sciatica

[kingharold11]

I have suffered with this in the past and the only medication that touches it is Neurofen, seeing as I am on steroids and blood pressure pills I am not supposed to take them. What will they do to me if I take them and what other pain killers can I take Wendy

[PMRpro Ambassador]

NSAIDs and pred both can cause irritation of the stomach lining and together it increases the risk of bleeding. NSAIDs can increase blood pressure themselves and can also interfere with the action of most blood pressure medications (other than calcium channel blockers) so that they become less effective. Paracetamol doesn't have this effect - but it is also far less effective for this sort of pain and it is now being alleged it isn't the perfectly safe drug that many doctors appear to think it is (I never have thought it is as good as it's painted).

It may be worth seeing a sports massage therapist or physiotherapist. The trigger points in myofascial pain syndrome that are in the lower back can cause muscle tension around them that is severe enough to trap the sciatic nerve where it passes through the middle of the piriformis muscle. This then has exactly the same effect on the sciatic nerve as a protruding disc which is the other cause of sciatica. Myofascial pain syndrome is often associated with PMR - it is caused by the same inflammatory substances just they are in high concentrations at the trigger points.

[kingharold11 in reply to PMRpro]

thanks for replying

[Badgergirl]

I have a similar problem. I am due for an MRI scan for a suspected protruding thoracic disc, which is causing me a lot of pain over the spine and stiff, painful trapezius muscle. This could also be myofascial pain syndrome.

I have been prescribed gabapentin. You could possibly take this too if physiotherapy or massage doesn't help. It takes a while to start working though but does help. The only problem I find is wobbly legs and I wouldn't recommend driving with it.

[Runrig01]

As Badgergirl recommended you could try Gabapentin. The spinal specialist I work for prefers Amitriptyline for Sciatic pains, a low dose of 10mgs is usually sufficient. Hope it settles soon, been there and not pleasant. Take care Runrig x

[Hidden]

Hi Wendy,

I've had sciatica twice in the past - it was during my pregnancies, so long before I developed PMR. The pain was horrid and paracetamol was of little help.

I use ibuprofen regularly, when I need it. I find it's a good pain killer, but I always take it with food and never at the same time as I take pred. I am also on BP meds - Ramipril 2.5mg. Not much I know, but that's all my body will tolerate.

If your doctor says you really can't take Neurofen, then can he suggest something else? I seems too bad that you have to suffer even more pain. PMR gives enough, surely?

Pats.

[kingharold11 in reply to Hidden]

Hi Pats It has just occurred to me that I have had rumblings of back pain ever since I went for that horrible colonoscopy about a month ago I am never going for another. I am a bit to blame also because the PMR I think has receded, I am slowly reducing the pred and was feeling a lot better so I went for a 4 mile walk on Tuesday. Got quite enthusiastic. Then I walked 1 and 1/2 miles to the local butcher yesterday thats what did it I have been in AGONY ever since. Now I can't do anything but lie on the sofa with a hot water bottle on my back

[Badgergirl in reply to kingharold11]

Oh dear Wendy. You mirrored exactly what I did. I was reducing and then did a 7 mile walk on a seaside break. It wasn't meant to be that long but we got a bit lost. Anyway, I have been in agony with my back ever since the end of June, waiting for the effects of gabapentin to take its full effect. Upping the pred didn't help my back but did help the PMR flare the back problem caused.

I hope you feel better very soon. Badgergirl

[kingharold11 in reply to Badgergirl]

So do I we've been down to our local Morrisons this afternoon I wasn't too bad to begin with having rested and had full quota of Nurofen however by the time hubby had decided what beers he wanted the pain had set in again and I only just managed to make it back to the car. Felt stupid limping and hopping Hey ho. Wendy

[trish29 in reply to Hidden]

Hello Pats.. I see in your reply to Wendy that you are on B/P medication Ramipril 2.5 mg. I have just been put back on this at the same dose as well as 80 mg morning and evening. My blood pressure was sky high again when I saw my GP on Thursday. 160/100 .. I never suffered with BP in my life not even during Pregnancies. But 10 years on steroids and one Problem after the other this year with Flare- ups etc just isn't helping. I was wondering when you take your Ramipril as it gave me awful indigestion yesterday but maybe that was 1st day back on it . I always take my propranolol first with a biscuit and a drink . best wishes. trish29

[Hidden in reply to trish29]

Hi trish,

I'm not quite sure what dose you are on?

I take my ramipril when I remember, usually later in the day along with the suppliments I also take. To be honest, it never seems to upset my tum. If you are concerned that it could be causing trouble then just take it with a little food or try a stomach protector like omeprazole.

If you are on high dose pred then it will certainly push your BP up - it did mine. I woke up one morning thinking 'how inconsiderate of my neighbour to be hammering on the wall early on a sunday morning!' I took me a while to realise the 'hammering' was my heart beating - the racket was in my head. Heaven knows what my BP was, but I survived.

Ideally, BP is around 120/80, but it usually goes up with age. I have 'white coat syndrome' which makes the medics recoil in horror when they see figures like 200+/ 100+, but my GP allows me to take my own BP at home - it's usually OK.

Try not to worry about it because that won't help - it will make it worse. By the way, 160/100 isn't too bad if you are on high dose pred.

Pats. ps. monitors can be bought for about £50. Worth every penny.

[trish29 in reply to Hidden]

Thank you Pats ..yes I have a B/P monitor at home and I am on omeprazole as well .. I have spoken to my usual pharmacist today when I picked up my medication .. It seems strange that my Rheumatologist took me off the Ramipril a year ago and since then I have been having free rides on merry- go - rounds on waking in the mornings and very swollen feet and ankles ..I thought it was the Propranolol that was causing the problem ..anyway I will see if things settle down now as well as taking 10mg Leflunomide ..I am determined this steroid reduction plan Is going to work . thanks trish29

[Hidden]

Hi Wendy,

Well, you might just have over done it a tad. I've never had to endure that proceedure - thank heavens! You poor dear, but enthusiasm and PMR in my opinion should not run concurrently - far better when you have over done it, so to speak, is enthusiasm then 'rest, rest, and rest again.'

The hot water bottle + rest may just do the trick, but if you have poked the inflammation button, then you might have to up the pred for a while. By how much? It depends what dose you are on.

The alteratives are - put up with sciatica and hope it goes or find another anti inflammitory drug to take with the steroids. What would I do? I would up the pred and rest.

How often do we hear this story - in agony again, done far too much. I myself am guilty and I understand. Whilst PMR still has life it thrives when you over- exercise - then it flares and causes havoc. Don't let it win! Look after yourself. Remember that you are ill and spoil yourself. Try not to over do things and pace yourself.

PMR runs it's course in each one of us individually. It thrives on stress - mental and or physical. We are advised to up the steroid dose if we are experiencing any stressful event. Have I done that? Well no and that's probably why I have had a major flare which set me back a year.

Best wishes,

Pats.

[paddyfields]

I found gabapentin very effective for sciatic nerve pain. The doctor said use it when needed for pain. But the pharmacist and a nurse at the PD physio said to take it as a course of tabs. ie. continually until he irritation o the nerve has subsided. It can take 2/3 months according to the pharmacist but presumably as mine was not so severe, although very wearing, when you have to drive, it took about a month with one or two mlld reoccurrence's.

[Badgergirl in reply to paddyfields]

Hello paddyfelds. I've been on gabapentin for about 2 weeks now, gradually upping the dose. Now that I'm on a moderately high dose of 400 mg three times daily I am staggering about like a drunk person, even bumping into walls! My legs and arms have gone so weak. Did you find this?

Thanks. Badgergirl

[paddyfields]

Hi Badgergirl GP suggested 1 to 3 x 100mg capsule at night but I found just one was enough to help me drop off at night. As my sciatica was not of the electric shock variety - more of a toothache nerve pain I didn't need up the dose. In the daytime the pain was not continuous so I could tolerate it somewhat. As long as I can get to sleep it takes a lot to wake me up. If I'd taken what you are on I would have been out for the count but I have always fallen asleep easily

I'd be inclined to check with the doctor about the staggering about.

[Badgergirl in reply to paddyfields]

Thanks for your reply paddyfields. I did ring the doctor and she said to reduce the dose to see if the lack of coordination rights itself. Unfortunately, the pain was so unbearable when I reduced for just one day that I had to up it again that same night.