Mid-left back pain

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I have not been able to stay at 10mg of pred. after a slow taper from 20.  I've been at 15 twice, now back to 11mg and feeling like I might need to go up again. I've developed a, at times and especially at night and in the mornings, back ache in the center left portion of the back. Having trouble with sleep from it and getting mobile in the mornings.   I did not have this symptom when was diagnosed with PMR around a year ago.   Most of what i started with was should and hip an sometimes in the forearms and between the fingers.  Any ideas. 

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10 Replies

  • Posted

    I'd say it might not be the PMR itself but what I call "add-ons". It is very common to find something called myofascial pain syndrome alongside PMR - caused by the same cytokines that are the cause of PMR but in concentrations in what are called trigger points (not the same as fibro trigger points). In MPS they form hard knots of spasmed muscle fibres in pairs on either side of the spine, in the shoulder muscles, about rib level and in the lower back about where your baby dimples were. These can irritate nerves that pass nearby which causes referred pain or they can make the surrounding muscles tight - and that then can pull on other muscles, spreading the joy. 

    I kept it fairly well under control with Bowen therapy during the years before pred. The oral pred did help a bit but even sleeping on a strange mattress or pillow or leaning forwards to do something like foot care or gardening for any length of time made the other muscles go into spasm and that was very painful. That responded to a hot water bottle and rest quite well - just like most such back muscle problems. Eventually it went into total meltdown and I spent a couple of nights in hospital on a muscle relaxant and pred drip - which certainly made a difference but I reacted badly to one of the drugs and had to stop. However, the pain clinic here continued with cortisone shots into the back muscles together with some manual techniques that gradually eased it all but it kept recurring. In the end it was solved by my having a wisdom tooth out! It was affecting my bite and that was putting stress on my back muscles. I still have the occasional twinge but take that as a warning to intervene quickly.

    A physio or a sport massage appointment might shed some light - but be sure they know you have PMR. There are things in both techniques that can make the PMR feel worse in the short term - the cytokines in the trigger points are the same as in PMR, they are released into the system and obiously make you feel worse for a while. I know about and expect it may happen so don't worry about it. But they can identify any hard knots of muscle and work on them if you can put up with it. Otherwise - a doctor/physio who will use steroid shots or a technique called needling can help. Common in most places except the UK it seems!

  • Posted

    Hi John and Eileen. I have this pain too. Upper back and ribs. I went for hydrotherapy this week. The physio said she knew PMR and said she would go easy on me. However when I was doing some of the exercise I was in intense pain. She said keep going it's because it new... I am now stiff and hurting so badly. Not been this bad for a while. I am so tempted to up my pred. I can hardly move without squealing out. I am currently on 10mg.
    • Posted

      I hope you tell her what she did. In words of one syllable since she was obviously claiming to understand something she doesn't.

      I don't care what ANY physio says - it it really really hurts it is your body warning you to calm down and not do something. It's like the fitness buffs who tell you "go for the burn" and "no pain, no gain" - it is WRONG! 

      I did hydrotherapy - it was great and the physio never asked me to do anything that hurt more than just being slightly sore.

      Maybe a few days at slightly more would calm it down - how very annoying.

    • Posted

      I had something similiar.....while on PT the therapst had me sit in

      chair and go to standing without holding on.  After several of these

      exercises I felt something "rip" in my right upper thigh.  Well, it took

      weeks for that soreness to go away.  Needless to say I never did that

      again.  Chiro also had me lay on stomach and took my legs and

      pushed them over my back.....Whew!  Such pain.  It took about

      two weeks for that soreness and pain to ease off.  Never did that

      again either.  I'm not sure any of that kind of theraphy is good when

      the possibility of inflammation in the muscles is likely.  Hard to know

      what to do.  I'm not an expert of any of PMR problems but would

      advise being very careful with any type of exercise.

    • Posted

      Obviously a total lack of understanding of what PMR can do to our muscles. I trust you didn't pay that chiro's bill?
    • Posted

      I'm on Medicare and secondary insurance so don't have to pay

      anything.  He's really a great guy and felt bad about causing me

      pain.  I didn't know enough to tell him not to do that particular

      move.  He's like most doc's including Rheumy's, they know very little

      about PMR.  I haven't seen him in about a month but want to go back

      becuase I have a rotated right pelvis and some exercises and seeing

      him are the only thing to try for relief.

      At 79 I'm on the SLIPPERY SLOPE anyhow......

  • Posted

    Oh John, I've felt your pain. I had lower and middle and upper back pains. Doctors didn't seem to care. I went to pain management doctor to see if he could atleast diagnose it, but I left with him giving me more drugs and an appointment for injection to see if it helps.  I said NO! No more drugs and no injection.

    I went to Bowen.  Now either the Bowen worked!!!! Or the DMARDS Plaquinel and Sulfasalazine kicked in, but it sure seemed like it was the Bowen. Took 4 sessions.

    so lower and middle went away! Yea! Bowen also taught me to stand with weight more on heals of feet and the big one was align spine by lowering ribcage, this helps get more straight line from heels up spine and chin down and back, ear over shoulders.  I focused this alignment while walking.

    Been a life savor.

    Now upper back has been really, really hurting. Several days now it has not! Yea! I've been doing exercises (only 5-6 reps) pulling my shoulders down and back AND the yoga type breathing filling my lungs from lower to higher expanding my upper back. Feels so good.  I believe it's really helping. 

    Oh and the rowing type exercise using stretch bands, pull back, squeeze shoulder blades together, hold 3 seconds, release.

    i thought it was the acid reflux causing my upper back to hurt as both are subsiding now. So...it could be that or the exercises. ??? But I need the exercises anyway wink

    If if you want better info on this let me know. 

  • Posted

    Hi John,

    Like you after a year on Prednizone I have not been able to reduce below 10 mg without experiencing a great deal of pain in my lower spine and left leg.  I tried Bowen 3 times and it seemed to have increased the pain instead of releasing it.  I just recently had an MRI to investigate further and the results showed a cyst between 3 and 4 vertabrae and it was determined that a pinched nerve has been causing the pain.  Presently I am waiting for an appointment with a neurologist so I can be referred to pain management for steroid injections.  In retrospect I think I had this pain earlier on  but it was managed with higher doses of  Prednizone.

    like Eileen said to you and had suggested to me awhile back that there may be a secondary problem.

    • Posted

      Yes - pinched nerves can have a whole range of causes. It isn't just "discs" as so many people will try and tell you. An MRI will help find the less pleasant options. and it is a shame GPs won't request them a bit more often. Don't show much with muscles though.

      Glad they found you an answer and the injections work. 

  • Posted

    Hello, John,

    I, too, have the kind of pain you describe. I believe Eileen is absolutely right about the MPS. Have tried PT, Bowen Therapy, Cupping Therapy amongst others. What has really helped is using a jade stone heating pad. It is hard to differentiate the various pains you have.  I am at 15 mg prednisone currently. Started at 20 mg over a year ago. It has been an up and down journey to reduce. We just have to persevere. Once in awhile, I have a day where I feel good.  That gives me hope! Hang in there and best wishes to you! Linda

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