CheeZheng pain-relieving plaster

Purported Benefits, Side Effects & More
CheeZheng pain-relieving plaster

Common Names

  • Qizheng Xiaotong plaster
  • Tibetree pain-relieving plaster
  • Tibetan herbal pain-relieving plaster

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For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.

CheeZheng pain-relieving plaster (PRP) is a pain patch. It contains camphor and six different herbs.

CheeZheng pain-relieving plaster is used to:

  • Relieve aches and pain caused by strained or sprained muscle
  • Relieve aches and pain caused by arthritis

Talk with your healthcare providers before using herbal formulas. They can interact with some medications and affect how they work. For more information, read the “What else do I need to know?” section below.

Side effects of PRP on your skin may include:

  • Redness
  • Pain
  • Itching
  • Blisters
  • Do not use PRP on wounds or damaged skin or with a heating pad. Do not bandage tightly over the applied plaster. Avoid contact with eyes or mucous membranes when using the plaster. 

For Healthcare Professionals

CheeZheng pain-relieving plaster (PRP) is a topical analgesic widely used in the Asia-pacific region and U.S. to manage musculoskeletal pain (1). It consists of camphor, Zanthoxylum bungeanum Maxim. (Hua Jiao), Lamiophlomis rotate (Benth.) Kudo (Du Yi Wei), Curcuma longa L. (Jiang Huang or Turmeric), Myricaria germanica (L.) Desv. (Shui Bai Zhi), Carthamus tinctorius L. (Hong Hua), and Oxytropis falcata Bunge (Ji Dou).

Clinical data are limited with most studies originating in China. A systematic review/meta-analysis found PRP to be associated with improvements in low back pain and function compared to diclofenac/NSAIDs (2). Notably, PRP did not increase the number of adverse events compared to medications.

Another systematic review/meta-analysis reported PRP to be more effective against osteoarthritic pain/function compared to NSAIDs, glucosamine, intra-articular corticosteroids, hyaluronic acid injections, or acetaminophen (3).

However, majority of the studies in the above analyses are limited by small sample sizes, lack of placebo control, and risk of bias. Methodologically rigorous studies are warranted to bolster the evidence.

Preliminary data suggest benefits of PRP in reducing chronic musculoskeletal pain in cancer survivors (4) (5). Larger trials are needed to establish efficacy. 

  • Muscle pain
  • Arthritis

The bioactive compounds in PRP, such as diphenylheptanone, sesquiterpene, luteolin, and iridoid glycoside, may help suppress proinflammatory factor expression and improve substance P receptor (SP-R), c-Fos, and glial fibrillary acidic protein (GFAP) expression in neurons to alleviate central and peripheral hyperalgesia (6). 

PRP has also been shown to reduce inflammation and inhibit nociceptive response in animal models, which in turn may help alleviate pain (7) (8). It also affected significant reductions in levels of proinflammatory cytokines interleukin (IL-1B), cyclooxygenase-2 (COX-2), TNF-alpha, and 5-lipoxygenase (5-LOX) in macrophages (9).

  • PRP can irritate mucous membranes, eyes, and broken skin, therefore avoid using on wounds or damaged skin or with a heating pad. Do not bandage tightly. Avoid contact with eyes or mucous membranes.  

PRP may cause skin allergies, redness, itching, pain, and blistering (3) (10) (11) (12).

  1. Wen JM, Tong PJ, Zhan HS, Liu XG, Wen GN. [Experts consensus statement on Cheezheng Xiaotong Tiegao in clinical practice]. Zhongguo Zhong Yao Za Zhi. Feb 2019;44(4):629-635. doi:10.19540/j.cnki.cjcmm.2019.0012
  2. Yang M, Li SQ, Smith CM, Zhang YL, Bao T, Mao JJ. Tibetan herbal pain-relieving plaster for low back pain: A systematic review and meta-analysis. Biomed Pharmacother. Aug 2021;140:111727. doi:10.1016/j.biopha.2021.111727
  3. Chen C, Li SQ, Bao T, Zhang L, Seluzicki C, Mao JJ. A systematic review of CheeZheng Pain Relieving Plaster for musculoskeletal pain: implications for oncology research and practice. Integr Cancer Ther. Jan-Dec 2020;19:1534735420918933. doi:10.1177/1534735420918933
  4. Liou KT, Chen C, Emard N, Lynch KA, Hou YN, Mao JJ. Herbal Topical Analgesic for Pain Management: Perspectives from Cancer Patients.  Pain Med. 2021 Jun 4;22(6):1435-1440.
  5. Yang M, Li QS, Baser RE, Li X, Hou J, Mao JJ. Nocebo expectations rather than placebo expectations affect topical pain relief: A randomized clinical trial.  Biomed Pharmacother. 2024 Jun;175:116728.
  6. Tian J, Duoji Z, Chen L, Zhang Z, Chen W. A review of pain-relieving plaster research, Chinese traditional patent. Medicine 2020;42(2):434-439.
  7. Duan WR, Lu J, Xie YK. Mechanisms of topical analgesics in relieving pain in an animal model of muscular inflammation. Pain Med. Sep 2013;14(9):1381-7. doi:10.1111/pme.12199
  8. Wang YZ, Guo CY, Zhong HG, et al. In vivo effects of Pain Relieving Plaster on closed soft tissue injury in rabbit ears. BMC Complement Altern Med. Sep 15 2008;8:51. doi:10.1186/1472-6882-8-51
  9. Peng SY, Liu Y, Bao XH, et al. Inhibition of 5-lipoxygenase and cyclooxygenase-2 pathways by pain-relieving plaster in macrophages. Pharm Biol. Jul 2011;49(7):716-26. doi:10.3109/13880209.2010.544043
  10. Huang X. Effect of CheeZheng pain-relieving plaster versus diclofenac for acute soft tissue sprain: a clinical study. Chin J Aesthet Med. 2011;20(3):375–376.
  11. Li J. The effect of CheeZheng pain-relieving plaster combined with ultrashort wave for low back pain. Chin Pract Med. 2010;5(30):147–148.
  12. Wang Y, Wang T, Yuan Y, Xu Y, Ren H. Clinical study on CheeZheng pain relieving plaster for acute soft tissue injuries. Proc Clin Med 2010;19(1):12-13.
  13. Wang J, Sun H. Clinical study of CheeZheng pain-relieving plaster combined with fenbid for 80 cases of lumbar strain. Proc Clin Med. 2010;19 (2C):200-201.
  14. Li J, Long F, L.W. F. Clinical observation of Qizheng Xiaotong plaster combined with acetaminophen in treating knee osteoarthritis. Pharmacy Today. 2012;22:693-695.
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