I'm looking for some insight/advice with respect to oral diclofenac.
I have Ankylosing Spondylitis in my mid back. I had been taking Naproxen for 4 weeks, but there was little to no pain relief. I started taking Diclofenac on Monday, and it immediately helped with the back pain, but on Wednesday night, shortly after taking it, I had a strange mild pain in my upper left thigh (almost like a pulling feeling). Same thing Thursday night. Haven't had that since.
Then Friday in the late afternoon I started having a strange pain on the bottom of my left foot, up by where my toes start. Today it is in the exact same spot of both feet. I can't really describe it, but I suppose it reminds me of having a pebble in my shoe and stepping down on it. I can still walk, but it is a bit sore.
Has anyone every had a side effect like this from Diclofenac or any other NSAID? I am new to all of this, having been diagnosed with PsA at the end of January, and AS in mid February.
That sounds a bit weird. Typical NSAID side effects are GI upset, but obviously the list doesn’t stop there. Definitely talk to your doctor. But I’m wondering if it’s unrelated to the new med.
I’m sure you’re right, but it just seems so odd to have come on right after switching to a new med.
I’m putting a call in to my dr. Monday morning, so we’ll see what he says.
Thanks, Stoney! Hope you have a wonderful Sunday!
If you were asking if these manifestations sounded like possible symptoms of PsA then I'd have to say 'yes, absolutely'. So it could just be coincidental that they have occurred at the same time as trying diclofenac. When my PsA started that is exactly the kind of pain I had in my foot, it was synovitis and bursitis. Something else which can cause that 'pebble' feeling is a Morton's Neuroma. Let us know what your doc thinks ... glad, though, the diclofenac is helping your back.
Both the pulling and the ‘stone in your shoe’ symptom sound like they could be tendon issues, which are common with PsA - I get both. I don’t think they’re likely to be side effects of Diclofenac, but maybe they’re symptoms that were being controlled by the Naproxen, but which the DCF isn’t now controlling? Just a thought, not a definite conclusion!
I'm not sure what your foot pain is, but sometimes I think some of my foot pain isn't just bad feet but also from bad back. I also had pain in my mid back--as long I can remember my back was very weak and my mid back would hurt and cramp up when I walked any distance (like a half block). I never had an MRI on my thoracic spine, but a few years ago had extensive p.t. to strengthen my back and that area improved considerably--it doesn't hurt when I walk. However, my feet do, and they cramp up when I sit and relax in the evening! I also had lumbar spine stiffness for as long as I can remember, which went away 20 months ago after I started taking Enbrel. I had neuropathy in my feet a few years ago, too, and it was never determined where that originated, nerve conduction tests suggested from pressure on nerves in my back, but it wasn't sure.
I'm telling you this because it seems like foot pain is very difficult to figure out! My feet were pretty good after the neuropathy was cleared up from taking Nortriptyline, but they always felt a little sore and then got really, really bad last March 1 after I made at least 50 trips up and down our basement steps carrying our Christmas stuff to storage! Turned out my cartilage has worn down to nothing in several joints, among other things.
I've never taken diclofenac or a lot of nsaids, so can't tell you if they could directly cause your foot pain, but wondering if it is something to do with your increased mobility in your back putting pressure on different nerves which then send pain signals down to your feet.??
Yes, think PSA progress on the door part. Beautiful part about this disease is it likes to move around. I have a the same issue just up by where my toes connect and recently saw a podiatrist about it. I also have huge problem with sausage toes as well. I went to see how much damage I have, which I do but not ready for surgery yet, thank god!
Thanks Jules, flow, Grandma J, Seenie and Rachael for taking the time to comment. I really appreciate your thoughts, and information. It helps so much, particularly in arming myself with information and questions for my doctor.
I saw my Rhuematologist today and he thinks the foot pain is simply progression of the PsA, and as you mentioned, flow, that the Naproxen was likely "treating" it, and then it became noticeable with the switch to Diclofenac.
I did have very high blood pressure today (along with some general puffiness), so he is taking me off the Diclofenac and putting me on Meloxicam for 2 weeks to see how things go. I am also getting foot x-rays, and he is sending me for a tuberculosis test in preparation for the likely necessity of biologics being the next step. He said DMARDS are not very effective for the spine, so we will skip them.
So all in all, I feel like things are moving in the right direction. I am a bit nervous about the new medication as the Diclofenac was really helping with the back pain. Fingers crossed that Meloxicam also helps with that and the foot pain.
Thanks again, everyone. I hope you all are well and have a great day!
Don't you wish there would be a simple solution? I hope the Meloxicam works and helps your pain. Preparing for biologics is great--your doctor is on top of things! The biologic, Enbrel, helped my stiffness so much it's unbelievable. It won't help any damage already done, so the sooner you get on one, the better.
I do think that when the swelling and stiffness is out of the way it's much easier to tolerate the pain in damaged joints. I've been saying if I still had all that inflammation along with my bad back and feet I couldn't handle it!!!!
Speaking of my back--it has been so good lately, I can't figure it out! I can testify to the fact that taking care to not lift anything too heavy and applying ice alternating with heat and also mild exercise can get a back well. I'm crossing my fingers it stays this way!
Good luck to you, Aspyn! I hope your foot and back pain is helped with the new med and eventually with a biologic!
Aspyn, I am so happy that you have a doctor who seems to be on top of things and who is planning to cut to the aggressive treatment asap. I’d be jumping for joy! (But in my condition, I can’t even jump to a conclusion, LOL)
Just something to check with your doctor though: will you run into problems later if you start on a biologic without failing 2 or 3 DMARDs first? Here’s what happened to me: I failed all four of the DMARDs. I went on a biologic, with excellent results, and my drug plan covered it. Then my supplemental health drug coverage insurance went horribly wrong. I was forced to go onto our provincial health plan coverage. (In ON that is Trillium, in BC it is called Fair PharmaCare, I believe.) To have my biologic covered through Trillium, though, I needed to have failed at least two DMARDs. Fortunately, I had and there was no trouble getting coverage. But if I hadn’t already done that, I would have been forced to backtrack and fail two DMARDs, and then apply again. (That would have been a delay of 3-6 months.)And apparently if you do that and go back to your biologic, it may not work as well as it did on the first go 'round.
To be sure, just check with your rheumatologist about whether you might be wise to do a trial of two DMARDs first, so that if you have to go on BC’s Fair PharmaCare, you will meet their criteria. With any luck, your rheum will say he’s got that eventuality covered and you can go straight to go without taking DMARDs first.
Another thought, if he does decide to do a DMARD trial: it is possible to do two DMARDS concurrently, although he might not want to do that in case of SEs. At one point, in fact, I did MTX, Sulfasalazine and Hydroxychloroquine concurrently. I did read something in the BC materials about sulfasalazine, and that if that is one of your DMARDs, you have to have tried three. Obviously they don’t think much of sulfasalazine in BC. And I’d tend to say that they are right.
Hi Seenie, thank you so much for all of this information. I’m not sure about the process of this, other than what my doctor has told me. I get the feeling he’s done it this way before, otherwise he wouldn’t be suggesting it? Regardless, I’ll speak to him about your suggestions above.
I am currently on my third NSAID. So far the meloxicam has been working very well for me. No tummy upset, and it has relieved the pain almost completely. I’ve only been on it for four days though, so we’ll see how it goes over the next couple of weeks.
Where can I find the BC materials you mentioned?