After fighting for over two years I have forgotten some info I used before

Posted , 5 users are following.

As many of you have experienced, coexisting medical problems many times confuse our ability to manage our useage of Pred. About six weeks ago I began fighting a new manifestation of my age old back problem in the form of sciatica. But I confused it with PMR pain and blamed it on low adrenal output and felt I had gone too low and passed the magic point of just enough. So I kicked it up from 4 and half to 10mg. After three days I realized that i was on the wrong track. Here is where I think I have been over this once but dont recall. I have been trying to get back down without problems and have reached 5 and half. How fast can I drop the other 1 mg? Even though I asked for this dance, I would like to finish it.

0 likes, 11 replies

11 Replies

  • Posted

    As a PS to The 1st post, I was onto this problem here 2 months ago with what apears to be a very good answer from Eileen. I'm back at PT again and there has been no reesolution yet. Walking with a cane now for safety.

  • Posted

    You should be able to drop back to the original dose if it were not a PMR problem, as you have been on the higher dose for such a short time. I had sciatica at the beginning of last year in my left leg, it was so painful it took my breath away. I went up to 10mg too, but it made no difference so I dropped back. My GP offered me paracetamol, cocodamyl and naproxen! The only thing that worked for me was physiotherapy. 
    • Posted

      Thank you very much for the rapid reply. Good guidance. I'm going to be very diligant with the PT and hope for the best. Sciatica lives up to its reputation and I am not looking forward to a possible injection.

    • Posted

      Do injections work for sciatica? It will be interesting if they do.
    • Posted

      I'm told that the guided injection has a good record in back problems. I had it done to upper sterum/clavicle area with great results. It's the next step if PT does not work.

  • Posted

    Adrenal insufficiency doesn't cause sciatica - almost certainly the first thing you would notice there is increasing profound fatigue. And adrenal insufficiency also has no link with PMR pain.

    The most likely cause of your sciatica - if you don't have disc problems, and even then probably in addition to - is muscle spasm due to either myofascial pain syndrome or piriformis syndrome. They are both often found alongside PMR, not part of it but parallel. Physio as such in the form of exercises may not help - it could be other techniques physiotherapists use that are more important such as manual mobilisation of trigger points and spasmed muscles. I have had physios who were aware of the techniques but not all are so good. Someone who is experienced in sports physiotherapy would be the most useful IMHO. The stretching exericises that are commonly suggested are to stretch spasmed muscles - but that will only work if the actual underlying cause of the spasm is also being addressed. In MPS that is trigger points of hard spasmed muscle fibres that can be felt as hard knots in the body of the muscle and which can irritate nearby nerves - in this case the sciatic. I've had steroid shots into those knots - they are formed by concentrations of the same cytokines that cause generalised PMR pain and stiffness so that will work. Whether steroid shots will help sciatica or not depends on the cause and there are needling techniques that don't use steroids that also work in my experience.

    As ptolemy says - after 3 days you could have gone straight back to 4 1/2 mg immediately. How fast you do that other 1mg is now dependent on how long you've taken to get this far.

    • Posted

      Thanks Eileen. I'm going to attempt to interject some of that logic in my next appt. monday. I do have degenerative disc disease however which complicates things. As usual a lot of the time in first sessionwas evaluation and Q & A. I will ask some questions about any hard knots he may encounter if he can get past the adepose. Actually I'm not overweight. 

    • Posted

      I am and the GP has no difficulty identifying the bits! A gentle prod elicits the required squeal! I was told I had degenerative dics problems and would have to live with thepain, Sorting the muscle problems also sorted the low back pain. Hmmmm....
    • Posted

      In an effort to explore all possibilities, I'm going to get the therapist to measure my leg length. The last chiropractor 2 months ago who I left after 2 visits, tried to tell me I had a 2 inch differential and went on with adjustments based on that. I am about to research the connection to sciatica and other similar problems.

    • Posted

      A 2in differential? I think you just MIGHT have noticed that before! Clothes wouldn't fit for one thing. 

      I can tell you though that my back muscle problems actually caused an apparent difference in leg length - they led to my pelvis being uneven. But that was a "twisted" back - not different length legs. Frames of reference are also significant.

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