Diclofenac For Back Pain | Study, Safety and More

Diclofenac is classified as a nonsteroidal anti-inflammatory drug (NSAID) with the generic name Diclofenac sodium. It is an over the couter medication you can also buy diclofenac over the counter  from certified pharmacy.

It is used to treat conditions like mild to severe pain, fever, inflammation of tissues (red, swollen, and tender tissues), rheumatoid arthritis, back pain, and gout.

As Diclofenac can be used for any type of joint, muscle, and bone problems, it can be used to treat back pain (Todd, P.A. and Sorkin, E.M., 1988).

A Study On The Efficacy Of Diclofenac In The Treatment Of Back Pain

A study was conducted in the Department of Health Policy and Management/iMTA, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands, to determine the effect of Diclofenac over back pain.

The patients were given Diclofenac (immediate-release) 2 doses daily of 75 mg, placebo paracetamol four daily doses. It was observed that Diclofenac is relatively effective and fast-acting in cases of back pain (Efficacy of paracetamol, diclofenac and advice for acute low back pain).

Mechanism Of Diclofenac

Diclofenac is responsible for the inhibition of cyclooxygenase-1 and -2, the enzymes that are responsible for the production of prostaglandin (PG) G2, the precursor to other prostaglandins. These are related to the activity in pain and inflammation, inhibition of which by Diclofenac relieves the pain.

This inhibition of COX (COX-1 and COX-2) activity decreases the synthesis of prostaglandins involved in the mediation of inflammation, pain, and swelling while it could cause gastrointestinal ulceration, respectively (Todd, P.A. and Sorkin, E.M., 1988).

Half-Life And How Long Does It Take Work?

The half-life of Diclofenac on a general basis is of 2 hours. However, depending upon the condition and medical history, it could be extended to 25-33 hours. Consumed orally, Diclofenac takes about 20 to 30 minutes to initiate its action, and in about one to two hours, the full effect is observed.

In the case of Diclofenac gel, it takes approximately 1 to 2 days to start working. To reach peak concentration, it could take up to 7 days, depending upon how severe the condition is (Todd, P.A. and Sorkin, E.M., 1988).

Forms And Strengths

Diclofenac is available in the forms of packets, regular tablets, delayed and extended-release tablets, and capsules.

Diclofenac sodium is available in the strengths of 25, 50, and 75mg delayed-release tablets, 100 mg extended-release tablets, and 18 and 35 mg capsules.

Diclofenac potassium is available in the strengths of 50mg single dose packet, 50 mg generic tablets, and 25mg capsules (Todd, P.A. and Sorkin, E.M., 1988).

Dosage

For Rheumatoid Arthritis

Standardized adult dosage:

• Diclofenac sodium- 50 mg divided into an eight-hour cycle or 75 mg divided into a 12-hour cycle.
• Diclofenac potassium- 50 mg divided into 8-12 hour cycle.
• Extended-release tablets- 100 mg once a day, can be increased to 100mg divided into a 12-hour cycle.

For Osteoarthritis

Standardized adult dosage:

• Diclofenac sodium- 50 mg divided into an eight-hour cycle or 75 mg divided into a 12-hour cycle.
• Diclofenac potassium- 50 mg divided into 8-12 hour cycle.
• Extended-release tablets- 100 mg once a day, can be increased to 100mg divided into a 12-hour cycle.
• Capsule (Zorvolex)-35 mg three times a day

Dosage

For Ankylosing Spondylitis

Standardized adult dosage:

• Diclofenac sodium- 25 mg to be taken four to five times a day
• Diclofenac potassium- 50 mg divided into a twelve-hour cycle.

For Dysmenorrhea

Standardized Adult Dosage: 100 mg once a day, increasing by 50mg divided into an eight-hour cycle depending upon the condition.

For Acute Pain

Standardized adult dosage:

• Regular tablets- 100 mg, increasing by 50 mg when required divided into an eight-hour cycle.
• Extended-release tablets- 25 mg four times a day of Zipsor or 18-35 mg three times a day for Zorovolex.

NOTE: Diclofenac is advised in the acute pain cases for mild to moderate pain in adults

How To Consume Diclofenac?

Swallow Diclofenac capsules and tablets with water, juice, or milk. In case of consumption with water, consume Diclofenac after a snack or meal. Consumption of juice or milk is less likely to upset your stomach or irritate it. Do not chew, crush, or break the capsules. Consume the whole (Todd, P.A. and Sorkin, E.M., 1988).

What To Do If You Missed A Dose?

Diclofenac is used only when needed unless prescribed otherwise. Skip the dose that is missed if you are close to the next dosage. Do NOT consume a double dose to even it out.

What Happens If You Overdose?

Seek emergency attention in case you overdose or call the poison helpline. Overdosing symptoms may include nausea, vomiting, stomach pain, drowsiness, black or bloody stools, shallow breathing, coughing up blood, fainting, or stroke.

Who Should Not Take Diclofenac?

If any of the below conditions sound relatable and familiar, it is not advised for you to consume Diclofenac. However, consulting the doctor before the decision would prove of help.

• Allergy to aspirin
• Allergy to any NSAIDs
• Allergy to Diclofenac
• Faced any side effects to NSAID such as wheezing, asthma, skin allergy
• Suffered stomach ulcers
• Have or had hypertension
• Heart failures
• Liver disease 
• Kidney disease
• Crohn’s disease
• Ulcerative colitis
• Lupus
• Blood clotting disorder

If you are either pregnant or are breastfeeding, it is advised NOT to consume Diclofenac. Consult your doctor if you face any confusion.

Side Effects Of Diclofenac

Common side effects of Diclofenac include:

• Gas
• Indigestion
• Nausea
• Vomiting
• Stomach pain
• Diarrhea
• Constipation
• Headache
• Dizziness
• Drowsiness
• Abnormality in lab tests
• Itching
• Sweating
• Stuffy nose
• Increase in blood pressure
• Swelling or pain in arms or legs

Consult your doctor or seek immediate attention in case you notice any of the following side effects to Diclofenac:

• Skin rash, even if mild
• Flu or flu-like symptoms
• Heart problems such as shortness of breath, swelling, or rapid weight gain
• Little or no urinating
• Stinging or difficult urination
• Stomach pain
• Dark urine
• Excessive fatigue
• Jaundice
• Bloody or tarry stools
• Coughing up blood
• Coffee ground look-alike vomit
• Slurred speech
• Burning eyes

Conclusion

Diclofenac is an NSAID (nonsteroidal anti-inflammatory drug) that is used for conditions like mild to severe pain, fever, inflammation of tissues (red, swollen, and tender tissues), rheumatoid arthritis, back pain, gout, period cramps and migraine. It is useful and effective for both acute and chronic back pain problems. However, the visible effect may vary depending upon the condition.