Achilles tendonitis and damage due to antibiotic side effect - odd icy sensation?

[Braecoon]

I have had RA for nearly 10 years, currently on Benepali and Metotrexate injections. Rheumatoid factor 74 and Anti-cpp 600 in 2014 and generally do not score above normal for blood CRP tests (interesting anomaly) even when ultrasound in clinic reviews shows inflammation. As well as small joint hand and feet issues, suffer with a lot of tendonitis in shoulders, elbows, wrist and left Achilles tendon (partially tore this tendon 15 years ago).

Started physio and hydrotherapy (lucky to have a hydrotherapy pool 5 miles from home) last summer for left Achilles tendonitis. I have severe bilateral ankle and feet swelling that has been permanent for last 5 years (not caused by heart or varicose veins) it is making it difficult for the physio to feel the underlying structures but they suspect it may be degenerative tendonitis due to the tear injury decades ago. Was given antibiotic Ciprofloxacin in December which caused damage to both Achilles tendons, could not walk without severe pain and was at risk of rupturing the tendons for up to a month after stopping the anti biotic. With rest, ice, compression, and elevation of my legs for first 4 weeks recovery has been slow but good. Returned to physio and hydrotherapy in February and I am only allowed to do the ankle weight bearing exercises in the hot water pool. Can now walk at my normal stride instead of short shuffling steps and can get round the large supermarkets without pain.

The right Achilles tendon seems to have come of worse from the antibiotic damage. For last couple of weeks I get an odd sensation in the right Achilles during activity, at rest, and during the night. The sensation is like someone with ice has gripped my right ankle, the ankle does not feel cold to touch when this happens. It is getting more frequent day and night. I have physio review this coming week so will ask about this.

Anyone else have this icy coldness sensation in their tendon area and any ideas for minimising this?

[Stills]

yes I have this following a grade three rupture of the soleus and gastrocnemius muscles that went untreated during the pandemic. I had a tendon strain about 23 years ago too and it’s never been right since then.

I have Adult Onset Stills Disease diagnosed aged 17 in 1979 which for me manifests as RD. Both big toe joints are rigid and painful and I use codeine based OTC treatments.

I have little experience with antibiotics so can’t indicate them as a cause but did take steroids for about 5 years upon diagnosis.

I’ve had physio and recently a pair of orthotics. A guided steroid injection is promised if these don’t provide relief. The physio mentioned peripheral neuropathy.

The jury is out but I recognise your description exactly .

[Braecoon in reply to Stills]

Unfortunately, after joining the dots, reading the Ciprofoxacin information leaflet, and then academic research, the recommendation is that people 60 or over should not be prescribed this anti biotic as they are at higher risk for this adverse side effect (tendon damage especially Achilles and risk of tendon rupture). Don’t know why the right tendon has come off worse, as I would have thought the already old injury tendon on left ankle would have been worse! I am just grateful that I did not completely rupture either tendon. Will see what physio says at my review this week, though I suspect they will tell me to speak to the rheumatologist or GP if it is looking like it might be neuropathy.

I hope you continue to get some relief with your steroid injections - best wishes.

[Stills in reply to Braecoon]

Hope the physio review goes well

[Mainman007 in reply to Stills]

Was prescribed Cipro 250mg 4 times a day due to lung infection back in 2018.Within 2 weeks ruptured my right Achilles during training.Never had any issues prior to taking Cipro.Both Achilles felt “tight” prior to rupture.I was never given warning of what the possible side effects of taking Cipro.This drug is directly responsible for countless tendon ruptures.If you look at the UK study done in 2018.Of 6.5 prescriptions 28K tendinitis and 9000 ruptures.May not sound like many but 1 out 200 reported tendinitis is a lot.That is reported.How many not reported?Cipro should of been banned long ago.It is not a sale drug.

[J1707-]

I have several small tear in my Achilles and calcification. I have gone through all the physio and a steroid injection was only thing that helps but my Achilles is permanently inflamed. I didn’t know antibiotics caused tendon damage . Very interesting. I get icy feeling in my feet was diagnosed with peripheral neuropathy. I think you need to talk to someone about a nerve conduction test.

[welsh12 in reply to J1707-]

Do you take medication for the peripheral neuropathy

[J1707- in reply to welsh12]

I take pregablin. Compression tights help as well.

[welsh12 in reply to J1707-]

Thanks just started the compression tights

[J1707- in reply to welsh12]

Hope you get some relief. It’s so disconcerting

[Braecoon in reply to welsh12]

I have gone back to wearing my compression socks, thanks for mentioning that. It’s such a horrid feeling - feel as if I am being gripped by the frozen hand of the ‘living dead’ like in a horror movie, lol.

[Braecoon in reply to J1707-]

Specifically Ciprofloxacin antio biotic, it is detailed in the side effects information. You are more at risk if you are 60 and over. I wish I had known this before being prescibed this antio biotic. It is now on my list of drug adverse effects.

[Braecoon in reply to J1707-]

Thank you for mentioning neuropathy, I suspect that maybe that’s what the odd skin icy coldness is. Will speak to physio this week to get their thoughts on this, I suspect they will tell me to speak to my rheumatologist!

[J1707- in reply to Braecoon]

Good luck it’s a horrible feeling

[Fra22-57]

interesting reading as I have had Achilles tendinitis for couple of years.Just back from holiday after accident on it.simple trip n heard a snap which I think is torn tendon.ankle n leg a mess.local hospital abroad could only put me on a painkiller drip and X-ray to see if broken.So so painful so struggling to walk.I have had 2 lots of steroid injections in past and am awaiting to see orthotics

[Braecoon in reply to Fra22-57]

Funny enough, that’s how I partially tore my tendon when I was abroad on holiday. It is very painful and a long recovery because the Achilles tendon tends not to have a very good blood supply like other tendons. A few years after I recovered, I had a bout of tendonitis and received physio and ultrasound for the scar tissue that had formed and had a good recovery from this. Now it seems that I have degenerative tendonitis on that old injury and not helped by RA. Now the anti biotic damage to both Achilles tendons is just the icing on the cake that I did not want. Strange that it was the good ankle that has come of worse from this insult, I would have thought it would have been the old injury ankle!!!!

Wishing you a good recovery and definitely follow up with physio once the pain and inflammation settles, as the scar tissue that develops can stiffen the tendon reducing foot movement and can flare causing bouts of tendonitis at a later date if you don’t exercise it.

[Fra22-57 in reply to Braecoon]

Many thanks for your words of wisdom