"I've had good success with topicals for localized pain but would like to try something for more systematic relief. I've seen transdermal patches but they seem expensive. Do they actually work? I don't care about getting high."
This is a great question, and one we get quite a bit. First I'll say that it depends on what symptoms you're trying to treat, and which cannabinoids you're focused on using (THC, CBD, CBN etc...) to treat those symptoms.
I think patches can be really useful for getting a longer release period for CBN which helps aid in sleep, and for treating body pain with a ratio of THC to CBD that works best for your body.
The problem I've found with transdermal patches is that they tend to work with varying effect, even by the same manufacturer. I've also gotten feedback from a lot patients that they experience a reaction to the adhesive.
I saw this article about the patches; let us know if this helps.
It certainly sounds like you may be experiencing neurological pain and for that, CBDs show great promise. I encourage you to try a high CBD vape for your pain but also the topical salve applied to your left foot and your low back where the nerves exit your lower spine and apply the salve frequently and over time, you likely will experience a significant reduction in pain. If you do not want to vaporize your medication you may use a tablet, sublingual strip or tincture to utilize more CBD cannabis to reduce your inflammatory and neurological pain challenges. The THC patch I only recommend for evening and night use since the THC patch will go systemic and it may have a significant psychoactive effect so please, use caution if using the THC patch.
Neuropathic pain, or pain related to damaged nerves, is something that cannabis can probably help. A patch is often designed to be "transdermal", meaning that the medicine goes through the skin and into the bloodstream, so it has widespread effects. Topical products like most balms, lotions, salves, etc are designed to sink into the skin to calm inflamed nerve endings, but not into the bloodstream in general. You could try topical products to your foot to have local effects, and/or try a patch or other product with broad effects like gummies, tinctures, etc. There are some more in-depth articles on the HelloMD Health & Wellness section to check out for more details.