Another Way with Pain
Lidocaine is friendly. It’s a topical (used on the skin) anesthetic that relieves/prevents pain by numbing the nerves in the areas it’s applied to. As an injection, it prevents local pain during surgical procedures. It’s also sometimes used to treat irregular heartbeats.
My experience with lidocaine
Years ago, a hand specialist injected the stuff into and around a dog bite wound in my right hand so he could debride (clean) it. Initially, the stuff burned white hot, but that sensation quickly faded away as the lidocaine numbed everything. As the doctor worked on the deep, ragged puncture wounds with his scalpel, I was deeply grateful for that magical numbness, believe me.
My other lidocaine experience was when my rheumatologist injected lidocaine, along with a steroid, into my hip bursa to help relieve my miserable chronic bursitis. After a brief, sharp burn, the stuff numbed the injection area so quickly I didn’t feel the long needle slide through my skin, though the thick muscle underneath, and down into the inflamed bursa. Nor did I feel the steroid as it flushed and mixed with the inflamed fluid inside the sore, aching bursa. Afterward, my hip didn’t hurt for hours. And again, I was grateful.
But when a Twitter acquaintance suggested using topical lidocaine for rheumatoid arthritis pain, I scoffed.
Sure, I’d heard of people using prescription lidocaine patches for low back pain, but that was different, right? RD pain, I reasoned, originates down inside the inflamed joint. Only injecting the lidocaine directly into the inflamed, painful joint could help. The very thought makes me shudder.
Lidocaine can be helpful for RA too
Now, I can be stubborn. Sometimes I assume I know stuff when in reality, I don’t. For this reason, I am frequently humbled and reminded that I am but a grasshopper. I have much to learn--such as the fact that lidocaine does soothe some RD pain, at least temporarily.
Here’s how I finally learned: my mother has frequent low back pain caused by osteoarthritis, bone spurs on her spine, and sometimes, sciatica. One day, as I waited in the drugstore for the pharmacist to fill one of her prescriptions, I wandered the aisles, perusing the many products on display. My eyes fell on a box of lidocaine patches. They were, I read on the back of the box, infused with 4 percent lidocaine, the strongest you could get without a prescription. Might they help Mom’s chronic back pain? Couldn’t hurt to try them, I thought and bought a box.
They worked! Within minutes of applying the lidocaine patch, Mom’s back pain faded. She could stand up straight and walk with only a minimum of pain. Now she takes ibuprofen and Tramadol only when ice, heat, and lidocaine aren’t quite enough.
A couple of months passed. As usual, my RD frequently attacked my wrists, hands, ankles, and feet. Sometimes the dragon only gnawed lightly; other times, he ground my joints between his teeth ferociously, trying to crack and shatter them.
One morning, as I massaged my aching knuckles, Mom said, “Hey! Why don’t you try one of my patches?”
Lidocaine? “Oh, I don’t think …” I began, then stopped. Sure, it probably wouldn’t work, since it could only numb the skin, but why not try it? It couldn’t hurt, right?
“OK,” I said, “Good idea!” I got one from the bathroom cupboard. It was too big for my knuckles, so I cut it in half and trimmed each half down to fit over them neatly. Not expecting much, I put them on.
To my astonishment, they worked! Within minutes, my dragon dozed off and my pain level dropped from six to three. I could now bend and flex my hands without gritting my teeth. I could type with only a little bit of pain, lift my coffee cup to my lips without grimacing, and go about the small tasks of the day without constantly creaky, painful hands. It was wonderful!
Since then, I’ve discovered 4 percent lidocaine in a cream. It’s much easier for me to use than a patch, though I’m sure the patch would be perfect larger areas.
But how does lidocaine work when it goes no deeper than the nerves just below the surface of the skin?
The answer is in pain as a process. The inflammation in the RD joint irritates the nerves in its immediate area. They send urgent “do something!” signals up the spine to the brain. So we’ll favor and rest the joint until the inflammation stops and it can heal, the brain makes us perceive—or feel—pain.
Where it’s applied, the lidocaine numbs the irritated nerves, interrupting or disrupting their frantic signals to the brain. The result? It doesn’t react—or perhaps, react as strongly—and our perception of pain is briefly lessened or even eliminated.
Isn’t that cool? I love knowing how things work.
I’ve only used lidocaine cream and patches for mild and moderate pain, so far. I don’t know how well it might work on a severely flared joint, but I’m a believer now. When that bad flare happens—and I know it will—I’ll try it.
Have you used lidocaine to relieve pain caused by rheumatoid disease? What did you think?
Does your RA impact you financially?