Short-Term Joint and Back Pain: When to Consider Medication

Pain in the limbs and back?

Hello Doctor, I have been experiencing upper back pain, pain in the finger joints and fingertips, pain in the toes, knee pain, and occasional elbow pain for the past 1 to 2 months.
This past month, I went to a large hospital for examinations.
The doctor checked for lupus erythematosus, ankylosing spondylitis, gout, and rheumatoid arthritis.
The blood test results showed no issues, and even the ultrasound did not reveal anything significant, except for a little fluid accumulation in my knee.
The doctor asked how long the pain lasts, and I said it lasts at most 5 to 10 minutes before it goes away.
He mentioned that the short duration of the episodes is not concerning, so he prescribed Aceclofenac 100 mg for me, advising that I take it only when in pain and not to take it when I am not in pain, as it can be harmful to the kidneys.
Therefore, I have not taken it, but I still experience pain, just in different areas and for short durations.
Doctor, do you think I should take that medication, or should I just try it for a few days? Thank you, Doctor.

Ken, 20~29 year old female. Ask Date: 2022/12/29

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
Some young individuals do experience intermittent joint effusion, with symptoms that come and go, often lasting no more than three days.
In such cases, we generally first check for any serious rheumatic diseases behind these symptoms, as your physician has arranged with the tests.
If none are found, it is indeed advisable to take medication only when joint pain occurs, and not to take it when there are no symptoms.
If you wish to reduce the frequency of these episodes, it is recommended to maintain a regular lifestyle, avoid staying up too late, and engage in regular exercise, which may help decrease the occurrence of symptoms.
Regarding pain relief medications, taking them early during an episode usually allows for quick pain control, and there should not be a need to take excessive amounts, as the impact on the kidneys is minimal.
Therefore, if the symptoms are bothersome and affect your quality of life, it is advisable to consider taking them.
Best regards from the Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare.

Reply Date: 2022/12/29

More Info

When it comes to managing short-term joint and back pain, especially when the pain is intermittent and not linked to any serious underlying conditions, understanding the role of medication is crucial. Based on your symptoms and the medical evaluations you've undergone, it seems that your pain is not indicative of severe conditions like lupus, ankylosing spondylitis, gout, or rheumatoid arthritis, which is reassuring. However, the discomfort you're experiencing can still significantly affect your quality of life.

The medication prescribed to you, Aceclofenac, is a non-steroidal anti-inflammatory drug (NSAID). NSAIDs are commonly used to relieve pain and reduce inflammation. While they can be effective for managing pain, they do come with potential side effects, particularly concerning kidney health, especially if used long-term or in higher doses. Your doctor’s advice to only take the medication when you are in pain is a prudent approach, as it minimizes the risk of adverse effects while still providing relief when necessary.

Given that your pain episodes last only 5 to 10 minutes and are not constant, you might consider a few strategies before deciding to take the medication regularly:
1. Pain Management Techniques: Explore non-pharmacological methods for pain relief. Techniques such as heat therapy (using a heating pad), cold therapy (ice packs), gentle stretching, and physical therapy can be beneficial. These methods can help alleviate pain without the risks associated with medication.

2. Activity Modification: Pay attention to your activities that might exacerbate the pain. If certain movements or positions trigger discomfort, try to modify those activities or take breaks to avoid strain.

3. Over-the-Counter Alternatives: If you find that Aceclofenac is not suitable for you due to concerns about kidney health or if you prefer to avoid it, consider other over-the-counter NSAIDs like ibuprofen or naproxen. These medications can also help manage pain and inflammation but should be used with caution and not exceed recommended dosages.

4. Monitoring Symptoms: Keep a pain diary to track when the pain occurs, its intensity, and any activities that may trigger it. This information can be valuable for your healthcare provider to understand your condition better and adjust treatment if necessary.

5. Consultation with a Specialist: If your symptoms persist or worsen, consider consulting a rheumatologist or a pain management specialist. They can provide a more comprehensive evaluation and may suggest other treatment options, including physical therapy, corticosteroid injections, or alternative medications.

In conclusion, while Aceclofenac can be effective for managing pain, it is essential to weigh the benefits against potential risks, especially concerning kidney health. If you choose to try it, monitor your response closely and communicate with your healthcare provider about any concerns. Additionally, incorporating non-pharmacological pain management strategies can be a valuable part of your overall approach to managing your symptoms. Always prioritize your health and well-being, and don’t hesitate to seek further medical advice if needed.

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