Back and hip problems now

[Patricia157]

I started with PMR this January on 15 mg Pred and have successfully reduced to 10 mg in July. Ten days ago I was looking after my two grandsons (10 & 8) and doing a little more walking than usual. I also tripped on a rough pavement and thought nothing of it until I woke up the next morning with a very painful groin, buttocks and lumber/back region. I have resorted to a walking stick but since then it has not really improved. Life is a bit difficult now! So I suspect it is possibly PMR related. I have taken paracetamol but it doesn't help really. I would value any suggestions as to whether I should see my doctor about this. He has so far been happy to let me dictate my levels of Pred reduction. He has not taken any blood tests etc. since I was diagnosed. I think his In depth knowledge of PMR is fairly limited. My doctor has given me enough Pred at 10 mg until the end of August.

I would appreciate any advice you can give me.

Also Is this likely to be a long term problem?

[Annodomini]

It might not be PMR related. Many years before PMR, I had a fall in the street - embarrasing - and subsequently, my hip flared up really badly. X-rays showed really severe osteo-arthritis, necessitating a replacement. It would have flared up eventually but the fall must have exacerbated it. Maybe your doctor could refer you to a physio - they are much better at diagnosing joints than most GPs!

[piglette]

Patricia, I am so sorry things have got worse for you. It sounds like the shock of the fall may have affected the PMR, I find it can happen if I overdo things. You could try increasing the pred and see if that helps. I would also phone up your GP and say you are having problems and also ask if you can have a blood test for CRP and ESR. How did he diagnose PMR without a blood test? Or make an appointment if you can get one reasonably soon. He should also have arranged a Dexascan for you. Are you taking vit D and calcium supplements? They are recommended with pred. I must admit I have to arrange my blood tests myself as my GP is not very knowledgable either. You may need to be diplomatic as I find they don't like us to think they are not sure of what they are doing.

[DorsetLady PMRGCAuk volunteer]

Hi Patricia,

As someone who has a "problem" back, I would suggest your problems are more likely to be related to your trip, did you actually fall to the ground? Even if you didn't, you probably pulled muscles in your groin/back. To that end a physiotherapist is probably the best option, but do tell them you have PMR as well, as it can be exacerbated by too much physio!

Have you tried cold and/or heat treatment. I always start off with cold gel, or if really bad frozen peas, followed by heat patches or hot water bottle. Although having said that, if you still have pains ten days on, then more profession help is probably required.

Your CRP/ESR levels are likely to be raised from your back problem, not necessarily PMR so don't get too worried if they are higher than usual.

You could try seeing a physio privately, going thru GP usually takes ages. A good one should be able to get you sorted in one session, or maybe two. Hope you're soon felling better.

[Celtic PMRGCAuk volunteer]

It could be that the stress of the fall has exacerbated the PMR inflammation or it could be that you have injured your spine. I have had a spinal problem (spondylolisthesis) for years, and my PMR started within weeks of a heavy tumble from a train. See if your GP can firstly arrange an X-ray or scan of your spine to rule out a positive injury. Increasing the steroid dose, perhaps to 12.5mg for a few days might provide an answer. Did your GP at least arrange blood tests, ESR and CRP, before diagnosis? If he did and PMR was diagnosed through raised markers of inflammation, those tests should have been carried out on a regular basis since. If you are referring to PMR in your last sentence, then yes it is unfortunately a long-term problem - if there is one thing we learn whilst suffering from PMR and/or GCA, it is patience! Hope you get some positive answers and feel better soon.

[Patricia157]

Thank you Annodomini, Piglette, Dorset Lady and Celtic for your very quick replies. I appreciate all your comments and suggestions.

I did have a blood test initially in early January to confirm I had PMR but haven't had any tests since.

I didn't actually fall, thank goodness, or my grandsons might have laughed at silly grandma. Only joking, I love them to bits! I tripped and took a few hasty steps to correct my balance. That is why I was so surprised to wake up in such pain etc. the next day.

I did have X-Rays a number of years ago on my lumber and right hip ( it's the left side causing me pain now) the X-Rays taken then did show the start of arthritis but taking paracetamols regularly on my previous doctors recommendation seemed to work. I haven't had to take them regularly for a few years now.

I am taking calcium and vitamin D each day as well as calcium regularly in my diet - all thanks to the information I pick up on this great forum.

I will try the hot/ cold treatment Dorset Lady - thanks for your suggestion. I will also pay a visit to the doctor and hopefully he will arrange the various tests you mentioned Celtic.

Thank you all for your help.

[PMRpro Ambassador in reply to Patricia157]

I had a similar experience - PMR followed by a trip which within weeks had me in hospital with severe sacroiliacitis. I couldn't move at all.

It was treated with iv corticosteroids and pain killers and iv diazepam - a recognised protocol. Unfortunately I reacted badly to the diazepam and I was sent to the pain specialist who used cortisone injections and manual mobilisation techniques instead. It took some months but worked well in the end.

The cause was something called myofascial pain syndrome which can cause spasmed muscles and irritated nerves which then cause referred pain. Some people with less severe symptoms have benefited from Bowen therapy and that is what I use now to keep things in check. It is well worth trying - if it is going to help you will know in 3 sessions, often less, but if it hasn't helped in 3 sessions it is unlikely to do so. It isn't a never-ending thing where you are told you will need sessions every few weeks for the foreseeable future.