NSAIDs and FQs Damage Mitochondria, Increase Oxidative Stress, and Cause Cell Death

As I noted in the post, Why NSAIDs Suck for Floxies (and Probably Everyone Else Too), NSAIDs often exacerbate fluoroquinolone toxicity symptoms, and there are several mechanisms through which NSAIDs can interact with fluoroquinolones. The results of a recent article published in the Journal of Molecular and Cellular Cardiology by researchers at UC Davis, Different effects of the nonsteroidal anti-inflammatory drugs meclofenamate sodium and naproxen sodium on proteasome activity in cardiac cells, help to further explain why NSAIDs trigger fluoroquinolone toxicity symptoms, and why they are a horrible combination.

NSAIDs and Fluoroquinolones Damage Mitochondria

The study showed that NSAIDs “Attack mitochondria, reducing the cardiac cell’s ability to produce energy” (source).

Likewise, fluoroquinolones have been shown to attack mitochondria. The studies, Bactericidal Antibiotics Induce Mitochondrial Dysfunction and Oxidative Damage in Mammalian Cells and Delayed cytotoxicity and cleavage of mitochondrial DNA in ciprofloxacin-treated mammalian cells show that fluoroquinolones damage mitochondria, deplete mitochondrial DNA, and cause oxidative stress.  Also, the FDA admits that mitochondrial damage is the likely mechanism through which fluoroquinolones cause peripheral neuropathy.

Healthy mitochondria are vital for cellular energy and health. Unhealthy mitochondria have been linked to many diseases, including M.S., fibromyalgia, M.E./C.F.S., P.O.T.S., diabetes, cancer, aging, and more. Do NSAIDs and fluoroquinolones increase one’s chances of getting those diseases that are related to mitochondrial dysfunction? It’s certainly reasonable to think so – via the mitochondrial damage link – but studies have not shown a direct connection (mainly because neither have been researched).

NSAIDs and Fluoroquinolones Increase Reactive Oxygen Species (ROS)

NSAIDs also “Cause the production of reactive oxygen species, which stresses heart cells and is associated with many diseases, including heart disease” (source).

Fluoroquinolones have also been shown to increase production of reactive oxygen species (ROS – aka oxidative stress). The article, Oxidative Stress Induced by Fluoroquinolones on Treatment for Complicated Urinary Tract Infections in Indian Patients notes that, “Several in vitro and in vivo study using animals revealed that fluoroquinolones induced oxidative stress by producing reactive oxygen species (ROS)” and that in vivo human studies show that, “ciprofloxacin and levofloxacin induce more reactive oxygen species that lead to cell damage than gatifloxacin.

ROS are described as follows:

Without oxygen, we could not exist. However, in the process of generating energy by “burning” nutrients with oxygen, certain “rogue” oxygen molecules are created as inevitable byproducts. Known as free radicals and reactive oxygen species, these unstable, highly reactive molecules play a role in cell signaling and other beneficial processes when they exist in benign concentrations.  But when their numbers climb, as may occur as a result of aging and other conditions, they may wreak havoc with other molecules with which they come into contact, such as DNA, proteins, and lipids. As such, these “pro-oxidant” molecules become especially toxic.

In fact, a prevailing theory of disease and aging states that the gradual accumulation of pro-oxidant molecules, and the harm they incur, is responsible for many of the adverse changes that eventually cause various diseases. These include cancer (possibly triggered by free radical-induced damage to cellular DNA) and inflammatory and degenerative diseases such as Alzheimer’s, arthritis, atherosclerosis, and diabetes. While scientists have not yet reached consensus on the topic, accumulated evidence overwhelmingly identifies increased oxidative stress with age as a source of damage to cellular structure and function. (source)

To drastically over-simplify things, ROS are the opposite of antioxidants. If you’ve ever read about the benefits of antioxidants like vitamin C or glutathione, ROS have the opposite effects. In excess, ROS are harmful and damaging to cells.

NSAIDs and Fluoroquinolones Cause Cell Death

NSAIDs were found to “Impair the cardiac cell’s proteasome, the mechanism for degrading harmful proteins. This leads to toxic buildup and eventually to the death of cardiac cells” (source).

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Fluoroquinolones have also been found to cause cell death (apoptosis). This has been shown in many articles that note that fluoroquinolones are useful as chemotherapeutic agents specifically because they kill cells. Unfortunately, they don’t just kill cancer cells, they also kill healthy cells. The following articles note that fluoroquinolones are chemotherapeutic drugs that damage and kill cells:

  1. In an article published in the journal Urology, it was noted that, “Ciprofloxacin and ofloxacin exhibit significant time and dose-dependent cytotoxicity against transitional carcinoma cells.” That’s great – excellent, actually – if you happen to have carcinoma cells in your bladder. But if you just happen to have a bladder infection, chemo drugs that exhibit toxicity toward human cells – cancer or otherwise – are inappropriate for use (1).
  2. The mechanism for action for fluoroquinolones is that they are topoisomerase interrupters (2).Topoisomerases are enzymes that are necessary for DNA replication and reproduction. All of the other drugs that are topoisomerase interrupters are approved only for use as chemotherapeutic agents. It is only appropriate to use drugs that disrupt the process of DNA replication and reproduction when someone’s cells are already so messed up that they have cancer.
  3. Fluoroquinolones have been found to interfere with the DNA replication process for human mitochondria (3, 4, 5). Mitochondria are vital parts of our cells, (cellular energy is produced in our mitochondria), and disrupting the process through which mitochondrial DNA replicates causes cellular destruction, oxidative stress and disease.
  4. Fluoroquinolones have been shown to be genotoxic and to lead to chromosomal abnormalities in immune system cells (6).
  5. Fluoroquinolones disrupt cellular tubulin assembly (7). All of the other drugs that disrupt tubulin assembly are chemotherapeutic drugs.
  6. Fluoroquinolones disrupt enzymes, including CYP1A2 enzymes, which are necessary for detoxification.

Avoid NSAIDs and Fluoroquinolones

Dr. Aldrin V. Gomes, one of the authors of Different effects of the nonsteroidal anti-inflammatory drugs meclofenamate sodium and naproxen sodium on proteasome activity in cardiac cells, “advised caution when using NSAIDs either topically or orally” (source). Likewise, caution is warranted when using fluoroquinolones, as one can gather from reading any of the stories of pain and suffering caused by fluoroquinolones. Personally, I will do everything in my power to avoid both NSAIDs and fluoroquinolones for the rest of my life. Mitochondrial destruction, oxidative stress, and cell death aren’t things I want.

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19 thoughts on “NSAIDs and FQs Damage Mitochondria, Increase Oxidative Stress, and Cause Cell Death

  1. cindy Meredith May 10, 2016 at 8:55 am Reply

    Thank you once again for an informative article about fluoroquinolones. As someone who was floxed but have mostly recovered (it’s been 8 months) from symptoms, can we expect that this cell damage can be reversed? It is very concerning. I looked back into my prescription history and found that I had taken levaquin and cipro at least 3 times in 9 months before the prescription that finally sent me over the edge.

  2. kris t May 10, 2016 at 9:03 am Reply

    Lisa, I can understand why taking both Cipro and Advil at the same time can be harmful, but what if you waited a year or two, after your body has healed, can you take Advil then? If I have a toothache, Tylenol just does not get rid of the pain like Advil. Are you saying that your Flox symptoms will return if you take NASIDS even years after taking your last Cipro or flouroquine drug? Kristin

    • Lisa May 10, 2016 at 9:25 am Reply

      Hi Kris,

      It seems to really depend on the person. For me, taking NSAIDs corresponded with my delayed FQ toxicity symptoms, so I’m going to avoid them from now on. Other people, for example Lizzy – https://floxiehope.com/lizzys-story-recovery-from-ciprofloxacin-poisoning-2/, are also set-back from taking a NSAID even long after they have finished taking FQs and all the FQs “should” be out of their system. Because of examples like those, I think that caution is warranted even long after the FQs should be out of your system. There are counter-examples too though, where people tolerate NSAIDs post-flox just fine. It truly seems to depend on the person. I very much think that caution should be used when taking NSAIDs though, as they do have side-effects and are bad for gut health and mitochondrial health.

      Have you tried kratom? Several floxies swear by it as an herbal painkiller.

      Have you seen a dentist about your toothaches? Maybe there’s something that a dentist can do to help too.

      Regards,
      Lisa

      • kris t May 10, 2016 at 9:50 am Reply

        Lisa, I think what you are saying has a lot of truth to it, because I took a half of a Celebrex on Friday for my arthritus, broke out in hives (probably because it contains sulfa which I am allergic to) and now this week, feel like I have the brain fog again. But not nearly as bad as when I first got off of Cipro last year. I was in a fog for months then. I think the tooth thing is sinus related. I may try taking a Sudafed for that. I heard kratom is addicitve and heard to get off of. I guess if I do try it, do I get it at a health food store?

        • Lisa May 10, 2016 at 10:00 am

          Kratom can be addictive, and caution should be exercised with use of it. I am not entirely sure how one manages that risk, but I made sure to only take it for acute pain episodes, not for chronic pain. I suggest asking people with more expertise than I have about the risk of addiction. There are kratom advocacy and information groups on facebook and other places online that may be helpful. When I was going through some pain, I got some kratom from a “head shop.” You can also get it online. I think it’s illegal in a couple of states (Indiana?), so check that before ordering it.

          Regards,
          Lisa

  3. Erika May 11, 2016 at 9:35 pm Reply

    Lisa, I am one of the ones that has been able to tolerate alleve after my antibiotic reaction. However, I only took it for 5 days when I was diagnosed with the tendosynovitis in my left forearm and wrist which I believe was a side effect of the cipro. That was at 8 months out. Since then, just this week (11 months out) I have had another flareup of the same thing and thanks to advice from other floxies on your site, I bathed my left hand, wrist, and forearm in epsom salt water. Symptoms and pain immediately disappeared with no recurrence yet. That sure beats taking alleve!!

  4. Ken January 13, 2017 at 4:09 am Reply

    I have tendinitis in my left foot tendons. I am also taking NSAIDS to reduce inflammation. How would I be able to tell if I can’t tolerate them?

    I have a hot feeling in my left calve and some hotness under the knee. I have noted some weakness in the leg and a lowering of strength. The tendons in my arms have started to ache a bit also, but I’ve been reading articles online nearly all day on my iPad, which tends to make my old somewhat recovered carpal tunnel flare up.

    I took 6 days of levofloxacin (Levaquin/Quixin). I felt a sharp pain in my foot on day 4. My doctor says I have not ruptured the tendon, but that I need proper ongoing rest.

    I am suffering from unusually high levels of anxiety and panic. The Internet doesn’t help. My limbs are heavy/tired at times.

    Question:
    How would I be able to tell if I can’t tolerate them?

    Does anyone have any stories about tendinitis they can share? Did it lead to rupture for some? (This is my biggest fear as my posterior tibiula is involved and that holds up my arch.)

    • kris t January 13, 2017 at 8:06 am Reply

      Ken, I was doubtful about the NSAIDs also. I am thinking what do these people know on this website, they are NOT doctors. So this past summer, i started up on them again, my pain is in my back and all my problems started again, the brain fog, the feeling that I was going crazy, awful, awful, went down to that dark place, anxiety a lot! I stopped taking the NSAIDS and within a few weeks, I started to feel better. I try not to use anything now, just ice. All the supplements recommended by either Lisa or Ruth did not help me and only made me feel worse. I did change my diet and ate only anti-biotic free meats. I guess my point here is that I agree with them now, its best to stay away from Advil and all that. Especially if it has not been that long since you stopped the anti-biotics. It will be two years this February when i stopped taking the Cipro. I would also suggest that you see a therapist, but you have to shop around to find the best one. Because some of them think you are downright crazy, but I found a good one and she helped a lot. Aquatics helped me also and I think that might help your legs. Chiropractic and massage did not help at all and in fact, made me worse. But everyone is different. Lisa always said that Time is the best thing and so you have to realize it just takes a lot of time to heal. Kris T

      • Ken January 16, 2017 at 3:16 am Reply

        Thank you, Kris.

        Did you recover okay from the initial pain caused by your back while using NSAIDs?

        I’m in pretty dire straights as far as options go. If I choose to not take them then the inflammation may not recede. The implications of that are lose of the arch in my left foot. I’m fighting tooth and nail to get that down because the financial burden is more than I can bare.

        Any other thoughts? Anyone not have issues with NSAIDs and was able to work through tendonitis?

        If I really have been effected by the levofloxacin and not just had it coming (or that the medication just worsened the situation) then I feel like it was one hell of an expensive UTI.

        • kris t January 16, 2017 at 7:23 am

          Ken, I still have the back pain so the NSAIDS did not help me. Can you use ice for your inflammation and Tylenol for the pain? Another idea would be to try the NSAID called Mobic as it is not as many milligrams as Advil, I think its only 15 and you can take one a day. Prescription only. I would go on Ruth’s story, here on this webpage and ask your tendonitius questions there as I think she had leg troubles and she can direct you on some ideas. Ruth has a continuous discussion going on her story site. Look on the column for Ruth’s story. Kris T

        • andshewasandstillis August 9, 2017 at 4:38 am

          An alternative to NSAIDs is Inflavonoid. It contains vit c and turmeric and was recommended by my chiropractor for pain and I flamation. I would check with your local alternative health person for your dosage. I was taking 2 three times a day to start and then 1 twice a day. Good luck

      • Ken July 21, 2019 at 9:18 pm Reply

        Hello everyone. This is Ken from above. It has been 2 years and 6 months since I wrote the message you can see a few posters up. In that time I have mostly recovered. The are only three remaining symptoms from my experience and those are: 1) I still get some nerve pain if I don’t wear shoes (too much pressure on the base of the foot); 2) I’m a side sleeper and putting my knees together (inside joints) makes my calves hurt just a little; 3) My stomach condition isn’t too great and I have more things I am intolerant to or can’t eat now.

        None of these issues are particularly bad and I can go a month without any issues (well, except the intolerances, which also aren’t really too restrictive and are quite mild).

        There are some things that I think are worth pointing out:

        1. I had spent six months doing hours of walking to lose weight prior to the issue. The tendon in my foot that was effected was HEAVILY worn out and I suspect that the antibiotics pushed it over the edge. It’s also worth pointing out I was on a very low calorie diet during this time and my body was definitely not in good physical condition (very poor recovery). I was really worn out before I got hurt.

        2. The nerve issues in my feet (both of them) started after the antibiotics, but I probably had nerve issues before. As I mention I have elbow and wrist issues and these were pretty severe for a time. Pressure (just like my knees) on my elbows on the desk are the primary cause of pain in my hands and forearms and this is true of my feet and calves as well. If I sit for too long and put pressure on the bottoms of my thighs in doing so, I usually get mild pain in my feet. What I think is (like 1 above) that the antibiotics made an existing problem worse.

        3. I was already unable to handle milk and yogurt with minor issues with bread and butter. These didn’t agree with me before the antibiotics. However, they became worse after. A good example is milk. I can drink a liter a day for about 3 days and then I will start to feel fatigued and sick. Nowadays I might feel sick much sooner. If I stop drinking it then I’ll feel better in 2 days. This is a regular pattern. I wasn’t like this with yogurt or bread (butter is a newer issue) to this point. I could eat bread just fine up to the antibiotics, but now I have to be careful not to eat it too many days in a row and, honestly, I just avoid it. These days I eat a pretty restrictive diet, but that’s a good thing. I am quite aware and careful about things that make me feel bad.

        4. I generally get pretty terrified when I am sick in a serious fashion, so my above comment about being afraid was not due to the antibiotics. However, this one was terrifying simple because I read about what can happen to me if my tendon’s snap.

        5. I can’t exercise much these days. Riding a stationary bicycle is mostly okay as long as I get up and move around every half hour. Running is a no go, but I have bad knees (which is probably why pressing them together irritates my knees) and so I don’t run anymore. Light weight training seems fine (except squats). I hear swimming is good, but I don’t like swimming, so I don’t do it. In regards to exercise of any kind, I didn’t do anything for quite awhile after the injury. Now I walk a bit and cycle sometimes, but never intensely. My bones (not related to the antibiotics) aren’t in great condition and I have a lot of old injuries. Given I am middle age, that seems about right considering my past family history. It doesn’t really bother me. I’ve always been a bit sedentary anyway.

        6. After writing the above I realized that probably the biggest change was my nervous system getting more sensitive to pressure. However, you could say that it was like that before, but just got a little worse. I’d say its only a slight change and I am guessing not confirming in this case. It’s something like under 30% worse than before, but it’s not a very noticeable 30%.

        7. Another important point is that I took non-Fluoro antibiotics when I got an ear infection a few months back. These are the penicillin based ones I think. I had no major issues after I stopped them. I felt bad during, but not more than expected (the ear infection was really painful). What I did find out though was that NSAIDs REALLY disagree with me. I felt nasty. The over the counter stuff isn’t as strong compared to what my doctor gave me. There was a period where I only took NSAID to bring down the swelling in my ear and it became very clear to me that they were most of the cause of how bad I was feeling at the time. I don’t like pain killers nowadays and only take them when I absolutely have to (which is almost never).

        8. I think on the day of the primary injury I lightly tore a very small part of the central tendon running down through the middle of my foot. When I say lightly, I REALLY mean lightly. It was like pulling a hamstring. This was nothing more than a microtear or two in my opinion. Now that I have had some time to think about it, this was very similar to when I lightly tore my hamstring several months before. It hurt, but all it really needed was rest for a few weeks to heal.

        To those that read this I will say: Most of you are going to get better in a couple of months and those couple of months are going to suck. I made so many mistakes in how I dealt with my recovery. I walked on my busted foot for 2 weeks before seeing a doctor. I got crutches a little too late. I wore stupidly tight shoes. I messed with inner soles that put my feet in a position they had never been in before (I have normal arches, but I forced them upwards in hope of relieving some pain). I mistook nerve pain for physical damage even when my doctor (who has always been right in the past) examined me (four times over different days at my insistence) and said there was no mechanical damage (confirmed by so many doctors, but I didn’t listen). I took a cortisol shot into a foot with seriously over stimulated nerves (the pain was like being kicked in the testicles several times – worst ever). I made so so so so (!!!) many mistakes in my care. All in all, I was only lightly effected by the antibiotics. My mind and my behavior were not in alignment with the severity of the situation. In my opinion, the less mistakes you make shortly after the issues arise then the less you have to suffer later. That was true in my situation.

        Looking back and talking ONLY about my case, I should have done this:

        1. I should have rested my foot from day 1. That 2 weeks probably extended an injury with a month long recovery into a year long one. (The first four months sucked big time, but the remaining eight were a gentle and slow recovery.)

        2. I would have used two books placed on either side of my effected foot (the pain switched from one to the other) to hold it in place while I was resting on my back in bed. I would have used tons of pillows to avoid putting pressure on my inside knee joints, calves and inner thighs during sleep (I do this with my knees now and it helps). Less movement without constriction or pressure in my case would have really helped.

        3. I would have bought loose fitting comfortable shoes with either minor arch support (because my tendon was not effected, my arch didn’t lower) or none at all. Currently I wear flat arches because my feet don’t like pressure.

        4. I would have perhaps had my nerves checked. I would have asked if perhaps I was just feeling more pain than normal. I think my main doctor would have done some minor tests and agreed. He definitely felt there was no mechanical damage to the tendons and such and the tests he did agreed with that. I also, now, agree with him. All this time later it’s a lot easier to see and the evidence is there for it. The doctor who gave me the shot should have definitely realized something was up. I ended up unable to leave the exam room for 10 minutes as I tried to deal with the pain. It was the worst pain I have ever known and I have been kicked in the groin a few times by accident in the past playing sports in school. The response to the nerve being tapped by the needle was a huge clue in my opinion. (Cortisol steroids didn’t help by the way because there was no swelling – just my pinon.)

        5. I would have been more calm about things and assessed the situation more clearly. I should have realized that I had a tendency to freak out and possibly asked for some assistance with this. By that I mean counselling and not more drugs.

        6. I would have never taken the antibiotics I was given. I did my research at the time, but I thought that nothing would happen to me. I don’t blame the doctor for not knowing either. As far as I can tell this is something that effects well under 1% of the users of the drug. It would not be strange if he’d never seen anyone with issues with it before. I highly suspect that a lot of people with these issues have either minor damage and recover or moderate damage and see another type of doctor or another doctor entirely or get major damage and either lose trust and never go back to the same doctor or the issue isn’t attributed to the cause (or the doctor is an idiot). That’s why I don’t blame the urologist I saw (I had a UTI by the way). He didn’t know what would happen and had no experience with it. Finding a doctor that knows about this issue is like finding a needle in a haystack to be honest.

        7. I would have taken a penicillin based antibiotic. Now that I know, I keep a list of Fluros in my wallet so that if I get in an accident, I can pull it out or someone finds it when trying to ID me. It might just save me another year of healing.

        8. I should have not overexercised up to the issue and should have eaten a diet rich in protein, vegetables, fats and fruits (current diet) instead of a diet that was limited in all of these and very low in calories. A 20% instead of a 40% (around that) deficit in calories would probably have avoided the injury and perhaps I wouldn’t have been hurt at all (or maybe just got nerve damage and some stomach issues).

        9. I would have avoided things like stretching and other weird stuff that actually made the pain worse by injuring my injury or creating new injuries. These extra injuries increased my pain and probably reduced my healing time. I think I did some exercise during the first four months that also made things worse. I didn’t take it slow and realize I was going to need to heal over six to twelve months. I was impatient and wanted to be better right away. I kept thinking that I’d be better in three months. Because I wasn’t, I would keep trying new things that made me worse. I definitely wasn’t thinking straight.

        There’s probably more I should say, but I have forgotten. My case was mild by other’s standards in the comments section. I think if I hadn’t been freaking out then I wouldn’t have come here at all to comment (something to consider for those reading and thinking that these drugs always result in the worst outcomes – there’s a community of people who survive the more minor forms of this and never mention it). Your case will be different from mine (not two people are alike). You could heal up in no time at all or you might end up doing some hard time getting better. Because people who aren’t hurt badly don’t tend to report in about it or don’t do so for very long, the information you get naturally leans in that direction. It really depends on a lot of factors. Either way – and whatever your case – I hope you get better. The first four months was the worst thing I have ever experienced. It was a fearful and difficult period. 2 years plus later I can look back and see things as they were, but when I was in it… well, it wasn’t pleasant.

        Good luck with your recovery. I hope it is a short one.

    • Linda Armstrong July 20, 2019 at 3:14 pm Reply

      Same here. 4 pills of cipro in 2016. Left foot, posteror tibula tendon has let my heal slip to the left. My arch is on the floor.

      The ankle specialist says that the only thing that wil fix it is surgery. But before i coukd get the surgery, I had to see a Rhuematologist. He put me on the synthetic Qunilone Placqunel and Prednisone. My appendix ruptured. I was listing an allergy to Floroquinilones. Had no idea that i was getting more of it.

      My Functional medicine Doctor put me on Low dose Naltrexone and told me about using DMSO to relieve the pain in my ankle. I delute it with 3 parts water and rub it on where ever I hurt. We floxies hurt in lots of places.

      I have not had another flair on the Natrexone. Had to increase the doseage from 2.5 to 4.5.

      There is 2 products named Comfort Max and PEA (same active ingredient) from Life Extention foundation that i take for pain. My husband takes it too and has stoped taking NSAIDS. These products take 2 weeks to kick in. We take them 2 x each day.

      • Ken July 21, 2019 at 11:13 pm Reply

        This is going to be terrible advice and you shouldn’t follow it, but there was this lady online who ran a rehab center. She did deal with some feet issues (hers and clients’ issues). Her primary advice was that the muscles of the body control the position of the limbs. I don’t know how healthy you are and I don’t recommend this, but your inside tendon is connected to your inside calve muscle. If you focus your mind on shifting the tendon upwards using this muscle, can you raise the arch of your foot? I can do this (took some practice), but I have healthy tendons.

        (Edit: She mentions in the book I added in the edit below that she showed a bunch of doctor’s how she could walk with her feet in certain positions for extended periods of time when they didn’t think it was possible. There are some pictures of patients with deformed feet due to hereditary conditions and the after photos are not spectacular, but still very interesting in the amount of positional change.)

        Personally, I think her advice is harmful as other structures must move to compensate for the new foot position. It sounds like your tendon is lengthened somehow (?) and, therefore, others would have compensate by being in different positions (if they are healthy). There’s also the issue of muscle tension in the inside calve and other structures used when walking or standing. These are likely to become fatigued from holding a different position. I also would add that the tendon might rub against the nerves in your inside ankle, but that might already be a problem given the situation. Overall, I would approach her ideas with caution, but at the same time if I faced surgery and there was no pain in doing this then I would try it.

        The reason I know about all of this was that I feared damage to the same tendon you mentioned in your post when I got injured. In the end I was incorrect and my issue was really some small tears to the tendons in the base of the foot. Nothing more serious than a pulled hamstring to be honest. I was certainly not in your situation.

        If you would like to try this then give it a shot on your unaffected foot first. Try to raise the arch by concentrating on the inside calve muscle and bringing the arch (and only the arch) upwards. Your foot will turn slightly to the direction of the outer foot (this might be a correction to normal in your case rather than an over extension). You should keep your toes planted. This tendon can be moved. It takes a bit of a mental effort though. I tried just now and it took me a minute to get the inside calve to do what I wanted it to. I haven’t done this for nearly 2+ years.

        (Another edit: By moving the tendon into place, you might find the others sit more comfortably or are loose. It’s likely they have stretched or shortened as well. I’m not really sure if you would be more or less comfortable doing this. You’d have to give it a shot.)

        AGAIN, TERRIBLE ADVICE. However, you are probably looking for options right now that don’t involve trimming down the tendon length. Maybe this works for you.

        Edit: her name is Jolie Bookspan. She has a book on Amazon with two to three chapters on the subject of feet and she also has a website with a few articles. All can be found through Google. The book I read was called “Fix Your Own Pain Without Drugs or Surgery.” I had the newest version with the pictures (latest one on Amazon right now). Again, it is likely other structures will need to compensate and this might hurt you. That is my primary criticism of her work.

  5. Anna October 8, 2018 at 4:32 pm Reply

    Has anyone tried steroids after being floxed? I had a horrible eye reaction to one Cipro pill. Tightness/pain behind the eye, severe light sensitivity, blurred vision, resulting in ER visit. Thankfully, the vision returned and pain let up, but a terrible swelling has remained in the under eye muscle. Ophthalmologist confirmed the optical nerve and eye itself is very healthy, so the issue is occurring in the sinus cavity, eye muscles or tendons. I am afraid muscle can turn fibrous if left inflamed for too long, so I am tempted to try steroids. I also developed my first sinus infection after being floxed, but worth noting the swelling was there before the sinus infection. My guess is the sinuses were weakened by the Cipro. Has anyone here developed swelling in the orbital area? (likely sinus or immune related)

  6. Charlotte Ruth May 28, 2019 at 1:37 pm Reply

    So what does one take for pain instead? I have terrible pain when I don’t take them

  7. Bj July 19, 2019 at 9:25 pm Reply

    Charlotte, I’m sorry you’re experiencing pain. I’m working on stretches for an issue but you might check out the LDN or Low Dose Naltrexone group.

  8. Honestly July 20, 2019 at 5:01 pm Reply

    Thank you Lisa for continuing to.keep us updated. .Has anyone had sciatic nerve issues after floxing?

    • Ken July 21, 2019 at 10:24 pm Reply

      Check my post up above. I have nerve issues in my left and right feet. In my first six months of recovery, I thought I would try stretching my hips because I thought that might help (1). The stretching made it a lot worse. I also tried running a tennis ball up the backs of my thighs. If I did this on the front then I felt a bit looser. If I did this on the back of my thighs then it felt worse. The thing that has helped me (after recovery) is avoiding pressure on the backs of my thighs (2). However, it really depends on whether a mechanical injury (bone, tendon, ligament, or muscle) is the cause or if you have, like me, become more sensitive in that nerve than you were previously (3).

      What is interesting about nerve damage is that it usually results in less sensation. Diabetics are a great example of this (4). They frequently have some nerve damage if their disease is not properly controlled and they often complain of a lack of sensation in their toes and feet. This is a huge problem for them as they have a greater tendency to hurt themselves and this results in foot and leg injuries that can become quite scary if not treated carefully due to the nature of their disease. Thankfully, most diabetics are very careful of wound healing and particularly their feet. Hence, it is much less of an issue compared to 20-30 years ago. (Based on my minimal reading online about the topic.)

      That said, some talk about having the opposite situation. They stub a toe and it feels like someone rammed a needle into their foot. That’s probably a lot worse than what you are probably experiencing and mine wasn’t that bad except in the first four months.

      In my case, my nerve sensitivity got better with time. After realizing that things like stretching and massage were actually making me much worse (there was no mechanical injury to fix and, hence, these didn’t work) because I was pushing and prodding a set of nerves that were already in very bad condition, I started to look at my behavior. It took two weeks for the damage from stretching my hips to go away and then I spent a lot of time avoiding putting pressure on the nerves (this was mainly just pain avoidance. I don’t think it solved anything.) This mindfulness made things a little bit better after 1-2 months and around 6-8 months after the initial injury I started to be able to loosen up my discipline. I had a few times where I sat too long (a big issue for me) or I got really tired (lack of sleep made my nerves WAY worse) and after these flare ups I would tighten up my discipline, but after about 9 months to 1 year I was mostly okay. Nowadays, I do need to be mindful, but it is more habit than anything else. I only get flare ups when I really abuse my body. Otherwise, it’s no big deal.

      Honestly, I would go to doctor and see if they can find a mechanical reason for your issue. I would then consider my options and if I felt like trying some of them then I would. In my case it was mindfulness of my behavior, rotating sitting and standing and lying down, and avoiding making things worse that helped. Probably the normal reduction in sensitivity or readjustment of the brain to the new level of feeling was the number one thing that brought about some minor healing on my part. I needed time and that amount of time was about 9 months to 1 year before I was functional again in a state that is only a little worse than before I was injured.

      Finally, I would also consider whether I have had issues with my legs before and particularly with the effected nerve. If you did then it could be what you normally feel (but that your body blocks out) becoming more intense due to the antibiotics effecting your nerves.

      # Disclaimer: I’m probably wrong. Your situation is going to be different from mine. Be careful what you do and don’t take anything I have said as factually correct or good advice. Do your research before taking action and asking around for second opinions.

      (1) The nerves of the feet run up to the hips and it is uncommon but possibly to have sciatic nerve issues with the pain appearing anywhere from the hips to the feet – based on my limited knowledge of the subject – rather than the backs of the thighs and buttocks.

      (2) As I point out in three below, pushing on a nerve that is overstimulated or more sensitive will cause more pain than you would normally feel in that area if the nerve wasn’t in that condition. The obvious solution of putting a pillow under my thighs and buttocks didn’t really help as this only delayed the inevitable. Alternating sitting and standing and lying down was quite helpful after the initial injury (micro-tears in the middle tendon of my foot – not serious) had recovered and I was feeling less pain because of it.

      (3) I have bad knees (before the antibiotics) and pressure on them makes my calves and feet ache (after the antibiotics). I have the same pattern with my elbows and my hands (feels like carpal tunnel). Hence, my issues were probably pre-existing and were (possibly) worsened by the antibiotics. (The pain in my case alternates between my feet. Sometimes it’s my left and other times my right. It’s usually the left side where my tendon was injured and is centered in the inside of my ankle where the big important nerves of the foot run down to the foot itself. It can go up the foot into the inside calve and down towards the toes if I really screw up big time with my body and hurt something along my legs.)

      (4) You might try checking diabetic forums for this kind of thing. It is vastly less common than losing sensitivity. Also, maybe go see the doctors that they see for nerve damage. They might be able to do some tests to see if something is going on.

      Extra: (5) Hot and cold water during the first 5 months had a weird effect on me. Hot would make me feel worse. Warm had usually no effect. Cold would make me feel a little better when it was really bad, but if I did this too much in one day then I would feel worse later. All I did was run the shower head under my thighs and along my calves and feet. It didn’t take long (like 30 seconds) and I felt a little numb. I stopped doing this at some point because I was doing it too often and I was hurting myself. If I was to do it again, I’d try 1-2 times a day and if it helped them I would not do it more than that each day. Everyone is different. This was just something weird that helped for a few weeks mid-recovery and then hurt me later on due to overuse. Nerves are sensitive by nature and overdoing this made the pain worse after the numbness wore off (maybe 2-5 minutes?)

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