Voltaren, (diclofenac) topical gel OK with pred? - PMRGCAuk

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Voltaren, (diclofenac) topical gel OK with pred?

Mstiles profile image
14 Replies

My GP has prescribed Voltaren (dicflocinac), for osteoarthritis and hip bursitis pain. I asked about taking it with prednisone and she assured me it’S OK because it’s topical, doesn’t affect internal organs, etc.

Has anyone used this gained relief from pain? Currently having pain in right knee, left hip, and both sacral joints. On 12 mg pred. PMR/GCA.

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Mstiles
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14 Replies
HeronNS profile image
HeronNS

I was recommended Voltaren. I looked it up, as is my wont, and learned that it is not recommended for older people. I think that is even on the insert for the extra strength version. Also, because the drug is indeed absorbed into the tissues, it can affect your gut, just as oral forms do. I had used it once (on my knee) and had a gut bleed which I did not connect to the medication until I did some reading. So depending on your own personal and perhaps your family history, caution may be advised.

All nsaids should be avoided as much as possible for osteoarthritis as they interfere with cartilage renewal. (Prednisone may also be implicated in this but I can't really find anything about it.)

Thanks to recommendation from jinasc I've been using a magic potion called Flexiseq which contains no drug, and is supposed to work something like WD-40 for your joints. It does seem to be helping. Certainly soon after starting to use it I became much more nimble and my knee improved quite rapidly, which after months of suffering seems like more than a coincidence. My son ordered it for me through Amazon as there is no other way to buy it in Canada. It is a British product.

Linlang profile image
Linlang in reply toHeronNS

Finally after 4 yrs of leg pain initially caused bu side effect of slow release b pressure tablet legs ankles became tree trunks drug discontinued no swollen ankles after 2 months but weak painful legs. Finally last week went to older osteopath.She started at my toes and gently worked way up to lumber spine.

Painful for 2 days but tolerable. Then last Tuesday walked for 11/2 hours slow walk but for four years had hardly left house..........almost a miracle! Had tried previous more conventional osteopath and concentrated on lumber region and absolute agony laterFor days .

so finding right one is important. I’m now on 2 mg and hope the journey is ending

HeronNS profile image
HeronNS in reply toLinlang

That's interesting. When I went to my physiotherapist last week for the light therapy (which has been helping me taper the pred back down) she spent a few minutes at the end doing something to my lower spine, next day I felt fine, but since then have had a lot of pain, so I'll have to tell her to go easy on me.

It certainly is a journey regaining strength in disused muscles isn't it? Sometimes I have no idea what of several possible issues is causing pain, all I know is there's likely to be something going on during any given day! But, like you, when my injured knee allowed me to start walking again, that was great, and with warmer weather it's been lovely getting out and about more. We both of us need to be careful not to get carried away and overdo it, though!

Jolaine profile image
Jolaine in reply toHeronNS

Try Dynamint

HeronNS profile image
HeronNS in reply toJolaine

What does it do?

PMRpro profile image
PMRproAmbassador in reply toHeronNS

It's a bit like Deep Heat without the salicylate content - a muscle balm.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Never used Voltaren...not sure why, but did use ibruprofen gel when on steroids (sparingly).

Unlike jinasc, HeronNS and many others Flexiseq did nothing for my OA. I now use CBD cream for arthritic shoulder and lumbar spondylitis . Link, just in case voltaren doesn’t suit you - cheaper on Amazon -

sensiwellness.co.uk

Telian profile image
Telian

Hi Mstiles, I used a rub in Voltarol (UK) because tablet form gave me stomach gripes. You are only supposed to use the tube form short term ie 7 days - it still gave me diarrhoea. It was good for pain relief though! Won’t be trying that again. Good luck!

S4ndy profile image
S4ndy

I use volterol gel for my knees. It does help a bit. I've had no problems with it. I took diclofenac for years which was great at keeping my back pain under control. Had to stop when taking Pred and to be honest really miss it. When I had a kidney stone they gave me diclofenac suppositories and it was so obvious that this drug works really well as a painkiller for me. My Rheumatologist hasn't ruled it out for the future but as I still need prednisolone to keep the PMR under control he's holding off on this at the moment but is absolutely fine with me using the gel. I use the 12 hour gel which you only need to use twice a day on my knees. Hope it works for you xxx

PMRpro profile image
PMRproAmbassador

Silly woman - how does she think it works from outside the skin except by being absorbed into the system? It is better to use topical if you MUST but still only in limited amounts and small areas.

"Topical NSAIDs offer an alternative to decrease the risk of systemic NSAIDs.22 Although topical NSAIDs are considered relatively safe, their skin adverse effects (AEs) cannot be ignored (ranging from 10% to 39%).23 24 With respect to systemic AEs, GI bleeding, dyspepsia, acute renal impairment and asthma have been reported in relation to topical NSAIDs.25–27 Furthermore, the prevalence of systemic AEs in the older population has been reported to be as high as 17.5%, of which 2%–9% may be GI AEs.24 However, these studies did not have control groups and the risk cannot be wholly attributed to the use of topical NSAIDs. Therefore, the safety profile of topical NSAIDs remains unclear."

bjsm.bmj.com/content/52/10/642

LemonZest11 profile image
LemonZest11 in reply toPMRpro

Well I won’t be using that then. Thanks.

pegpowell profile image
pegpowell in reply toLemonZest11

I agree with Heron. I have an ulcer and it immediately made me know it was still there.

Mstiles profile image
Mstiles in reply toPMRpro

I didn’t mention my prednisone in the appt. because she has been refilling it without questioning me as to tapering, etc. Because it has been such a struggle and stressful before, with her and previous doctors, I didn’t want to bring up the subject but she must know I’m on pred from my chart. I’m still without a rheumatologist but have an appt with a new one this month. Been putting off seeing one or discussing it with her because of being stuck at 13 since last July. I’m at 22 now, about to go to 11. She does listen if I explain, but I’m not confident how knowledgeable she is about PMR/GCA. She once told me it didn’t affect the joints and cause joint pain.

PMRpro profile image
PMRproAmbassador in reply toMstiles

In theory it doesn't affect the joints as such. But it DOES affect the soft tissues around the joints where the muscles and ligaments/tendons attach to the bones and so it makes the joints sore and stiff. It also can cause synovitis, inflammation of the lining of the joint, but it doesn't cause any damage to the joint in the long term like RA does.

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