PMR flare or Sciatica Pain
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I have been on the PMR journey for 5 years and 9 months now!! I started at 30mgs and gradually came down to 2/3 mgs, and went up and down again like a yoyo over the whole period with flares in between. This latest leg pain got me a bit confused. I have sciatica with bulging discs on L4/5 and S1 as shown on the MRI diagnosed April 2018.That seems to have settled down now since I follow a regime of exercise. But it has left me with 2 numb toes (the last 2 little toes) and numb feeling along side the foot on one leg. I managed this so far with very little analgesia.
Three / 4 days ago, I was doing some moderate gardening, and after that I felt this pain on my leg (same left leg all the time) . At the time I thought it was my sciatica , so i was mindful of my posture and exercise and had to take analgesia to manage the pain. However, this pain become quite constant and gripping, and i could hardly bear weight on it. And it reminded me of the type of pain I had when I have flare ups. The only small relief i have is by lying down or sitting down.
I am on 7mgs of Pred using the DSAS method, and it seems fine so far , until now!This morning, I have decided to go up to 8.5mgs. My question is , is that a reasonable increase dose to curb this ?? flare? And if i manage to bring the pain down a bit, how long should i stay on 8.5mg before returning to 7mgs, and then continue my journey in reducing ?
Thank you ALL for your expert advice, especially Eileen. I always read all the PMR posts, and it is such a good learning source.
0 likes, 4 replies
EileenH ling42044
Posted
Sciatic-type pain is typically relieved by sitting or lying and I have rarely found PMR pain relieved by anything except steroids!
https://www.spineuniverse.com/conditions/sciatica/6-leading-causes-sciatica
It may be piriformis syndrome this time - I find that eases a bit with higher pred doses.
BettyE ling42044
Posted
I've said before how much simpler it would be if we could have one thing at a time!
How do you tell whether it's PMR or sciatica ( or both! )? Sometimes we feel we know but how much do we put up with before trying a Pred. increase? And it's more complicated than that. I had years of being almost free from OA pain which, presumably, was being subdued by the Pred. I've never had sciatica but I would imagine OA is easier to differentiate for PMR.
Like you I had months of yo-yo-ing until my GP asked me to try taking Paracetamol before upping my Pred. yet again. He felt if the P stopped the pain increasing then maybe it was OA and not PMR. It didn't work so he upped the dose from 4 to 10 for one week and then straight back to 4, after which I was able to continue reducing again. But I don't think these things are set in stone and you may need a different regime. What does your doctor say?
I had further hiccups along the way but I did eventually get there. That was almost six years ago. Still have the OA pain but no return of PMR so far.
Other will have different stories.... and that's the next problem; we're all different.
BettyE ling42044
Posted
PS. I had two sessions of PMR. the first lasted 3 years, the second more than 5.
Michdonn ling42044
Posted
Hi Ling, it is not easy and so far no clear cut formula. Being an over active jerk . I hurt myself all the time. So when I hurt myself and think it could be a flare, I double my dosage, a little relief I triple it, then as high as quadruple. Each stage is in 3to 4 day intervals and I reduce by the same amount just as quickly as I increased. If not relief time to see my PCP, last time it didn't work, I had torn thei n my hip, strain my piriformis muscle and strain my SI joint. The MRIs showed the damages. But I had a flare couple of months ago and used that method and got it under control. And I am back skiing, so it has worked for me. Good luck figuring it out, think positive, try and stay active and not hurt yourself and try to smile. 🙂