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Piriformis Syndrome part of PMR Muscle inflammation?

Posted , 5 users are following.

erika59785
erika59785

A recent Sacroiliac prolem was resolved with physical therapy, but now I suffer under sciatica pain in my left buttock and the pain going down my left leg.  It bothers me most at night when I am laying down and sitting

.....not much when I am standing.  I had physical therapy yesterday because of the sore muscles in my left buttock which helped.

Eileen was so kind to refer to the problem a while ago.  My question is, should I continue with Physical Therapy.....or consult my GP about a possible MRI to find a solution about the pain.  I am on fairly high Prednisone 25 mg for a week because of severe pain in my right side which is getting better.....but now the left side is acting up! 

Thanks for anybody's input who might have had the same problem.

Erika

1 like, 9 replies

9 Replies

  • EileenH
    EileenH erika59785

    Posted

    I'd say more physical therapy to be honest. I don't think an MRI will show much if it is piriformis syndrome. It would if it were a disc problem. Do discuss it with the physio - because it is possible a cortisone shot would be a solution.
    • erika59785
      erika59785 EileenH

      Posted

      Eileen, thank you for your quick reply and advise.  I have another physical therapy appointment next Tuesday and Friday.  I felt that it helped, but I was still bothered with pain during the night.  Strange, that I don't have pain during the day, although I took Prednisone at night to cover the pain.  If PT will not work than I will ask my GP for a cortisone shot.

      THANKS AGAIN!

       

  • pattik
    pattik erika59785

    Posted

    Hi Erika, 

    I read your post a while ago, but since then

    I have developer sacroiliac problems too. 

    I developed PMR in Sept.  Currently taking 

    15 Mg of prednisone.  I see Rheumatologist 

    On Tues and don't know if he will reduce dosage.

    In between appointments his office had me pick up an RX of MXT.   I've been reading lots of posts of people who hate taking this drug.  I have had 3 doses and I guess we will see why he added it and if it's helping anything.  Right now I'm suffering 

    With the sacroiliac in my hip.  Hard to sleep or do anything

    • erika59785
      erika59785 pattik

      Posted

      Sorry to hear about your sacroiliac problem.  Physical therapy helped me a lot ----mainly massage and heat therapy. It is not all resolved yet because it does effect the hip area. It was first the left side, but now it is in the right buttock area with ciatica pain at times, especially bothersome at night.

      My GP put me on 30 mg of Prednisone for a week, and I am now down to 25 which helps the pain.

      I let Eileen and other more knowledgeable fellow sufferers to give you their guidance.

      Rheumatologists LOVE to put their PMR patients on MTX.  Horrible!   And he would want you to reduce ....... fairly fast which is not good.  My Rheumy tried to talk me into taking MTX as well and I refused.  Luckily my GP understands PMR andhas dealt with patients with this dreadful, unpredictable and painful disease..

      Good luck.  Please let me know your experience with your Rheumatologist.

      Happy and HEALTHY New Year to you.

      Erika

    • EileenH
      EileenH pattik

      Posted

      Whether people hate taking it or not - there is NO real evidence that it makes any difference in the long term with regard to PMR. Some patients are able to reduce the amount of pred they take initially but then have a flare which sends them back to a higher dose. Howwever, there were 3 studies which came to no conclusion: one said it helped (that is the one the rheumies all remember of course), one said it didn't and one didn't know. That was work done maybe up to 10 years ago. More recent work has come to the conclusion that while it may apparently work in the meantime, overall there were just as many flares and the dose taken overall much the same even if MTX had been used. All it really did was expose patients to another drug with its own side effects and my suspicion is that the patients for whom it worked either don't have PMR but LORA (late onset RA) which is something that is known to happen in maybe 20% of patients at least anyway and probably happens in other patients too.

      Anecdotal evidence is suggesting that reducing very slowly achieves just as good reduction results - and there are no side effects. By slowly I don't mean leaving it months between reductions, I mean in VERY small steps, never more than 1mg at a time even at higher doses and, as the dose falls, by spreading the reduction over a few weeks. Many flares are actually steroid withdrawal being mistaken for PMR returning. REducing in tiny steps avoidds that and also identifies the longerterm dosage more accurately straight away rather than getting into a yoyoing pattern of pred dose.

    • erika59785
      erika59785 EileenH

      Posted

      Excellent advise about MTX and reminder about very slow reduction.  I am up and taking my Prednisone in the very early hours here in USA.....reducing by  2 1/2 from 25 mg for a week until I reach 20 mg, and then reducing by 1 mg for about a month.  I have been feeling better.
  • wardy
    wardy erika59785

    Posted

    Hi Erika

    I had sciatica for thee months this autumn I couldn,t walk for most of the time and the pain moved from the whole of my right leg into my left leg and then back again into my right leg then into my lower back. I had phisio just exercises but in reality the only thing which took the pain off was cocodamol I took the recommended dose all of the time eventually after 3 months it cleared up and fingers crossed it doesn't come back. I know what you are going through the pain is horrific, Wendy

    • erika59785
      erika59785 wardy

      Posted

      Wendy, thank you for sharing your experience with Sciatica.  I needed to seek URGENT CARE (here in the USA) in ;the middle of night because the pain was so bad,  and I could not sleep.  They did not give me cortisone shot, but prescribed Tylenol with some kind of narcotic. They said I have a flare up.

      When I started to take the whole amount of prednisone in the early morning hours 22 1/2 mg,  I noticed lesss pain and less muscle inflammation near the SI joint, left buttock and nerve pain going down my left leg.

      I also decided that I should stay away from meat in general...wheat......wine...and sweet dessert....All the good things I enjoyed during the holidays which might have broght on a flare up because it started a week ago.

      It is so difficult to know the cause.  Presently, I am getting Physical Therapy, massage and heat.... with a couple of exercises.  It seems to feel better and hopefully it will go away, soon.

      I hope your sciatica pain will not come back.

      All the best,

      Erika

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