• Richard Rauck, Michael Busch, and Thomas Marriott.
• Carolinas Pain Institute, Winston-Salem, North Carolina 27103, USA. RRauck@ccrpain.com
• Pain Pract. 2013 Sep 1;13(7):533-8.

ObjectiveEvaluate potential usefulness of a heated lidocaine/tetracaine topical patch for treatment for pain associated with myofascial trigger points (MTPs).BackgroundDepth and duration of analgesia when patch is used as indicated, on intact skin to provide local dermal analgesia for superficial venous access and dermatologic procedures, suggest utility in relief of MTP-associated pain.MethodsIn this open-label, single-center outpatient pilot study, patients with ≥ 1-month history of pain associated with up to 3 MTPs and average pain intensity ≥ 4 on 11-point scale applied 1 patch to each MTP for 4 hours twice daily for 2 weeks, followed by 2 weeks with no treatment. Patients continued prescribed analgesic dosing regimens.ResultsTwenty patients enrolled; 17 completed the study. At baseline, mean ± SD average pain intensity was 6.3 ± 1.56. This decreased by 33% to 4.5 ± 2.31 (N = 20) at the end of treatment; 40% of patients had clinically significant (≥ 30%) decrease, and 25% had substantial (≥ 50%) decrease. Pain interference with general activity, mood, normal work, and enjoyment of life decreased by ≥ 50% in 35% of patients; and with walking, sleep, and relationship by ≥ 50% in 50% of patients (N = 20). Worst trigger point sensitivity improved in 45% of patients; 75% were satisfied or very satisfied with treatment; none required rescue medication. Two weeks after stopping treatment, average pain intensity was 5.0 ± 2.04; treatment benefit was maintained in 8 (40%) patients. The most common adverse event was erythema.ConclusionThe heated lidocaine/tetracaine patch has potential utility as a noninvasive pharmacologic approach for managing MTP pain. Further studies are warranted.© 2012 The Authors Pain Practice © 2012 World Institute of Pain.

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