Erosive Osteoarthritis

I have erosive arthritis in both hands. They are very stiff and the joints have nodules and I cannot fully close my hands. It is not rheumatoid arthritis. If you have access to your xray films you will notice that the joints have “wings”. Years ago I was told the FDA was fast tracking a drug for this particular problem. Whenever I paint or do remodeling or do heaving cleaning the pain increases. I take pain medication when needed. I can no longer wear rings.

@genie15 glad I could offer some suggestions! I hope they provide some relief!

@heyjoe415
Was this oral diclofenac or topical diclofenac which gave you the reaction?

Hi Kathleen,

It was oral diclofenac that raised my creatinine numbers. I have used the topical diclofenac gel, which is available OTC. Some of the drug will still get into your bloodstream through the skin, but I'm pretty sure it's not as impactful on the kidneys as the oral drug, which does require an Rx.

Talk with your Dr about this. Celebrex is another NSAID only available via Rx. It's easier on the stomach but also affects the kidneys. I would also get your Dr's opinion on long-term use of any NSAID.

Hope that helps.

Joe

@heyjoe415
Thanks for the reply. This lines up with the research of first pass liver problems for many if not all oral products.
This is one reason that I try to take anything topically when it is available.

Thanks Kathleen.

Coincidentally, there is another thread on Connect dealing with diclofenac gel (Voltaren). Even gels and creams can have an impact, so please use with care.

Joe

@heyjoe415
Could you hotlink me to the Connect dealing with diclofenac gel.
I do see this on some research:
"Topical forms of diclofenac (solutions, gels, creams, patches) have been associated with only a low rate of serum enzyme elevations (generally less than 1%) that may be no greater than occurs with placebo or vehicle application. However, product labels for topical diclofenac mention the possibility of liver injury and several cases of clinically apparent liver injury attributed to topical diclofenac have been reported in the literature although the diagnosis in these cases have often been questionable. Thus, if clinically apparent liver injury due to topical forms of diclofenac occurs, it must be exceedingly rare."
https://www.ncbi.nlm.nih.gov/books/NBK547953/.
Ai overview:
Topical diclofenac generally causes low rates (under 1%) of liver enzyme elevations, similar to placebo, but clinically apparent liver injury from the gel is documented.
There are reported cases of acute liver injury linked to topical diclofenac, often resolving after stopping the gel, suggesting a possible connection.
The resoulution after stopping is important since most topical treatment is meant to be short term and not continued for any long period of time.

@kathleen1314 I've used prescription-strength topical for 20 years. No elevation in anything. I'm sure it can't mess with your liver. Can't imagine how it could topically. They probably didn't control the study well enough. If you read the link you provided you see there is no known issue that isn't more than NOT taking it. I saw nothing stating it was for short-term use topically.

Thank you for posting on erosive osteoarthritis. I was diagnosed with EOA two years ago, although I think my previous rheumatologist had missed it for a few years. I’ve also had rheumatoid arthritis now for 30 years. I have found that erosive osteoarthritis is more aggressive, painful, and disabling then my rheumatoid arthritis. The difference is that, while there are now medication’s to treat RA, there are none for erosive osteoarthritis. The damage my hands have incurred and continue to incur is stunning.

I can tell you a couple of things that are helping me right now. I wear silver rings, similar to the plastic eight rings, but tailored to my size, joints: they are particularly affected. I buy these on Etsy, where a silversmith from Arizona could not be more gracious and helpful.. last year I ended up having two finger fusions when joints were simply too painful and swollen to allow me to function with my right hand. Both fusions have been helpful and, although it may seem extreme, I am happy that I’ve done them. Finally, this summer. I discovered low-dose naltrexone. You’ll need to talk to your provider about this since this is an off label use. I have been taking LDN now for six months and my use of NSAIDs is much reduced as is swelling in my DIP and PIP joints.

I’m sending you love and support. There are not so many of us out there and even our doctors sometimes are not aware of EOA. I know how frustrating this can feel. I’m glad you posted this discussion.