L5 Compression Fracture and Prednisone

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Have had PMR for 2 years now. Started at 15 mg of prednisone and symptoms were dramatically improved w/n 24 hours. Have been struggling with trying to reduce using the DSNS method and with multiple ups and downs and switching to methylprednisolone have now settled at 12.5mg.

Several weeks ago I started to have severe lower back pain. Went for an MRI and a had a consult with a pain management specialist and was told I have a stress fracture of my L5 vertebrae. No history of trauma so it's a fairly good chance it's from osteoporosis related to the methylprednisolone.

I am guessing my rheumy will want to put me on a bisphosphonate which I do not want to take ( on too many other meds for other issues ).

Ideally I would love to reduce or stop the methylprednisolone but as you know it's a Catch 22 situation.

I would appreciate your thoughts on what I should do since I feel trapped and would also love to hear from others regarding your experience, both positive and negative, with bisphosphonates.

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    It's now been 4 weeks of dealing with the pain from my stress fracture of L5 & I feel my PMR pain has increased.

    Is the stress of dealing with the fracture pain and the possibility of back surgery enough to trigger increased PMR pain and should I "give in" and increase the prednisone ? I am reluctant because it's likely the steroid is what contributed to the fracture and I don't want to increase the chances of it happening again.

    Between a rock and a hard place.

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