Can back pain be caused by or exercerbated by PMR? I have had all the usual shoulder and hip/leg pain (and hands and knees!) and I had tapered down to 8mg in 18 months. To try and combat the pain and siffness in my hands and one shoulder I have gone up to 11mg (taking 2 at night and 9 in the early morning). However, for a couple of months now I have been suffering from back pain as well. I have recently had an MRI and was told that the problem is inflamation between L4 and L5. The MRI doctor told me that the prednisone probalby masks some of the back symptoms I am getting but on the other hand the PMR probably makes the inflamation worse. My understanding of PMR is that the pain is usually muscular (although in my case this would not apply to my knees and hands) and would not apply to my back, so I'm interested if anyone else has views or experience of this.I had to have cortisone injections in both of my shoulders becasue the predinose was not dealing with it and am wondering if I should consider a cortisone injection into my back.
Hi Hugh, I too have similar and confusing pain. I do have spinal stenosis and have problems with degeneration in L3, L4, L5 having had trapped discs. I also have numb feet (peripheral neuropathy) caused, the orthopaedic chap said, by the back problems. I had always put my hip, leg, lower back etc pain down to these things, but since coming on this site, I now realise that I am not alone and that many others experience pain (despite Pred) in these areas and find difficulty in walking etc and get very, very tired, as I do. So, like you, I am confused about how much of all this constant pain and exhaustion is actually caused by the back issues and how much is as a result of PMR. I am currently on 16 mg of Pred (having got down to 5mg but then had a flare and my GP whacked it up to 20mg, so now am having to go down slowly, slowly again). In the three years I have had this wretched disease, no doctor or specialist has actually said definitively which is the cause. I live on an island and we don't have a rheumy here, just one that visits once a month for 60,000 people (!!) so no help there! So, if you get some knowledgeable people ansering your question, I too will be very interested in their replies. All the best, Sarah (Loulie)
Hugh, I've had PMR for 3 years and am tapering the Pred. carefully and very slowly. I'm not an expert here so I won't offer you any advice re. your tapering. However I DO remember my specialist saying that while I was on Pred. it would suppress other aches and pains that are part of just being older and that, when one starts a Pred. reduction, they can 'break through" (not her words) and that they can be mistaken for a flare. . . . This is just a vague memory going back a couple of years. . . Your doctor seems pretty clued in.
I think others will advise you on supplementing Pred. with injections or painkillers. Not sure if it is advised as maybe the Pred. should just be increased . . . . Hang in there!
J
Sorry Hugh, I meant to say that I had two cortisone injections in my hip and one in my spine and, for me, none of them worked at all. That is not to say that they will not work for you, as I believe some people do get relief from them, albeit for only 6 months I believe. Sarah
Before I was diagnosed with PMR I suffered through 8 years of severe back pain for which i take pain pills for.
Since being diagnosed with PMR my pain has not increased but my tolerance of it has decreased. Additional the alternate side has started to hurt off and on.
I will have to let you know how the pred works once I start it. I go see the rheumatologist on Friday.
I have a very sore back which is not related PMR - I believe it's from inactivity and carrying extra weight which I've had since starting on pred.
I also think it's from walking like an old penguin from the PMR pain!
It is not uncommon to find myofascial pain syndrome and piriformis syndrome alongside PMR. And PMR does not only have to manifest in muscles - bursitis, tendonitis and synovitis are all found in PMR.
I have had back pain for many years on and off (more on than off it must be said) - eventually it was identified as being myofascial pain syndrome - but the PMR definitely made it worse. In PMR we walk and stand badly - which puts increased strain on the back muscles which do a sterling job of adjusting to many abuses and keeping us upright. Eventually there is one bit too much - and PMR can be the cherry on the top.
Some rheumatologists are beginning to realise that dealing with these "add-ons" (as I call them) separately may result in a lower dose of oral pred ongoing - even if it means a steroid injection or 3 to sort things out. I find Bowen therapy, a good physio and sports massage all helpful.
Hi Eileen,
I don't remember reading before that PMR affects these other things apart from muscles, so this is really interesting. In my early days the Rheumy that I saw told me that my knee problems (tendonitis) were not to do with PMR! (I did not bother seeing him again) It also explains my more recent problems with hands. I do find that PMR problems tend to move around - which bit is painful/stiff today? So, I'm hoping my back problems will eventually go away. I saw my Ostiopath today who told me that without PMR he thought he would have dealt with my problem in about three sessions, instead of the dozen that I've had and will probably continue. He said he can tell the problem is more from inflamation than anything mechanical.
Hugh
Leeds rheumatology department did a study and found that, yes, PMR DOES affect hands and feet - and they don't have a lot of muscle! I had horrible tendonitis/synovitis in my hands and forearms and my feet felt as if I was walking on a mix of sharp pebbles and broken glass. All faded after several months on pred and has never come back - except as a gentle reminder if a flare is hatching. Weather can do a similar job - I'm better at forecasting rain 2 days ahead than the met office! Not a problem when it is actually raining though usually.
On occasions I mixed Bowen and sessions with my osteopath - one on its own wasn't enough to get a more lasting result. Strange isn't it.