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Mysterious widespread tendon pain

I am suffering from debilitating tendon pain in many joints.  I am inclined to accredit this as a side effect of Levaquin, but none of the doctors I've seen have agreed with this, though they also have not offered any other explanation.  Please find my story below:

I am a 25 year old male.  I have been an avid weight lifter for about 5 years, and a regular rock climber for about 1 year.  At the end of January of this year, I was prescribed 10 days of Levaquin with a (6 day) Prednionse burst pack, for a sinus infection.  On the 9th or 10th day of the Levaquin, I started to experience severe pain in both biceps, along the inside of my elbows.  I also had less severe pain in my shoulders, forearms, and the bottom of my elbows (the tennis elbow region).  I was doing a lot of rock climbing at the time, so I credited the rock climbing as the cause of the tendinitis, and resolved to take some time off.  After about 3 weeks without improvement, I went to my Primary Physician (who is also a Sports Medicine specialist).  He confirmed that I had biceps tendinitis and stated that it was likely due to a combination of the Levaquin and my high activity level, and that I should take if very easy for a few months and it should improve.  

For the next few months, I did very little rock climbing, and concentrated my weight lifting on lower body exercises.  I could still do upper body pushing (presses, etc...) exercises, but any sort of pulling movement (pullups, rows, etc...) aggravated my biceps and forearms.  In April of this year, I started developing terrible headaches.  My doctor was hesitant to accredit these to a sinus infection (I have bad allergies), so first attempted to treat with prednisone.  (When the prednisonse was ineffective, he prescribed a non-quinolone antibiotic, the headaches went away a few days after).  The prednisonse was a 21 day taper.  Towards the end of the 21 days, my joint pain got much worse.  The pain in my elbows, forearms, and shoulders intensified.  Also, I started getting pain in both legs: in the achilles tendons, knees, and the hamstring tendons (along the back of my knees).

At this point, I decided it was time to see an Orthopedist.  The Orthopedist confirmed the tendinitis.  Because the tendinitis in my biceps and elbows had occurred the longest, he wanted to try to treat that with physical therapy, and to readdress the other joint issues after they weren't so recent.  So, I did 2 months of physical therapy, which consisted of needling and eccentric exercises.  After this was produced no improvement, my physical therapist had me go back to the Orthopedist, who then sent me to a Rheumatologist .

The Rheumatologist did a lot of blood work, for things like Lupus and Rheumatoid Arthritis, all of which was negative.  He also had me try a few different NSAID (1 week on high dose of aleve, 1 week on voltaren, 1 week on celebrex, and 2 weeks on mobic).  After these produced no improvement, he conducted a bone scan, to definitively rule out anything insidious  After the bone scan results came back negative, he told me that he was labeling me with "enthesopathy" and recommended I either try a long course of anti-depressents  (cymbalta or savella) for pain, or consult a pain clinic.

I found this recommendation to be odd, so I returned to my primary physician for a second opinion.  I described to him that in addition to the tendon pain I also get extreme muscle stiffness, and fairly regular muscle spasms (my physical therapist often commented that my biceps were very "rope-y").  He told me to try Baclfoen for the stiffness, prior to considering the anti-depressant.  I've been on the Baclofen for about 2 weeks now.  I feel slightly less stiff, but this could also be due to the thorough, twice a day stretching I've been doing (This brings us to current day).

Every doctor I've talked to (my primary physician, rheumatologist, orthopedist, and my allergist (in came up in conversation)) is very hesitant to ascribe this to the Levaquin, because it does not fit the normal presentation, because of the two different onsets of the pain.  However, I find it much more likely that I have some sort of anomalous presentation of this rare side effect, than that I have some utterly mysterious, undiagnosable, unknown disorder.  It seems possible to me that the levaquin had done damage to the joints in my legs, which was then aggravated by the 2nd course of predniosnse.  The idea that it is a neurological pain condition, seems very unlikely to me.  It is my understanding that these are generally characterized by pain which gets worse with inactivity, and tends to dissipate with motion.  However, my pain seems much more musculoskeletal, it is aggravated by activity.  Weight lifting hurts my elbows, walking hurts my knees, etc.  

Thank you very much for your time and any advice you may have
11 Responses
798555 tn?1292787551
Time to step back and look at your whole body as 'one'.  How is your health otherwise? Any other wierd symptoms that gradually crept up on you?

Been tested for Lymes?

Thyroid disease? It makes you sore all over if your free T3 is 'out of range' or even 'in range' but on the low side. As a past athlete Hashimoto hypo thyrpiod almost crippled me. Took years to DX!
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I had blood work done by both my rhuematolagoist and PCP, not sure exactly what they tested for, but I think the tests included: lyme, gout, sarcoidosis, lupus, and Rheumatoid arthritis... among others.
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I have exactly the same symptoms with almost completely parallel treatment.  I was also given Savella, Lyrica, NSAIDS, etc. all to no avail.  My pain, especially in my elbows, has continued to increase, my muscles remain ropey, and no one has been able to offer any definitive diagnosis or relief.  I would be interested to hear of your continued progress, especially if a diagnosis has been reached.  Thanks and good luck!

Avatar universal
I have been going through the same thing!! I believe it is from Levequin as well!! I have been diagnosed with fibromyalgia but I don't believe what I have been experiencing is that. I am very active a dancer and avid yoga practitioner.  This tendonitis has been holding me back. I have opted to stay away from medications and eat foods that are anti-inflammatory and staying away from sugars, flour and aspartame. These three things seem to make matters worse.  Also take two does three times a day of fish oils, and vitamin e and vitamin d. This also helps your joints and tendons and helps detox your body!! Good luck!
Avatar universal
I hope you've improved by now. I have a long history of tendinitis due to repetitive motion. However I also took Levaquin and within 2 days my feet turned red and I suffered a recurrence of plantar fasciitis that hadn't acted up in years. My ortho agreed that the med brought it on. He treated it with ultasound with good results. Now it's 3 years later and I have multiple new tendon issues, arms, legs and ankles like yours. I also wound up in the ER with "spasticity". It was a new kind of h###. Neuro checking me for MS. I do have other symptoms, like vision issues. It is often years to get a Dx. If you haven't had therapeutic ultrasound it's worth a try. Good luck.
Avatar universal
I hope things have improved for you by now. I have a doctor who enthusiastically believes in the long-term negative effects of quinolones and has shared information with me about it. One major source of patient stories and discussion of the potential issues is called "The Flox Report." In fact, there has now been a case study reported in the British Medical Journal. ("Fluoroquinolone-induced serious, persistent, multisymptom adverse effects.") Try bringing that article to any doctors you see for this issue. My doctor is encouraging in his assurance that symptoms fade over time since your last dose (and you should never take it again, unless you're in danger of death and there is no other option!) However, he says there will often be flare-ups and setbacks (fewer and fewer over time.) I hope that's been your experience, and best of luck!
Avatar universal
please look at the article by hall, finnoff and smith (three mayo clinic doctors) or have your doctor do it.  also the book by jay cohen, about cipro and levaquin etc.  he was a physician who studied the effect of cipro, etc, 2001 and beyond, and who unfortunately just passed away.  there aren't any obvious "cures" but there are some things one can try.   it robs your body of magnesium and since magnesium is inside of your tendons, bones, cartilage, etc., those all get damaged.  magnesium can help, so can zinc, but i don't know how far.  it also damages your dna (and thus your repair mechanisms).  atheletes are often low in magnesium, my (non professional) guess is that this means that the levaquin takes out what little is left, causing horrible results.  you can't check it easily in a blood test, because most of it (~99%!) is not in your blood, but in your tendons, cartilage, etc.  
the book by jay cohen has advice on the pain part too,
it does act on your body like rheumatoid arthritis, so turmeric and i think ginger help there (i only tried turmeric,
and the pain went away, but my tendons are still not
ok, but they are getting better and better....very slowly...
i am hopeful, i can now hike and stumble, like i tend to do, without injuring them, but i cannot jump yet.  7 months so
far.  but they are getting better.  good luck!!)
How much turmelic are you taking?Hope you’re feeling better now.
Avatar universal
the fda has just updated the fluoroquinolone warnings, twice since feb, because they are
being recognized as more and more dangerous.  also there is a study, please join it, by ucsd.  the fluoroquinolone study.  hopefully more will be learned
to help people who have gotten these side effects!!

i've had several doctors tell me that these side effects don't exist though.  sigh!
They do read my story Minipawpaw) it is poisoning your body destroying the Central nervous system
Avatar universal
I was given Levofloxin Levaquin and I had to go to physical Therapy to walk again I also was diagnosed with Pereferial Neuropathy Tendonitis nerve damage in legs and arms and it is permanent. I got 750 mg for 10 days.DON't Take That Poison.Itook it in 2014 **
Avatar universal
Please get tested for lyme disease. I was active like you and now I have very similar sympton. Make sure you have a western blot test done regardless of what the screening test called the ELISA test shows.
Avatar universal
I've got tendonitis all over my body for the past 4 years (Elbows, achiles, pectoralis etc.. On top of that I have bone to bone cartilage degeneration on most of my joints (knees, elbows).
For the past 4 years I've been traveling the world in clinics trying to find cure for my problems. I've had 4 surgeries so far. I'll have a couple more soon. Most of the doctors don't know what's the cause. I thinks it's probably Cypro or Accutane. The thing that helped me the most for my tendon pain is peptides for injuries called Thimosine beta- 4. I feel like my tendons are recovering faster  with them. But when I stop them the pain is back. The pain is also spreading with the time. I'm curious to see your stories and what helped you guys. Wish I could share more details but using phone, keyboard or mouse causes me pain.
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