Prof. Dr. Mehmet Şenoğlu — Brain, Nerve and Spine Surgery
Among the things my patients with low back pain tell me, there is one sentence I hear often: “Doctor, I’ve been sticking a plaster on for two weeks, I get a bit of relief, but it doesn’t fully go away.”
There are actually two pieces of correct information hidden in that sentence. A medicated plaster really can bring relief — but it really does not cure. Understanding this distinction protects you both from false expectations and from delaying the actual treatment.
In this article, I want to explain in honest language what a plaster is, how it works, how much it helps in low back pain, and who needs to be careful with it.
What Is a Medicated Plaster?
A plaster (yakı) is an application placed on the painful area from the outside, which aims to provide relief by creating a sensation of heat or coolness in the skin. We can divide them in two:
The Traditional Plaster
It has been used in Anatolia for generations. It is prepared by spreading ingredients such as mustard, flaxseed, onion, garlic, or olive oil onto a cloth and placing it on the painful area. The aim is to relieve pain by creating heat and irritation in the region.
Modern Medicated Patches
These are ready-made, plaster-like products sold in pharmacies. Their ingredients generally include the following:
- Capsaicin (chili pepper extract) — creates a burning, hot sensation
- Menthol and camphor — coolness followed by a sensation of warming
- Methyl salicylate — with a warming effect
- In some products, anti-inflammatory active ingredients (such as diclofenac) — these actually fall into the “medicated patch” category
How Does a Plaster Work?
Understanding the mechanism here helps set the right expectation. A plaster has three basic effects:
1. The heat effect: It increases blood circulation in the area and helps contracted muscles relax. A significant proportion of low back pain involves muscle spasm; this is where the most genuine benefit of a plaster lies.
2. Counter-irritation: The substances it contains stimulate the nerve endings of the skin and create a burning-tingling sensation on the surface. When the nervous system is occupied with this new and strong signal, it perceives the deeper pain signal less. I explain this to my patients like so: a plaster does not remove the pain; it draws your brain’s attention elsewhere.
3. Psychological and comfort effect: Feeling that you are doing something, the ease that warmth provides — these are not to be dismissed, but they are not treatment either.
There is a critical fact here: the effect of a plaster is superficial. The substances in it act only a few millimeters beneath the skin. A lumbar disc herniation, however, lies deep in the spine, on top of the nerve root. A plaster does not reach there.
So, Does It Help the Lower Back? The Honest Answer
My answer will come in two parts, because the truth does too:
Situations Where It Can Help
- Muscle-related low back pain and stiffness: It can provide temporary relief in pain due to sitting at a desk for long periods or straining a back muscle with a sudden movement.
- Muscle fatigue after sport.
- Muscle spasm accompanying a lumbar disc herniation: It can help not the herniation itself but the muscle tension that develops around it. And this can make it easier for the patient to move more comfortably and return to exercise — which is a genuine contribution.
Situations Where It Will Not Help
I need to say this clearly: a plaster does not treat a lumbar disc herniation.
- It does not shrink the herniated disc fragment.
- It does not remove the pressure on the nerve root.
- It does not resolve pain radiating into the leg (sciatica), numbness, or loss of strength.
- It has no effect on structural problems such as canal stenosis, spondylolisthesis, or a fracture.
In short, a plaster is not a treatment but a comfort measure. If it eases the pain a little and gets you moving again, it is valuable; but on its own it is not a treatment plan.
Correct Use: Simple but Important Rules
If you are going to use a plaster, I recommend paying attention to the following:
- The skin should be clean and dry. On sweaty, oily, or damp skin it neither sticks well nor is safe — the burning risk increases.
- Observe the duration. Do not exceed the time written on the product’s packaging (generally 8–12 hours). The idea that “the longer it stays on, the more benefit it gives” is wrong; it only increases the risk of irritation and burns.
- Test it on first use. Stick it on a small area and wait a few hours; if redness, itching, or excessive burning occurs, do not use it.
- Remove it before showering. Hot water can amplify the effect of substances such as capsaicin and cause a severe burning sensation.
- Do not apply it to an open wound, a crack, or eczematous or irritated skin.
- Do not use it together with a heat source. Placing a hot water bottle, a warm pad, or an electric blanket over a plaster can cause serious burns. This is the most common plaster-related accident we see in our clinic.
- If unbearable burning starts, remove it immediately and wash the area with lukewarm water.
- Avoid contact with the eyes and mucous membranes; always wash your hands after applying it.
Who Should Be Careful, or Not Use It at All?
This section may be the most important part of the article.
- People with diabetes and those with nerve damage (neuropathy): This is the highest-risk group. Because sensation is reduced, they may not notice the burning, and serious burns can occur. I recommend that these patients of mine stay away from plasters.
- People with circulatory problems.
- Those with sensitive skin, eczema, or allergic skin conditions.
- Children: The skin is very thin and permeable; it is not recommended.
- Pregnant and breastfeeding women: Do not use without consulting a doctor.
- Older people whose skin has thinned.
- Those allergic to salicylates or to any of the ingredients.
An additional warning for traditional plasters: Mustard plaster in particular can cause chemical burns when left on for a long time. These burns can look superficial but progress into the deeper tissue, and healing can take weeks. The belief that “the more it burns, the more good it does” is not medically correct — and it is dangerous.
The Most Common Mistake: Relying on a Plaster and Waiting
The situation that saddens me most in my clinic is this: a patient uses a plaster for weeks, sometimes months; the pain goes down and up again; and meanwhile the numbness in the leg quietly progresses. By the time they come in, wasting has begun in the muscle.
A plaster can mask pain. And pain is the body’s warning system. A reduction in pain does not mean the problem has gone away.
For this reason I suggest the following rule: use a plaster alongside the treatment your doctor has recommended; not instead of it.
When Should You Stop Using a Plaster and See a Doctor?
In the following situations, stop trying a plaster and go to the nearest emergency department without losing any time:
- Losing control of urine or stool, incontinence
- “Saddle-shaped” loss of sensation in the anal region, the buttocks, and the inner thighs
- Suddenly starting, progressive marked loss of strength in the leg (being unable to lift the foot)
And in the following situations, you should definitely see a doctor (even if they are not emergencies):
- Pain and numbness radiating into the leg and down to the foot
- Low back pain accompanied by fever, night sweats, or weight loss
- Severe pain after trauma (a fall, an accident)
- Pain that does not go away with rest and wakes you from sleep at night
- Pain lasting longer than 2–3 weeks that is not going away or is increasing
- Blisters, an open sore, spreading redness, or a non-healing burn in the area where the plaster was applied
What Should You Do Instead of, or Alongside, a Plaster?
The methods that genuinely make a difference in low back pain are these:
- Keeping moving (not prolonged bed rest)
- A personalized exercise program and physical therapy
- Correct ergonomics — sitting arrangement, lifting technique
- Heat and cold application (cold in the acute period, heat afterward)
- Weight control and quitting smoking
- Medication under a doctor’s supervision
Looking at this list, you will see: a plaster replaces none of these, but it can be a small helper alongside all of them.
Frequently Asked Questions
Below, I have gathered the most frequently asked questions on this subject along with brief answers. These answers are for general information; the information that applies to your specific situation is the one given by the doctor who examines you.
What is a medicated plaster, what is it for?
A plaster is an application placed on a painful area that aims to provide temporary relief by creating a sensation of heat or coolness in the skin. There are traditional forms (mustard, flaxseed, and so on) and modern patch forms. It reduces the perception of pain through a muscle-relaxing and attention-diverting (counter-irritant) effect.
Does a plaster help the lower back?
It can provide temporary relief in muscle-related low back pain and in muscle spasm. However, it does not cure a lumbar disc herniation, does not shrink the disc, and does not remove pressure on the nerve. In other words, it is a supportive comfort measure, not a treatment.
Can a plaster be used with a lumbar disc herniation?
It can be used to reduce the muscle tension accompanying the herniation, and this can make it easier for you to move. However, if there is pain radiating into the leg, numbness, or loss of strength, you need to see a doctor rather than lingering with a plaster.
How long should a plaster stay on?
Observe the duration stated on the product’s packaging; it is generally 8–12 hours. Leaving it on longer does not increase the benefit; it only raises the risk of skin irritation and burns.
Can a plaster cause burns?
Yes, it can. Serious burns can occur especially when it is left on for a long time, used on damp skin, or when a heat source such as a hot water bottle is placed over it. The risk is far higher in people with diabetes and nerve damage, because they may not notice the burning.
Can you shower with a plaster on?
It is not recommended. Hot water can amplify the effect of substances such as capsaicin and cause a severe burning sensation. Remove it before showering; once the skin is completely dry, you can apply a new one if needed.
Who should not use a plaster?
People with diabetes and neuropathy, those with circulatory problems, those with sensitive skin and eczema, children, pregnant women (without consulting a doctor), and those allergic to any of the ingredients should not use one, or should be very careful.
Is mustard plaster harmful?
When used incorrectly, yes. A mustard plaster left on for a long time can cause chemical burns, and these burns can take weeks to heal. The belief that “the more it burns, the better it works” is not medically correct.
Can a plaster replace a painkiller?
No. A plaster provides superficial relief; it does not treat the underlying cause of the pain. If your pain is not going away or is increasing, you need to be assessed by a doctor rather than continuing with a plaster.
Disclaimer (Legal Notice)
The information contained in this article has been prepared for general informational purposes only and in no way replaces a medical examination, diagnosis, or treatment. The cause of low back pain, the appropriate treatment, and the methods that can be used vary greatly from person to person and can only be determined by a doctor who evaluates you. Plasters and similar products are not a treatment method but at most a supportive application, and they do not replace the treatment recommended by your doctor. Read the product’s instructions for use before using it; if you have a chronic condition (especially diabetes), a skin condition, or if you are pregnant, always consult your doctor. If emergency symptoms such as urinary/fecal incontinence, saddle-shaped loss of sensation, or sudden and progressive loss of strength are present, go to the nearest healthcare facility without delay.