What effect does Diclofenac have on joint arthrosis, and how to use it correctly?

Mechanism of action of Diclofenac

The patient almost immediately feels relief - the pain disappears or becomes minimally expressed, and the mobility of the diseased joint is restored. If the drug is administered by injection, then an improvement in the condition will be felt within 20-30 minutes after the injection; the tablets give the expected effect no earlier than 1-3 hours.

Despite the high effectiveness of the drug, it is prescribed in short courses for the diagnosis and progression of rheumatoid arthritis, because it is highly toxic and can negatively affect overall health. In case of exacerbation of the disease, it is recommended to use Diclofenac in injections - this will provide almost instant relief of pain and reduce the severity of swelling.

Diclofenac is not a complete drug; it cannot be used as the only drug because it does not have a therapeutic effect, but it successfully copes with the symptoms of diseases.

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Contraindications for use

Categorical contraindications to the use of Diclofenac in the treatment of arthritis are:

• severe kidney and liver diseases - for example, renal/liver failure;
• disruption of the blood clotting system;
• peptic ulcer of the stomach and duodenum;
• gastritis with low/high acidity of gastric juice;
• heart failure accompanied by congestion;
• cerebrovascular disorders occurring in acute form.

The decision to prescribe or prohibit the use of Diclofenac is made by the doctor in each specific case. For example, an injection solution can be used for diseases of the stomach and duodenum, because the drug does not enter the gastrointestinal tract.

Possible complications

Diclofenac is a toxic drug; complications can often arise even with short-term use:

• excessive drowsiness and general loss of strength;
• severe dizziness and migraine;
• problems with cerebral circulation;
• disturbances in the functioning of the vestibular apparatus;
• angina attacks and strokes;
• shortness of breath and vasculitis;
• meningitis and hepatitis;
• impotence in men;
• myocardial infarction.

It is also possible for a rapid development of an allergic reaction, up to Quincke's edema.

• How to properly use compresses with Dimexide for arthrosis of the knee joint

How to use Diclofenac for knee pain

Diclofenac for pain in the knee joint can be used not only as injections, although this is the fastest method of alleviating the patient’s condition; ointments, tablets or suppositories with the same active substance often solve the problem.

Injections are performed in the upper right quadrant of the buttock, using syringes with needles for intramuscular injections - it is important to inject the drug deep into the tissue. Direct injection is done slowly; immediately after removing the needle from the buttock, you need to knead the injection site with your fingers for several seconds, which will prevent the formation of lumps and lumps.

Ointment

Diclofenac ointment has a concentration of the main active ingredient of 1%, is used externally and is most effective in the presence of moderate symptoms of arthritis, arthrosis and other diseases of the musculoskeletal system.

Apply a thin layer of ointment to the skin over the affected joint and rub in lightly. For one application, 2-4 g of the drug is enough (a thin strip of ointment approximately 0.5-1 cm long), the dose should not exceed 8 g per day - the maximum number of manipulations per day is 4.

The duration of therapy should not exceed 14 days, but specific prescriptions are made by the attending physician. The ointment can be used even if there are contraindications to the drug, because it does not enter the general bloodstream and does not have any effect on the functioning of internal organs.

Pills

The pharmacological form of Dicofenac tablets is rarely prescribed because they are contraindicated if there is a history of diseases of the gastrointestinal tract. The maximum daily dose of the main active ingredient (diclofenac sodium) is 150 mg; exceeding the level turns the drug into a real toxin, and this leads to disruption of the functionality of internal organs.

Tablets are available in 150 and 75 mg doses, so they can be taken 1 and 2 times a day, respectively. The duration of the course should not exceed 10 days. If the patient has a history of hypertension (sustained increase in blood pressure), bronchial asthma, abdominal surgery no more than 3 months ago, then taking the drug should be monitored by medical professionals.

Candles

Diclofenac suppositories are intended for rectal administration; one contains 75 mg of the main active substance. Prescribed for administration is 1 suppository per day, the duration of therapy is determined individually, but the general recommendation prescribes not to exceed the duration of 7 days.

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A suppository is inserted into the anus after bowel movements and hygiene procedures; it must be placed behind the sphincter and held for 1-2 minutes until completely dissolved. Under no circumstances should the candle be cut/divided into 2 parts - the active substance may be distributed unevenly, which will not give the expected effect.

Diclofenac suppositories are contraindicated for use in:

• external and internal hemorrhoids;
• anal fissures;
• polyps and neoplasms of the rectum.

The appearance of the drug "Diclofenac"

The prototype of the group of modern NSAIDs is considered to be regular aspirin. It was acetylsalicylic acid, discovered at the end of the 19th century, that made it possible to develop a new class of drugs called “aspirin-like.” The drugs were highly effective, which has not been lost to this day, but the problem was the toxicity of high doses.

Acetylsalicylic acid

And after much research in this direction, during which it was possible to synthesize more than two hundred drugs with a relatively safe level of toxicity, diclofenac sodium appeared in 1974, and the medicine was released under the brand name of the same name.

History of the creation of diclofenac

At first, Diclofenac found application mainly in rheumatology, a branch where both analgesic and anti-inflammatory aspects are equally important for curing diseases.

But soon the area of ​​use of the new non-steroid expanded to neurology and surgery, gynecology and traumatology, and the drug became widely used to get rid of pathological musculoskeletal episodes.

Important! Today, Diclofenac is the very first drug for pain relief according to WHO estimates. Its intramuscular injection is effective for pain of various etiologies, including low back syndrome.

"Diclofenac" - solution for injection

Mechanisms of action

To understand how the anti-pain effect is achieved when using this drug, an analysis of its structure is necessary. Its action is based on the principle of inhibition of cyclooxygenase function. This enzyme is responsible for converting arachidonic acid into prostaglandins, which cause inflammatory fever and pain.

At the same time, the drug is balanced and well tolerated even in high doses, leaving no toxic side effects, and provides therapeutic activity at an extremely high level.

The drug is well tolerated by patients

Important! The drug has a complex effect on a number of mechanisms for the perception of pain, thereby ensuring complete suppression of pain syndromes of various etiologies.

Can there be an overdose?

An overdose of Diclofenac (in any pharmacological form) is impossible if the drug is used as prescribed by a doctor and strictly according to the regimen. When self-medicating, an overdose manifests itself:

• decreased blood pressure;
• cramps of the lower extremities;
• respiratory depression;
• stomach pain;
• bleeding from the gastrointestinal tract;
• rapidly developing renal failure.

Treatment of overdose is symptomatic; immediately when signs appear, you need to rinse the stomach and seek qualified medical help.

Side effects

Side effects from Diclofenac injections can be divided into groups presented in the table below.

To reduce the risk of negative consequences, it is necessary to use the minimum dose of the drug that can be effective, and the duration of the course should be short. If the duration of the course of use of Diclofenac exceeds the recommended one and/or too high a dosage is used, the risk of negative consequences from the cardiovascular system, including stroke and myocardial infarction, increases significantly.

Any reactions of the body to the administration of the drug must be reported to the doctor immediately. If pathological signs appear, Diclofenac injections should be stopped immediately.

Should you drink alcohol during treatment?

Alcoholic drinks and Diclofenac, according to official instructions, are categorically incompatible. The fact is that both ethanol and the main active ingredient of the drug have a toxic effect on the liver, and when combined, such an effect will be detrimental to the organ.

It is possible to restore the structure and functionality of the liver, but this process takes a long time, with widespread restrictions on food and the use of medications, which cannot but affect the functionality of other organs.

Interaction between Diclofenac and other medications

Characteristics of the simultaneous use of the drug and some medications are given in the table.

The patient must notify the doctor about the medications he is already taking. This measure will minimize the risk of possible consequences of drug interactions.

Drug interactions

Diclofenac does not interact with all medications:

• with other non-steroidal anti-inflammatory drugs - the risk of pathological changes in the liver and kidneys increases significantly;
• with lithium preparations – the concentration of this substance in the blood increases sharply, which threatens poisoning;
• with corticosteroids - negatively affects the functioning of the gastrointestinal tract, gastric bleeding may develop without gastritis and ulcers;
• with drugs that lower blood pressure – their effectiveness decreases.

Pharmacokinetics of the drug

Features of the pharmacokinetics of the injection form of Diclofenac are presented in the table.

Analogues of the drug

Analogs for pharmacological action include:

• Ibuprofen;
• Ketolac;
• Nimesulide.

Nimesulide Ketolac Ibuprofen
They also have anti-inflammatory, analgesic, antipyretic, and decongestant effects. Compared to Diclofenac, these drugs are less effective and do not relieve the symptoms of arthritis and arthrosis as quickly. But they have fewer contraindications and a lower level of toxic effects on the body.

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Pharmacodynamics of the drug

The medicine Diclofenac has the following effects:

• anti-inflammatory;
• analgesic;
• antipyretic.

The explanation for the effectiveness of the active substance lies in the inhibitory effect on cyclooxygenase. In connection with it, the reactions of prostaglandin formation are inhibited, and platelet aggregation reactions are suppressed.

Diclofenac eliminates pain, joint stiffness, and restores their functionality. If necessary, use in cases of post-traumatic and postoperative complications helps relieve spontaneous pain and pain during movements.

Arthritis Treatments

Treatment of arthritis is a complex of measures that are selected individually. The main methods of therapy include:

• Medication prescriptions . Specific medications are prescribed by the doctor after examining the patient; their choice depends on the nature of the origin of the pathology. Antibacterial (Azithromycin, Lincomycin), anti-gout (Colchicine), antifungal (Nystatin), immunosuppressants (Ciclosporin) may be prescribed.

Non-steroidal anti-inflammatory drugs (Diclofenac) or glucocorticosteroids (Diprospan) are prescribed as painkillers.

Additionally, medications that will correct metabolism, hormonal agents, and warming ointments may be prescribed.

• Physiotherapy . It is carried out only in a clinical setting; laser therapy, cold exposure (cryotherapy), and plasmapheresis are most often used. Additionally, massage, electrical stimulation, and hydrotherapy are prescribed - they help relax muscle fibers and prevent their atrophy.

If conservative treatment does not produce positive results, then surgical intervention is used:

• removal of pus;
• replacement of part or all of a joint.

Traditional methods can only be used as additional therapy and at the initial stage of disease development. Pine baths, rubbing with camphor, compresses with honey can only reduce the intensity of symptoms for a short time. They do not have any therapeutic effect.

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Diclofenac is the most effective drug for arthritis, arthrosis, which quickly relieves the patient of pain and stiffness of movement. It is highly toxic, so it must be prescribed by a doctor and taken strictly according to the proposed regimen.

Composition of the injection form of Diclofenac

One milliliter of injection solution contains 25 mg of the active ingredient diclofenac sodium. The structure of the active component of the drug is a derivative of phenylacetic acid. The solution is available in ampoules of 3 milliliters. Its additional components include purified water and benzyl alcohol. Diclofenac for injection is produced in cardboard packages of 5 or 10 ampoules.

Useful video

Watch this video for instructions on how to use Diclofenac:

1. Is it possible to treat arthrosis with Diclofenac?
2. What effect will this give? What types of arthrosis are treated with Diclofenac? The best ointments for treatment: Diclofenac (video) Contraindications

Rules for the use of Diclofenac for arthrosis

Analogues of Diclofenac

Being a non-steroidal anti-inflammatory drug (NSAID), Diclofenac is effectively used for arthrosis of any location. Treatment with Diclofenac is only symptomatic; the drug does not affect the causes of the disease.

There is only one problem with treatment with such a drug - NSAIDs often cause serious side effects with long-term use. Therefore, Diclofenac should be used in short courses and only under the supervision of a physician.

Diclofenac analogues and comparative costs of drugs

The price of Diclofenac Akos (manufactured by Sintez OJSC) for injection is not at all high; you can buy it from 16 rubles per package, which contains 5 ampoules of the medicinal solution. The cost of drug analogues can be found in the table:

If it is impossible to use Diclofenac in injection form for some reason, then the doctor should select analogue injections that are safer. Only the action should be similar, and not the composition of the solution for intramuscular injection.

Indications for use

Milgamma is prescribed to relieve symptoms and treat diseases of the nervous system and spine, including:

• Plexopathy. Damage to the brachial, cervical, or lumbosacral nervous system due to tumor, radiation therapy, compression, or trauma. An alternative name is plexite.
• Retrobulbar neuritis. Inflammation of the optic nerves.
• Polyneuropathy. Multiple lesions of peripheral nerves are usually accompanied by sensory disturbances and flaccid paralysis.
• Neuropathy. Non-inflammatory damage to a nerve or group of nerves.
• Neuritis. A disease of the peripheral nerves that is inflammatory in nature. Accompanied by paralysis, paresis and decreased sensitivity.
• Ganglionitis. Various nerve ganglion lesions, which have different symptoms depending on which nerve ganglion is affected.
• Neuralgia. Inflammation of a nerve in which the only symptom is pain.
• Night muscle cramps. Sudden leg cramps, occurring mainly at night. They are not dangerous in themselves, but they interfere with normal sleep and can signal the presence of a more serious illness.
• Facial nerve paresis. A lightning-fast progressive disease of the facial nerves, leading to their asymmetry.
• Sciatica. Lower back pain radiating to one or both legs. As a rule, the cause of pain is damage to the sciatic nerve.
• Radiculopathy (radiculitis). Damage to the spinal roots as a result of inflammation, trauma or pinching.
• Muscular-tonic syndromes. Prolonged and painful muscle tension, which is usually caused by osteochondrosis.

Overdose symptoms

If the dosage regimen for the injectable form of Diclofenac is not observed and the permissible amount of the administered drug is exceeded, the following symptoms may appear:

• clouding of consciousness;
• headaches and dizziness;
• convulsive states of myoclonic type;
• vomiting, nausea, sharp abdominal pain;
• impairment of the functional state of the kidneys and liver.

In case of overdose, it is advisable to carry out symptomatic treatment, the goals of which are to reduce blood pressure, correct impaired renal function, negative reactions from the gastrointestinal tract, depressed breathing, and convulsions. There is no specific antidote substance. Hemodialysis and forced diuresis have low effectiveness and are not used.

Chondroprotectors for arthrosis 8212 classification and correct choice of drug

1. Intra-articular injections are the most effective method, since the effect develops quickly and lasts quite a long time. Such manipulations need to be repeated only a few times a year. This is suitable for preparations that contain hyaluronic acid, such as Gialgan, Fermatron. The disadvantages of this method include the fact that injections into the joints are a medical procedure and are carried out in a hospital setting. Most often, chondroprotectors are administered to the knee joints.
2. Intramuscular injections are a convenient and widespread method of administering chondroprotectors. Alflutop, Chondrolone, Artradol, Chondroguard and many other intramuscular drugs are administered in this way. Suitable for patients who, for various reasons, are unable to swallow a tablet or capsule or have severe kidney disease.
3. Capsules and tablets are the most used and widespread method of drug administration. Does not require aseptic conditions or intervention of specially trained personnel, suitable for independent use. However, this method also has disadvantages: a long course of treatment, a large drug load on the liver and kidneys.
4. External use in the form of creams, ointments or gels is a good addition to the oral route of administration, but not as monotherapy. Preparations of hyaluronic acid and chondroitin practically do not penetrate the skin into the joint, but in combination with physiotherapeutic methods, the permeability of these substances can increase. Diclofenac (injections) can be used as a pain reliever. The price for external use drugs is in the range of 200-600 rubles.

And I have arthrosis of the knee joint. For several years now I have been taking the drug Jointace Omega-3 in capsules with glucosamine as a chondroprotector. Over time, knee pain and discomfort when moving stopped bothering me and the sensitivity of my joints to weather changes has become significantly less. Sometimes I use Jointace Omega-3 in gel form, it relieves inflammation very well.

Treatment procedure

Intramuscular injections cope with the symptoms of arthrosis

The injection can be intramuscular or intravenous. With its help, a person’s painful condition is alleviated. Intra-articular injections are considered more effective. However, they are not always able to cope with the symptoms and damage that the patient suffers from.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Drugs in this group are intended to eliminate pain, swelling and inflammation. They are traditionally included in every course of arthrosis therapy. There are several types of NSAIDs:

1. Non-selective (“Diclofenac”, “Analgin”, “Ketanov”);
2. Selective (“Movalis”, “Artrosan”, “Amelotex”).

Drugs of the first group are considered more dangerous, since they can negatively affect the condition of the gastrointestinal tract. Selective cyclooxygenase type 2 inhibitors are relatively safe. However, they also have their contraindications, including pregnancy, lactation and gastrointestinal diseases.

Dynastat is the only representative of the group of cyclooxygenase type 2 inhibitors. It goes on sale in ampoules. This drug is allowed to be used for peptic ulcers. It is not suitable for patients over 65 years of age.

Steroid drugs

Steroid drugs are prescribed for arthrosis of the knee joint in rare cases. This is because the indications for their use include only complex tissue lesions. The most effective steroid for this disease is Ambene. The drug copes with pain and reduces inflammation. It must be remembered that it can affect the ability of the joint to create new cells

Therefore, the drug should be taken with caution only as prescribed by a doctor.

Painkillers

A number of analgesics are added to the list of injections for joint diseases. This type of drug relieves pain well, making the patient feel much better. Painkilling injections for arthrosis are usually given to patients who suffer from pinched nerves, pain and muscle spasms.

The following drugs are used to relieve joint pain:

• "Methylprednisolone";
• "Hydrocortisone";
• "Novocaine";
• "Diprospan".

Painkillers are always included in the course of treatment for arthrosis.

Vitamin complexes

When arthrosis develops, doctors prescribe vitamin injections to patients. In this case, B1, B6 and B12 are required. They normalize metabolic processes and nourish tissues with missing microelements. Vitamin complexes also help cope with pain.

Injections for arthrosis help normalize the nutrition of the affected cartilage and restore its mobility. For therapy to be successful, the basic procedures must be carried out by a competent specialist. Attempting to give yourself an injection yourself can lead to very disastrous consequences, so such actions are strictly prohibited.

"Diclofenac" for lumbar pain

The lumbar area can hurt for many reasons. Since the drug was initially used and continues to be actively used for the treatment of rheumatological diseases, it gradually replaced almost all other drugs, even from the same group as NSAIDs. This was due to its broad analgesic activity, intense analgesic effect and high tolerance.

The action of the medicine is as follows:

• significant reduction in pain;
• rapid relief of pain;
• decreased stiffness;
• normalization of inflammation;
• removal of puffiness;
• increase in range of movements.

Injections can quickly relieve pain

It is these symptoms that are inherent in most rheumatological pathologies, the etiology of which includes diseases occurring in the lumbar spinal region.

Symptoms of ankle arthrosis

It is necessary to distinguish arthritic pain and joint subluxation from osteoarthritis. The inflammation that occurs with arthritis most often develops with inflammation of other joints. In this case, a small swelling appears on the ankle for no apparent reason, and the pain is much worse at night than with arthrosis. Arthrosis pain is more pronounced during the day during movement.

Ankle subluxation usually occurs in people with poorly developed limb ligaments. Obese people also often suffer from subluxation. With a weak ligamentous apparatus, it is quite easy to twist the leg, after which swelling of the foot appears, which disappears only after a few weeks. Full recovery takes about two months. However, repeated injuries to the ankle joints can contribute to the development of arthrosis of the leg, since subluxations deform the cartilaginous structure.

With arthrosis, pain in the foot and lower leg appears during normal walking, in a calm state, for example, while sleeping at night, the joints do not bother the person. There are cases when a sick person feels a leg affected by arthrosis, as if tucked in after a sprain or awkward movement, but the unpleasant effects do not go away over time, but only intensify.

With ankle arthrosis, the swelling does not go away in a couple of weeks, as with an injury, it persists constantly. However, there is a nuance. It is important not to confuse arthritic swelling of the ankle joint with swelling of the lower leg caused by vascular diseases. In medical practice, there are often cases when an erroneous diagnosis is made with these symptoms.

Rheovasography can help in making an accurate diagnosis; in addition, the ankle joint is x-rayed. Blood tests are taken. Usually these clinical studies are enough to identify the presence of arthrosis or arthritis, and then the proper treatment is selected.

Drug treatment

The use of medications, which can be found in various forms of release, makes it possible to get rid of the disease as quickly as possible.

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Treatment with tablets

These are the first remedies that a specialist will prescribe for you. Drugs that are available in tablet form and prescribed for this disease can be divided into two broad groups:

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1. Analgesics and anti-inflammatory drugs. Taking medications is aimed at relieving pain. These pills act immediately, but long-term use can cause the development of new diseases, such as ulcers or gastritis. Tablets that can be used for arthrosis include: ibuprofen, nimesulide, diclofenac, nise, meloxicam and others.

Anti-inflammatory drugs will relieve pain and inflammation

Ointments for ankle arthrosis

Ointments for arthrosis of the ankle joint are used mainly at the first signs of the disease or during the rehabilitation period. To a greater extent, such pharmaceutical products have an analgesic effect and cannot be used as an independent type of treatment. Some contain the same anti-inflammatory substances.

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Joint injections

Injections into the joint for arthrosis of the ankle joint can be divided into two separate groups, as well as tablet forms:

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1. Drugs of the first group effectively reduce pain symptoms and significantly reduce inflammation. The effect occurs within 24 hours. Subsequently, for a month the patient does not notice the symptoms of the disease. These drugs include: celeston, kenalog, flosterone and their analogues.
2. A group of chondoprotectors helps get rid of both symptoms and the disease itself. Such injections help build and restore the structure of cartilage tissue. These include: arteparon, alflutop and others.

Injections into the joint will deliver drugs directly to the source of pain

Some injections relieve pain and inflammation, while others help build cartilage tissue. However, they act more quickly; the course, as a rule, requires a shorter duration. Such drugs are administered exclusively under the supervision of a specialist after an accurate diagnosis has been made.

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Contraindications

Absolute contraindications to the use of diclofenac solution for intramuscular administration:

• hypersensitivity to the active component and other non-steroidal anti-inflammatory substances;
• dysfunction of the hematopoietic system;
• peptic ulcer;
• intestinal pathologies of destructive-inflammatory origin in the acute stage;
• bronchial asthma;
• age up to 15 years;
• periods of bearing a child and breastfeeding.

During pregnancy, injections of the drug should not be prescribed at any time; if it is necessary to use the drug during breastfeeding, lactation is stopped until the course of therapeutic correction is completed.

Strict medical supervision if it is necessary to administer Diclofenac injections and subject to an analysis of the risk-benefit ratio for the patient is necessary in the following situations:

• systemic connective tissue diseases (lupus erythematosus, collagenosis);
• induced porphyria;
• history of inflammatory and ulcerative pathological conditions of the gastrointestinal tract;
• impaired liver function;
• impaired functionality of the organs of the excretory system;
• hypertonic disease;
• heart failure;
• diabetes;
• lipid metabolism disorders;
• early postoperative period;
• tendency to hypersensitivity reactions;
• chronic obstructive pathologies of the airways;
• chronic infectious and inflammatory diseases of the respiratory system;
• elderly age;
• alcohol abuse.

The drug should be used with caution if concomitant drug treatment is necessary with anticoagulant, antiplatelet drugs, glucocorticosteroids for internal use, antidepressants from the group of selective serotonin reuptake inhibitors.

Since the administration of Diclofenac can provoke dizziness and excessive fatigue, during the course of use of the drug you should refrain from driving vehicles and other complex equipment.