1. Community
  2. Bones, joints and muscles
  3. Polymyalgia Rheumatica and GCA

How to judge what is PMR or lumbar pain

Posted , 7 users are following.

sharon61808
sharon61808

My journey with PMR & GCA started in December, 2015, by February, got down to 11mg preds a day, after starting on 60 because of the GCA.  In the meantime I have also been diagnosed with severe degenerative arthritis in my lower lumbar with spurs as well.  I suffered extremely bad sciatica and had nerve blocks on both sides which has helped on the left, but I still have extreme pain on the right side but in my buttock area and spreading around into the front.  I cannot stand up for any length of time owing to this pain.  I also have weakness and pulsating pain all around the centre of  my lower lumbar area.  I have trouble getting up as it catches and when it is severe cannot sneeze, or even breathe easily for the pain.  On my latest blood test my markers were up again, from 2 to 34, so I guess part of this is a flare up.  I was put back onto 25mg pred for a week, which immediatley gave me some relief.  However after 3 days all the pain was back and I have reduced back to 20mg as my doc wants me to.  I understand that this dosage should control the PMR, but are there any exceptions out there?  I have put on weight with the meds, so I know this is not helping my back.  I have an appointment with a neuro-surgeon but cannot get in for another 2 months.  So I guess what I am asking is what type of pain is usually experience with PMR, is it really intense (the pain in my right buttock is there all the time and is so constant and intense it is like something is pushing it along all the time (hard to explain)and it wraps around to the front.  Whereas the pain in my lower back is more touchy, pulsating etc. and mostly with movement.  I have also been put on the pain killer Targin and panadol osteo.  Thanks for reading and look forward to your feedback. 

1 like, 5 replies

5 Replies

  • EileenH
    EileenH sharon61808

    Posted

    My suspicion for the buttock pain is not directly PMR but either myofascial pain syndrome (MPS) or piriformis syndrome, both of which are often found alongside PMR. The pain you describe in your buttock is not typical PMR pain, which is almost always bilateral although one side may be worse than the other. 

    I had low back pain which an orthopod said was wear and tear which I'd have to live with, I couldn't stand or walk for more than 10-15mins without low back pain that made me feel sick. A year or so later a pain specialist in the hospital here identified it as myofascial pain syndrome, identified and worked on the trigger spots (typically in pairs on both sides of the spine in the shoulder muscles, about rib level and in the low back where the baby's dimples are) using local steroid injections and manual release techniques on the spots which can be felt as knots of hardened muscle fibres in the main muscle. The result was pretty much all the pain could be relieved in the short term - and after I had a wisdom tooth removed which had been affecting my bite I got a long term success. It is an all-over your back problem and getting it all right at the same time is a slow process - but it can be done. Anything that is putting stress on your back muscles needs to be identified - uneven leg length, poor posture as a result of the pain, poor gait (how you walk), bite problems (dental) for example can all underly the return of the symptoms. 

    Does 20mg always manage PMR symptoms? Probably - but at one point I was on 20mg Medrol which did nothing much, it took until mid afternoon to be able to move any better. I was switched to another form of steroid (a form of prednisone) and 15mg gave the usual miracle result. The MPS pain was still there - but the typically PMR pain and stiffness was gone. For some reason the Medrol wasn't working for me, although it caused severe side effects. I'd also been fine on prednisolone before the Medrol except when I had been given a new batch of 5mg enteric coated tablets  - they didn't work and I had a flare, the batch of 2.5mg pills worked fine. The only solution we could think of was that they had different fillers in the pill that had some effect on me absorbing them. That or the batch was counterfeit - but no-one else had complained I was told.

  • ptolemy
    ptolemy sharon61808

    Posted

    If the pain is one sided it is probably nothing to do with PMR. I have pain in my left buttock due to sciatica, although the intensity of pain varies depending what I have been doing. I just wish it would gonaway. Pain killers are useless for PMR, so if they work it is something else. 20mg pred should control the PMR for most people, normal starting dose is 15-20 mg. 
  • Kdemers
    Kdemers sharon61808

    Posted

    My only reply is that whenever the PMR flairs, every and any place on your body that has every been inflammed in the last year or so will somehow recall itself and hurt again. Most likely acute present nerve pain will be even more painful.  So the Prednisone will help with those memory pains for sure,but it looks like you need to see someone about the spurs, etc.--all that arthritis pain--maybe some of it could be eliminated with surgery. Once I was on high level of Prednisone for 2 weeks--dr. said whatever it took to reduce inflammation for GCA and PMR.  It is difficult to say when there may be two reasons for intense pain.  I wish you luck.
  • iellen32
    iellen32 sharon61808

    Posted

    So sorry. Sharon, you had a flare up, the tapering was done too fast as the docs do - our body don't accept - as we read here on the Forums.

    You are not alone on that.

    I do not have any massive knowledge - the inflammation

    is there working inside of your system.

    Lots of patience and carefully you will get back to the stage

    you were before all this happened.

    Take good care of you.🌷

    iellen

  • amkoffee
    amkoffee sharon61808

    Posted

    I have had lower back pain for 13 years before my PMR and most of it is arthritis at this point, with a little bulging disk too. So I'll tell you what I experience. When my PMR is flaring the pain is much sharper. See I always have bad back pain and I take opiates for it all the time, which we all know does nothing for the PMR pain. But when I flare Charley hold the door because it gets really bad. I've tried to tell my rheumatologist that my back hurts really bad when I flare and she says well you always have a back ache that has nothing to do with PMR. But she really is clueless and not just about this issue. Anyway the best way for me to describe it is it gets sharper pain. Otherwise my pain is a rather dull ache.

Back to top

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.