So you go to see your doctor because you have the flu. The doctor books you off and prescribes antibiotics. One or two weeks later you start to feel better so you decide to go for a jog, and thats when it happens! Suddenly you hear a loud “crack” and start limping. You’ve TORN your achilles tendon and you weren’t even straining yourself?
This same scenario has happened to many people and its not because they were sick or unfit, its because of the ANTIBIOTIC that was prescribed!!!
A group of Antibiotics called Flouroquinolones are associated with a wide variety of musculoskeletal problems that affect muscle, tendon, bone and cartilage. They are commonly used to treat a variety of urinary tract, digestive, respiratory and skin infections amongst others. In the USA, this class of antibiotic is THE most prescribed type to adults, even though since as early as 1983 it was known that this drug was toxic to musculoskeletal tissue. Symptoms have been known to occur as early as 2 hours after the initial dosage and as late as 6 months after!!
In one study of 42 patients who developed Tendon related problems, 76% experienced tendinopathy (sick tendons) and the other 24% had complete ruptures of the tendon. Muscle symptoms range from mild muscular pain to a very serious and life threatening condition known as Rhabdomyolysis. Bone problems are less conclusive in humans, but in animal studies, it has been shown to slow down or even stop a bone from repairing itself.
What they have discover in more recent times is that there are factors which make you more at risk of developing these symptoms. These include: increasing age, use of cortisone, playing sport, a previous history of tendon or joint problems, magnesium deficiency and diabetes to name but a few.
So what should you do or how can this be avoided?
Not to discredit any Doctor or other health professional, but if you are being prescribed an anti-biotic, check with them that this will be safe to use, especially if you are a physically active person. I had a patient recently that developed general muscle ache, along with severe elbow pain for no apparent reason. She had all the symptoms of someone that had trained heavily the past few days, which she hadn’t. She also had Tennis elbow symptoms and it turned out she was prescribed a Flouroquinolone by her dentist for a tooth infection the week before…
So your doctor should get a thorough history of your previous musculoskeletal problems, find out about your activity levels, ask about associated risk factors and advise you to stop the drug immediately if it is causing any symptoms.
If you are an Athlete, you should definitely not be using this class of antibiotic unless there is no available alternative drug. If you are presently taking this drug, or have used it in the past 6 months, reduce your training intensity, avoid ballistic movements and be aware of any development of symptoms.
Ric@PhysioPRO
Full article by Hall et al. Published in the American Academy of Physical Medicine and Rehabilitation, Vol 3. 132-142, Feb 2011.
BY: Riccardo Vaccaro
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