Will a lidocaine patch help a herniated disc?

October 7, 2025 •

4 min read

Approximately 80% of adults experience back pain at some point, with herniated discs being a common culprit. For those suffering from the radiating nerve pain it causes, the question often arises: will a lidocaine patch help a herniated disc?.

Quick Summary

Lidocaine patches may offer temporary, localized relief for nerve-related discomfort from a herniated disc. They work by numbing irritated nerve fibers and blocking pain signals to the brain.

Key Points

Targeted Nerve Pain Relief: Lidocaine patches work best for the localized neuropathic pain (burning, tingling) that can result from a herniated disc, not for broad, general backaches.
Minimal Systemic Risk: The topical application provides targeted numbing to irritated nerves with very low systemic absorption, minimizing the risk of widespread side effects.
Research Shows Promise, with Caveats: Some studies have shown effectiveness for localized neuropathic pain following disc herniation, though more large-scale, controlled trials are needed to confirm broader efficacy.
OTC vs. Prescription Strength: Over-the-counter patches contain up to 4% lidocaine for minor pain relief, while prescription patches contain 5% and are intended for more targeted neuropathic pain under a doctor's supervision.
Combined Treatment Strategy: Lidocaine patches are most effective when used as part of a comprehensive treatment plan that includes physical therapy, exercise, and other medications.
Safe Usage is Critical: Adhere strictly to wear times, avoid applying heat, and only use on intact skin to prevent increased absorption and potential adverse effects.

Understanding Pain from a Herniated Disc

A herniated disc occurs when the soft center of a spinal disc pushes through a tear in its tougher exterior casing. This can press on or irritate nearby spinal nerves, a condition called radiculopathy, leading to pain, numbness, or weakness in the area served by that nerve. A herniated disc can cause two primary types of pain: nociceptive pain from inflammation and tissue damage, and neuropathic pain, which is nerve-related and often described as burning, tingling, or shooting. It is the neuropathic component that topical anesthetics like lidocaine patches are best suited to address.

How Lidocaine Patches Provide Relief

Lidocaine is a local anesthetic that works by temporarily blocking nerve signals. When applied via a patch, the medication is absorbed through the skin and blocks voltage-gated sodium channels on the nerve cell membranes. This stabilizes the nerve's electrical potential and prevents it from sending pain signals to the brain. The patch's delivery method is advantageous for treating localized pain because it provides targeted relief with minimal systemic absorption, reducing the risk of widespread side effects.

Evidence for Lidocaine Patches and Herniated Discs

While prescription-strength 5% lidocaine patches (e.g., Lidoderm) are FDA-approved for postherpetic neuralgia (pain from shingles), their use for other neuropathic conditions, including pain from a herniated disc, is widespread.

Some studies, including a retrospective analysis of patients with neuropathic pain from disc herniation, have shown promising results. In this study, patients using a 5% lidocaine patch experienced significant reductions in overall pain intensity and associated nerve-related symptoms like burning and radiating pain. Other case series on chronic low back pain, which can be caused by disc herniation, have also reported positive outcomes, with some patients reducing their reliance on other pain medications.

However, it's important to note the limitations in the research. Many studies on back pain lack robust control groups, and some experts suggest a placebo effect may contribute to perceived pain relief. The effectiveness can vary greatly depending on whether the primary pain is neuropathic or inflammatory. For purely inflammatory pain, a lidocaine patch may be less effective than an anti-inflammatory medication.

OTC vs. Prescription Lidocaine Patches

Lidocaine patches are available in different strengths, which affects how they are used and obtained.


Feature	Over-the-Counter (OTC) Patches	Prescription (5%) Patches
Maximum Strength	4%	5%
Application	Up to three times daily, for a maximum of 8-12 hours per application.	Once per day, worn for a maximum of 12 hours.
Indications	Temporary relief of minor localized pain.	FDA-approved specifically for postherpetic neuralgia, but commonly used off-label for other localized neuropathic pain.
Cost and Access	Lower cost and available without a prescription.	Higher cost and requires a doctor's prescription.
Typical Relief	Generally for minor aches and pains.	Modestly effective for specific neuropathic pain conditions.

Safe and Proper Usage

To ensure safety and maximize the benefits of a lidocaine patch for a herniated disc, consider these guidelines:

Follow instructions: Use the patch exactly as directed on the package or by your doctor, particularly regarding how long to wear it.
Wear time: Respect the 12-hour 'on' and 12-hour 'off' schedule for prescription patches. Overuse can increase systemic absorption and side effect risk.
Skin preparation: Apply the patch to clean, dry, and intact skin. Avoid placing it on broken or irritated areas.
Placement: Place the patch directly over the area of most significant pain. Many patches can be cut to fit smaller, localized areas.
Avoid external heat: Do not apply external heat, such as from heating pads or electric blankets, over the patch. This can increase the rate of lidocaine absorption, raising the risk of serious side effects.
Handwashing: Wash your hands thoroughly with soap and water after handling the patches to avoid accidentally transferring the medication to your eyes or mouth.
Monitor side effects: While rare, systemic side effects can occur with misuse. Be aware of potential symptoms like dizziness, lightheadedness, or ringing in the ears and seek medical help if they occur.

Combining Treatment for Herniated Disc Pain

Lidocaine patches are often used as part of a multi-faceted treatment plan for herniated disc pain. Other common and effective approaches include:

Physical therapy: Exercises to strengthen core muscles and improve flexibility can support the spine and aid in recovery.
Ice and heat therapy: Applying ice packs to the affected area can help reduce inflammation and swelling, especially in the first 48-72 hours after injury. Heat therapy can relax tight muscles and improve circulation.
Oral NSAIDs: Over-the-counter anti-inflammatory drugs like ibuprofen or naproxen can help manage pain and inflammation. Stronger prescription NSAIDs like meloxicam are also an option.
Neuropathic drugs: Prescription medications like gabapentin are specifically approved for nerve pain and may be used in conjunction with other treatments.
Epidural steroid injections: For persistent pain that doesn't respond to oral medication, a corticosteroid injection can be delivered directly into the area around the spinal nerves to reduce inflammation.

Conclusion

For those asking, will a lidocaine patch help a herniated disc?, the answer is that it can provide effective, localized relief, particularly for the neuropathic pain associated with the condition. However, patches may be less effective for purely inflammatory pain. It is not a cure for the underlying disc issue but a tool for managing symptoms. The effectiveness varies by individual, and for many, it works best when combined with other therapeutic strategies, such as physical therapy and targeted medication. Always consult a healthcare professional to determine if a lidocaine patch is an appropriate part of your treatment plan, especially for persistent pain lasting more than a few weeks. For further information on the mechanism and use of topical analgesics, the Taylor & Francis Online journal offers a review.

Frequently Asked Questions

You can use an OTC 4% lidocaine patch for temporary relief of minor, localized back pain. However, for the specific neuropathic pain associated with a herniated disc, a doctor may recommend a stronger, prescription-strength patch.

Many people may experience some pain relief within 30 minutes of applying a lidocaine patch. However, it can take up to 2 to 4 weeks of consistent use to achieve the full effect, especially for chronic nerve pain.

For prescription 5% patches, you should wear them for a maximum of 12 hours within a 24-hour period. The specific duration for OTC patches can vary, so always follow the package instructions.

No, lidocaine patches are not a cure for a herniated disc. They are a pain management tool that helps block nerve signals to provide temporary relief of symptoms.

No, you should never apply external heat, like a heating pad, over a lidocaine patch. Heat can increase the absorption of lidocaine into your bloodstream, raising the risk of serious side effects.

You should see a doctor if your pain is persistent, severe, radiates down your legs, or is accompanied by numbness or weakness. Seek emergency care if you experience bowel or bladder problems alongside back pain.

You can use lidocaine patches with other medications, but it is important to discuss all prescription and over-the-counter medicines with your doctor first. Some interactions or additive effects are possible.

The most common side effects are mild skin reactions at the application site, such as redness, burning, or itching. Serious systemic side effects are rare when used correctly.