Adjunctive 5% Lidocaine Patches for Acute Non-radicular Low Back Pain in Emergency Department Patients

Low back pain is a common emergency department (ED) chief complaint. Multiple therapies have
been evaluated in the treatment of ED patients with low back pain including acetaminophen,
NSAIDS, opioids, steroids, and muscle relaxants.

Lidocaine is a local anesthetic that can be administered by various routes. It is used in a
transdermal patch for the treatment of pain. It is commonly used for focal causes of pain,
including low back pain. The addition of lidocaine 5% patches to standard low back pain
therapy has not been rigorously evaluated, although it is frequently used.

Inclusion Criteria:

- pain originating between the lower border of the scapulae and the upper gluteal folds

- treating ED physician plan for discharge of the patient

Exclusion Criteria:

- radicular pain defined as pain radiating below the gluteal folds

- direct trauma to the back within previous month

- pain of greater than 2 weeks duration or greater than 1 LBP episode per month in the
past 3 months

- patient being pregnant or lactating; no access to phone or ability to participate in
follow-up phone calls

- known allergy to lidocaine or skin breakdown over site of pain

- treating physician plan for opioid prescription (tramadol, codeine, hydrocodone)

- personal history of malignancy, fever (temperature greater than 37.9ºC), or previous
spinal surgery

- patients who are detainees

- previous enrollment in the study