sciatica

[kingharold11]

I have had sciatica for about 3 months have had xrays and am awaiting a mri scan. I also have had PMR for 3 years. have been trying to reduce steroids over the last year but to no avail since the sciatica reared its ugly head every time I try to reduce even 1/2 mg it hurts so much all I want to do is cry. Sorry for sounding mardy but I am in so much pain could the sciatica be connected to the PMR Wendy

[Runrig01]

Hi kingharold as far as I'm aware PMR does not cause sciatica. It is generally caused when a disc in your spine slips irritating the sciatic nerve. Are you taking anything like Amitriptyline or Gabapentin for pain, usual painkillers are not generally effective for sciatica. You need one that deals with neuropathic pain, these need to be prescribed by GP. Generally slipped discs settle on there own, but it is important to keep your spine moving, unlike the old days when drs advised rest, I do sympathise I have a slipped disc in my neck and 2 in my lower back that give me trouble time to time. I would rather go through childbirth again than the initial pain when disc slipped in my neck. There is the occasional case that doesn't settle and disc needs to be removed but that not often. Hope it settles soon, I found Amitriptyline very helpful. Gentle hugs, Runrig x

[kingharold11 in reply to Runrig01]

As I said the consultant at the hospital examined my spine and couldn't see anything immediately wrong which why he referred me for a mri. I did a few sessions of phisio but I have not been able to go because my husband has had knee replacement surgery, I don't drive and I have struggled to get there. Anyway I am going tommorrow I am taking paracetamol, Ibuprofen and amytriptylene at night

[Runrig01 in reply to kingharold11]

If you are on a low dose of Amitriptyline like 10/25mgs you could contact GP and ask if you can increase it. That should help more than Paracetamol or Brufen. Also it is not good to take regular Brufen with Prednisolone as it can cause bleeds in the stomach. Prednisolone as Polkadotcom rightly says has little impact on sciatica as it is an irritated nerve causing the pain. Hope this helps

[polkadotcom]

I agree with Runrig, sciatica and PMR pain are totally different conditions. Has your doctor/rheumatologist run through all of the possibilities of neuro painkillers? I'm on amitriptyline and gabapentin for peripheral neuropathy and Fibromyalgia and I would think that sciatica is likely to be treated similarly.

Also are they sure it definitely is sciatica? I didn't think it would respond to Pred but perhaps the MRI will solve the cause of your pain.

[bowler in reply to polkadotcom]

Hi polkadotcom

Can you tell me if your peripheral neuropathy is associated with your PMR/Fibromyalgia ?

Thanks

bowler

[polkadotcom]

Not with PMR - I'm also T2 diabetic which probably is the culprit with Fibro lending a hand.

[PMRpro Ambassador]

I'm sure I have suggested to you as well as others before that one cause of sciatic pain is the nerve being compressed by spasmed muscles in the lower back. One cause of that is myofascial pain syndrome (MPS) and that is found more often in patients with PMR than in patients who don't - according at least to a German orthopaedic specialist who does research in the field. In MPS there are concentrated areas of the same cytokines that cause the pain and stiffness in PMR - and they can be in the shoulders, causing similar pain and stiffness to what is seem in PMR, and others are in the lower back - and they cause pain radiating into the legs. As long as you are a higher dose of pred it keeps that under a bit of control but as you lower the dose it will come back.

Localised therapy is most effective using cortisone injections and/or mobilisation physiotherapy. It is a muscular problem that won't show up on a x-ray or MRI and the best person to see in the UK is a physiotherapist or a Bowen therapist. Yes it costs - but it works and the pain improves dramatically within weeks. I know - I've had PMR for 10 years but the worst pain I have had was MPS as I reduced the pred dose. It was diagnosed and treated by the pain clinic at my local hospital by a physio and a an anaesthetist who is a pain specialist - but the ethos here is rather different from the UK.

[Tanunda]

I also have recurring sciatica Very painful going for a scan tomorrow and if it is a bulging disc will ask for an epidural of cortisone ir helped when I had it 4 years ago My doctor has given me Lyrica whic certainly helps with the pain even if I feel a little spaced out