Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

A pill that trashes tendons

Paul Ingraham

A recent meta-analysis (Alves et al) confirms a serious side effect of the fluoroquinolone class of antibiotics: 2.5× greater risk of Achilles tendinitis in healthy folks, and a 4× greater risk of rupture. 😲 And all worse if you’re older, of course. And if you’re on corticosteroid drugs (much in the news lately because of dexamethasone for COVID-19, which is actually really promising, as a happy aside — really good clinical research showing a strong benefit for the right patients).

If you’re thinking that it’s weird that an antibiotic can do this to people… I know, right? It’s downright creepy, if you ask me.

This side effect is one of the best single examples of how musculoskeletal and sports medicine, although seemingly all about biomechanics to the uninitiated (and plenty who should know better too), is actually much more about physiology and biochemistry.

Because we are basically just “ugly bags of mostly water” organized by chemistry, miraculous but messy.

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