Intramuscular diclofenac should be avoided

EDITOR—The article by Wright et al on managing the pain of ureteric colic in the community has raised some concerns.1 The paper implies that a strategy of administering intramuscular diclofenac in the community would reduce the need for admitting patients to emergency departments. Although we welcome any attempt to reduce the number of unnecessary admissions to emergency departments, we raise the following points about using intramuscular diclofenac.

Firstly, diclofenac causes pain on injections with a concomitant rise …