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Lidocaine transdermal patches
Frequently used for lower back pain.
A single 5% patch contains 700mg of lidocaine.
There is low systemic absorption.
Data supporting efficacy for lower back pain are limited.
Best benefit in other neuropathic conditions such as post herpetic neuralgia.
Topical capsicum
Underused, safe, non-sedating.
Potential treatment option for acute and subacute back pain (<3 months duration).
Can be OTC or via prescription.
Available in cream, lotion and patches.
Best used 3-4 times per day for maximal effectiveness.
Grade A recommendation from North American Spine Society.
References
https://pubmed.ncbi.nlm.nih.gov/14581111
https://pubmed.ncbi.nlm.nih.gov/15563743