Ibuprofen

[JanboC]

Hello, wise ones.

I know you should not take Ibuprofen when on pred. But , I have read on here that people do take it occasionally. How often does that mean please? I am having serious problems with my feet (not diabetic) in that they feel tight all over, and in bed I get shooting pains in my right leg mostly. It interrupts my sleep to the point where I am getting up at 2/3am most mornings. I took 2 Ibuprofen at 2am and went back to bed at 3, the difference it made was lovely, I was able to get another 3 hours sleep. I am still up early as I am usually tired out by 8pm, so getting up around 6 ish is fine for me. I am seriously wondering whether acupuncture might help? I have mentioned it to my GP on numerous occasions, but I have so many other health problems at the moment, it never seems to be discussed! Thoughts anyone?

[SnazzyD]

Hello, when you say “tight” do you mean the joints, muscles or the skin? Just wondering if you are getting a collection of fluid in the feet and legs in the day.

[JanboC in reply to SnazzyD]

No, no fluid. It's the skin that feels tight. I told the physio last week that they were "numb", but he did some touch tests, and I squealed when he ran his fingers down the underneath of my foot and said, "no, definitely not numb"

[SnazzyD in reply to JanboC]

Sorry, more questions. So the skin feels tight but the shape of the foot, leg and ankle are completely normal and you can see the bones underneath on the top of the foot? The skin isn’t shiny anywhere? Do your shoes fit ok?

So when he ran his fingers down the bottom the foot and you squealed, was it finger tip or finger nail and was it pain or being ticklish?

Where do the shooting pains start and where do they go exactly in the leg?

What footwear do you wear in the day and what do you do?

[JanboC in reply to SnazzyD]

Yes, my shoes fit fine, foot not shiny or swollen. it's all underneath is this weird feeling. I am very ticklish on my feet! I wear slippers during the day , and don't do much as I am struggling to walk. The physio just used his finger to do the touch tests. The pain runs up the outside of my leg from the ankle, and then turn into shooting pains, then across the front of my ankle. No matter what I do, I can't get it comfy in bed. It doesn't happen much during the day, just aches! Yes, I can see the bones on the top of my foot.

[SnazzyD in reply to JanboC]

From the location I’m wondering about non- traumatic Peroneal tendinopathy. You don’t have to be an athlete to get it or any other foot/ankle tendinopathy and it can be jolly painful. As PMRPro says, slippers are no help for an ageing foot and although can be soft and cushioned offer no correction if your foot and ankle are not correctly moving which most aren’t. Your tendons take up the slack all the time if your ankles are rolling even a bit or your arches are too flat or high. I’ve been banned from wearing slippers by my podiatrist and have a soft shoe with a fitted orthotic to wear at home and it cleared up my tendinopathies.

This video shows really well with pics the physiology for the first 1 min 2secs. It then goes into exercises but really you need professional help with that and a diagnosis firs as there are a number or tendons that can play merry hell with your feet and lower legs.

youtu.be/0fsR5-oqcVU(Not working as expected?)

This explains it in words.

footeducation.com/peroneal-...

[JanboC in reply to SnazzyD]

Thanks, Snazzy. I have changed to shoes, and put some inserts in from when I had Plantar Fasciatis. Fingers crossed?

[PMRpro Ambassador]

My rheumy has put me on a low-ish dose of ibuprofen as it is the only thing that gives me relief from the low back pain that has severely restricted any activity for over a year. Paracetamol does zilch on its own, another NSAID the Pain Clinic used gives me a headache. I find a starting dose of 800mg ibuprofen, the so-called flooding dose gives me good relief for the best part of 24 hours and then can be topped up with less once a day. He gave me 600mg ibuprofen. I have not yet had any problems - and I'm also on an anticoagulant. I used to take the odd dose, maybe once a week or so. Now it is regular. DIscuss it with your doctor because many doctors DO approve of using it under their direction and my rheumy used to insist on a PPI when I was on a high dose of pred, now I'm at 6mg he didn't bother

For your feet - I don't know what sort of slippers you use but the usual sort have no support for aging feet at all and probably the best thing you coud do for your feet is get supportive footwear for in the house. I wear shoes that I keep for the house.

[Missus835]

I take 400 to 800 Ibuprofen daily for low back plus Tylenol. Only thing that works for that. Now have possible herniated disc so rhemy going to try pregabalin.

[JanboC in reply to Missus835]

Tylenol is the equivalent of Paracetamol. I an already on cocodamol and paracetamol and they are not helping with this specific problem.

[Missus835 in reply to JanboC]

I know. Use ibuprofen if it works.

[JanboC in reply to Missus835]

Yes, but I know you're not supposed to use it when on steroids.

[Missus835]

Did u see reply from PMRPro? My rheumy says it's ok but sparingly but right now too much pain.

[Twopies]

my doc wanted me to take it for a few days, said to call the pharmacist first. Pharmacist said 5-7 days ok, but if any signs of stomach distress, stop immediately. My tummy was ok.

[Blearyeyed]

Taking Ibuprofen when taking other NSAIDs or steroids is usually not recommended , especially long term , because it adds to the burden on the stomach and chance of getting ulcers , nausea etc. increased risk of anaemia and the possible effect on kidney function , breathlessness or on heart conditions. With direction and approval from a GP it can be used but as Twopies mentioned they usually prefer you to have it for short periods up to a week keeping an eye on the symptoms but if the symptoms persist after that time they generally prefer you to contact them again to arrange more tests and try other alternatives.

Topical Ibuprofen cream can be used and beneficial for specific joints or the feet and hands without the same effect on the body and stomach , it can be used initially with oral ibuprofen then used alone after the initial flare up of symptoms have been controlled by a few days if oral ibuprofen. You can get this OTT or get a prescription.

It may be worth asking your GP to refer you to have your feet checked and measured by orthopaedics to suggest or provide the right footwear or moulded insoles to reduce the problem or prevent it happening again.

[JanboC in reply to Blearyeyed]

Thanks, blearyeyed. I am aware of the risks as I read all the leaflets thoroughly when I get new medication. Due to other ongoing health issues at the moment, my feet problems seem to get swept under the counter! I am going for bloods tomorrow so will ask the pharmacist for some topical ibuprofen cream and see if it helps. I have also made an appointment to see an acupuncturist on Thursday, so will see what the outcome of that is.

[Blearyeyed in reply to JanboC]

Have you got any of those packs that can either be put in the freezer to ice up or warmed in a microwave used more often for injuries? I find , using one of those and massaging it around my feet quite useful as well. I use heat or cold based on which seems to give the most relief.

If you heat one of those and hold it on the foot before putting on the cream it actually helps improve the penetration of the active ingredients so helps the cream work better. I learnt this trick from the pharmacist while getting advice about using similar creams on my back.

[JanboC in reply to Blearyeyed]

No, I haven't got any, but it sounds a useful idea, thanks

[PMRpro Ambassador in reply to JanboC]

Really cold water, out of the fridge, in a hot water bottle is also good. And obviously that can be warmed too!

[Galore]

Just seen your post. I had severe shooting pain down outside right calf which woke me up for couple of weeks plus. Pain in thigh and buttock also 'dead leg' which was frightening! Felt knee was slightly numb. Foot was fine. Thought might be flare up as down to 5mg pred. Took 4 x paracetamol daily which helped but then had cocodamol. Same as you up about 3am real bad pain! Spoke GP and then zoom with physio who suggested pilate stretching exercises. Also spoke to Rheomo all thought sciatica. Was in agony for 10+ days, sick, lost appetite couldn't get comfy sitting or lying down. Saw chiro last week 90% better!! Doing stretch exercises, walking straight, ice pack, etc so hope on mend! Been sleeping with cushion underneath and between leg which definitely helps. Still can only sleep on one side. How did you get on with acupuncture? Hope you much improved.