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PMR relapse or something else??

Posted , 6 users are following.

ling42044
ling42044

Hello all,

I was here a week  ago with question of leg pain which may be due to PMR relapse or may be piriformis syndrome.  I am still on 15mg prednisolone, plus taking Naproxen frequently.  My blood test of ESR and CRP both came back normal, ie, EDR - 9 and CRP is 5.  Can i rule out PMR relapse with this normal result?  My leg pain is still quite intense , and it goes from the  (left leg only) calf , behind the knee to the buttock.  The intense pain stops me on my track!  and I cant bear weight or stand / walk for long.  Ive been doing some stretching ex, massage, and using TENs machine.  I got better for a few days, now it comes back even more intense.   

What shall I do, put up my pred?  The pain is eating me away !!  

Thank you for all your advice , much appreciated.

 

0 likes, 13 replies

13 Replies

  • ptolemy
    ptolemy ling42044

    Posted

    Hi, I am so sorry you still have leg pain. Your CRP and ESR are normal, as you say, but around twenty per cent of the population never have raised markers. One thing I would recommend you do not take Naproxen with pred, they are contra indicative. Naproxen has no effect as such on PMR, so if you stop the Naproxen does the pain get much worse, this would mean that you have something other than PMR, although you can have PMR too of course. Do you think you have sciatica? I have had it with

    PMR and it is agony. 

    • Silver49
      Silver49 ptolemy

      Posted

      I have had it too and found myself furniture walking.....extremely painful.
  • EileenH
    EileenH ling42044

    Posted

    First of all - you shouldn't be taking Naproxen (it is a NSAID) with pred. Each of them can cause gastric irritation, both together make the risk much higher.

    If your pain is just one-sided sciatic pain it is very unlikely to be due to the PMR. You probably need a proper course of physiotherapy. While you are on pred it is quite likely your blood tests will remain low.

  • Anhaga
    Anhaga ling42044

    Posted

    It seems that a lot of my "add on" pains have been due to issues with my spine, which a physiotherapist has helped me with.  You do need a physiotherapist who is familiar with the limitations of PMR, but there are always exercises even we can do.

    • EileenH
      EileenH Anhaga

      Posted

      And above all - they are better at diagnosing this sort of thing than any GP! They have clinical skills...
    • Anhaga
      Anhaga EileenH

      Posted

      My gp didn't even try - just told me to take ibuprofen without even touching me.

    • EileenH
      EileenH Anhaga

      Posted

      My GP does have a poke and sometimes offers needling - but she is rheumy trained...
    • ling42044
      ling42044 EileenH

      Posted

      Hello Eileen and Forum friends, 

      Is needling work with sciatica type pain?  Is needling same as acupuncture and which is more effective?  I usually take  prednisolone, ibuprofen or Naproxen with a full stomach, and so far, i have no gastric irritation.  I dont know what is the alternative pain killer, apart from paracetamol, or tramadol.   

      I spoke to my GP today, and he thought that it might be some nerve pinching and compressing, whatever it is , he thought it is not likely to be PMR flare up, and asked me to reduce my pred to my previous dose of 10mgs ( iam on 15 at the moment), do you think that is wise, or shall i wean Pred down slowly ??

      thank you for all your advice.

    • EileenH
      EileenH ling42044

      Posted

      You can go straight back to 15 if you've only been on it a few days, no real need to wean. But that is also a reason to think very hard about why you hurt - is it REALLY PMR? If you don't go up unnecessarily, you don't have to come back down.

      The needling I have (wet) does help with sciatic pain because it is aimed at relaxing the spasmed muscles that are pinching the nerve and causing the problem - I see your GP agrees with my suspicions. Dry needling (also called intramuscular stimulation) should also help because its aim is the same. It is similar to acupuncture but different  - it is aimed at specific trigger points in the muscle groups rather than wandering about along the "meridians" and so there are usually far fewer insertions. Independent assessments of acupuncture with self-claimed trained acupuncturists have found that even the same person may put the needles into totally different places while claiming they are not. If it works for you, then acupuncture is fine - but it is a lot of sessions and costly as a result. Intramuscular stimulation uses the same sort of needle but is usually fewer sessions, ergo less costly.

      Bowen therapy may also work for you - it did for me and a lot of others but it doesn't always. But a good physio is possibly the best place to start if you don't know any Bowen therapists - though there if you haven't experienced a change in symptoms after 3 sessions you probably won't benefit. I say change - it may take more sessions to achieve a lasting result/"cure" but you should see something after 3. Some go in in agony using a walking stick for their very first session and walk out forgetting it - ask lodger on here about that! Anyway - it's as relaxing as a massage and, if you have PMR, probably less uncomfortable.

    • ling42044
      ling42044 EileenH

      Posted

      Hello Eileen

      Thank you for your feed back and  advice, always so valuable and thoughful.  I've been checking on line for 'needling ' clinic in Hertfordshire near where I live, but they seem to be like Osteopath  clinics running alongisde with other treatments.  

      The pattern of my pain has changed a bit today.  Despite a night's rest, my leg pain is still there.  I now feel the pain with any 'careless' movements'  , and it 'catches' the area (mostly around the buttock area) and give me a shooting pain.  The only time when i am pain free is if i sit or lie VERY still !! 

      I am going to look into Bowen#s therapy or needling.  I had acupuncture before a while back for PMR, and I didn't think if make any difference. 

      Thank you again.

    • EileenH
      EileenH ling42044

      Posted

      I know there are several places offering intramuscular stimulation around the south east. Did you search for that too? There is one near Newmarket that a friend of mine was sent to by her Addenbrookes consultant (no, don't know if the NHS pays). And several in London of course. 

      Does sound very piriformis if the pain is in the buttock.

    • Mrs_CJ
      Mrs_CJ ling42044

      Posted

      Hi Ling

      i have piriformis problems each of the last three springs (spring gardening seems to trigger mine - I usually lift something wrong). I go to a physiotherapist and she eventually gets the area to feel better but it takes at least 4 sessions. It usually takes about 3 weeks for the pain to go away and then I need to take it easy for a couple more.....so it's a pretty long period of time......plus dealing with my PMR. This last time she gave me a few stretches to do every day and that should stop this from happening again.

      I read on the internet that once you have piriformis issues you have it for life so I am trying to get the stretches to help. They only take about 10 minutes, which is no time at all.  

      I slso get Bowen. I seem to do best with a session every 3 weeks so I've listened to my body about this. I'm waiting 4 weeks this time but thinking I shouldn't have tried that. Oh well, it's like PMR, we just have to experiment with doses and sessions and pay attention to our symptoms!

      i think a physiotherapist could probably sort out your issues pretty quickly. By the way, I read that the sciatic nerve runs against the piriformis muscle so one can cause issues with the other. 

    • EileenH
      EileenH Mrs_CJ

      Posted

      In some people it even runs THROUGH the middle of the piriformis muscle - and if the muscle tightens up the result is a neat pinching action!
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