Voltaren contains the active ingredient diclofenac sodium, a topical gel widely used for pain relief. It is specifically indicated for the temporary relief of arthritis pain in joints amenable to topical treatment, including the foot and ankle. This nonsteroidal anti-inflammatory drug (NSAID) provides a localized approach to managing discomfort, offering an alternative to oral medications. For individuals experiencing chronic foot pain related to osteoarthritis, the gel is a recognized treatment option. Understanding its mechanism, proper application, and safety warnings is important before use.
How Topical Diclofenac Relieves Localized Pain
Diclofenac is an NSAID that relieves pain by inhibiting specific enzymes in the body. The drug primarily blocks cyclooxygenase (COX) enzymes, particularly COX-2, which create pro-inflammatory prostaglandins. By reducing the production of these prostaglandins, diclofenac decreases inflammation, swelling, and the corresponding sensation of pain directly at the application site.
The topical gel formulation allows the medication to penetrate the skin and reach underlying joint tissues. This targeted delivery results in high concentrations of diclofenac in the synovial fluid where the pain originates. Topical application leads to significantly lower systemic absorption compared to oral diclofenac pills. This lower systemic exposure helps reduce the potential for gastrointestinal and cardiovascular side effects associated with oral NSAIDs.
This mechanism makes the gel effective for foot pain caused by osteoarthritis in the ankle or foot joints. Its anti-inflammatory properties can also help manage pain from acute localized soft tissue injuries like tendinitis or mild strains. The gel is not intended for immediate relief and may require up to seven days of consistent use to achieve the full benefit.
Applying Voltaren Correctly to the Foot and Ankle
Proper application of the diclofenac gel is necessary to ensure the right amount of medication reaches the affected joint and to avoid unnecessary systemic absorption. For lower extremities, including the foot or ankle, the recommended single dose is 4 grams of the 1% gel. This dosage should be applied four times daily, with the total daily dose for a single lower joint not exceeding 16 grams.
The proper dose is measured using the dosing card included in the product carton. Squeeze the gel onto the card up to the 4-gram line, which corresponds to a 4.5-inch length of gel. Apply the measured gel to the entire affected area, such as the whole foot, which includes the sole, top, and toes, or the entire ankle area.
Gently rub the gel completely into the skin until it is fully absorbed. Wait at least 10 minutes before covering the treated area with clothing. To prevent systemic exposure, do not wash the treated area, shower, or bathe for at least one hour after application. If the foot or ankle was treated, wash hands immediately after rubbing the gel in to remove residual medication.
Important Safety Considerations and Warnings
Although topical application minimizes systemic exposure, the diclofenac gel still carries the warnings associated with all NSAID medications. These risks include the potential for serious cardiovascular events, such as heart attack or stroke, especially with high doses or prolonged use. The gel should not be used immediately before or after coronary artery bypass graft (CABG) surgery due to a heightened risk of complications.
There is also a risk of gastrointestinal bleeding or ulceration, though lower than with oral NSAIDs. Use the gel cautiously if you have a history of stomach ulcers or bleeding. Patients allergic to aspirin or other NSAIDs, or who have experienced asthma or hives from these drugs, should not use the gel. Diclofenac can cause fluid retention, requiring individuals with heart failure or high blood pressure to monitor their condition closely.
The most common side effects are localized skin reactions at the application site, which can include redness, itching, rash, or dry skin. Never apply the gel to open wounds, infections, or broken skin to reduce local irritation. Avoid exposing the treated area to natural or artificial sunlight, as diclofenac increases skin sensitivity to light. If pain persists after seven days, or if serious side effects occur (like unexplained shortness of breath or signs of bleeding), stop use and consult a healthcare provider immediately.