A pilot study
TABLE 1
Patient demographics and baseline characteristics
| PARAMETER | LIDOCAINE PATCH (N=20) | INJECTION (N=20) |
|---|---|---|
| Age (mean years±SD) | 48.4±10.3 | 47.5±13.9 |
| Gender (%) | ||
| Male | 35 | 25 |
| Female | 65 | 75 |
| Average pain intensity at baseline (mean±SD) | 5.3±1.9 | 4.8±2.5 |
| Clinical Global Impression of Severity at Baseline (%) | ||
| Mild | 55 | 45 |
| Moderate | 45 | 55 |
TABLE 2
Impact of treatments on Clinicians’ Global Impression of Change and Global Assessment of Treatment Satisfaction scales
| PARAMETER | LIDOCAINE PATCH | INJECTION |
|---|---|---|
| Clinician Global Impression of Change (%) | ||
| Improved | 88 | 74 |
| No Change | 12 | 26 |
| Worse | 0 | 0 |
| Patient satisfaction | ||
| Patients satisfied or very satisfied (%) | 80 | 59 |
Discussion
The lidocaine patch 5%, a noninvasive, targeted peripheral analgesic, effectively relieved the intensity of localized pain reported by patients with CTS. The efficacy of the lidocaine patch 5% in reducing pain and improving symptoms was comparable to that of the more invasive anesthetic/corticosteroid injection. The lidocaine patch 5% significantly reduced CTS-related pain, thereby reducing the pain’s interference with QOL and resulting in a high level of treatment satisfaction. In addition, the lidocaine patch 5% was well tolerated with no reported systemic adverse effects.
These preliminary data from this small, open-label, pilot investigation suggest the possibility that the lidocaine patch 5% may be a useful option for some patients.
Study limitations. Since it was a pilot study, the number of patients included in the trial was small and the duration was short. Moreover, allocation was not concealed and the study was not blinded. Further controlled trials are needed to confirm the effects reported in this pilot study.
The lidocaine patch 5% targets localized damaged or dysfunctional nociceptors while reducing the risk of drug interactions and systemic side effects. Since this noninvasive treatment appears to relieve CTS-related pain with minimal risks, the lidocaine patch 5% may be a reasonable therapeutic option for patients with new-onset CTS who do not respond to more conservative options and who are unable or unwilling to receive more invasive therapies. Moreover, it affords clinicians a possible alternative to corticosteroid injections in patients awaiting surgery and eliminates the risk of adhesions due to injection.
CORRESPONDENCE
Srinivas Nalamachu, MD, 4601 W 109th St, Suite 302, Mid-America Physiatrists, PA, Overland Park, KS 66211. E-mail: nalamachu@sbcglobal.net
