Severe pain mid and upper back

[Joyful13]

I have PMR/GCA. I am currently taking 16mg of Prednisone. For the past 9 months, I have experienced sciatica which was helped by an epidural several months ago. I have also had severe burning pain in my mid and upper back. I have been trying Tramadol and Baclofen or Norco if pain is not helped with Tramadol and Baclofen. The doctors have tried trigger injections with cortisone without relief. I had an acupuncture treatment a week ago and the back pain has intensified to the point that none of the pain meds are really helping. I get some relief floating on my back in the pool. I tried physical therapy for a while, but was so inflamed I really couldn't do much. I am so sleep derived it is scary. Has anyone experienced this kind of pain or have any suggestions.

[PMRpro Ambassador]

I had something similar but in my lower back - so severe one morning I couldn't move without screaming. I crawled to the car to go to A&E when my husband headed for a phlebotomy appointment. I was admitted with the label sacroiliacitis and put on a drip. In the morning I got an infusion of pain medication and a high dose of steroid and at night another infusion of diazepam as a muscle relaxant. It was a minor miracle! Unfortunately I reacted badly to the diazepam, developing atrial fibrillation, so that was stopped and I was sent to the Pain Clinic for the slow medicine version.

There they diagnosed myofascial pain syndrome and used steroid injections into the trigger points and also manual mobilisation - my entire back muscles were solid and in spasm. It took several months with first weekly sessions, then 2-weekly sessions but it did work. Unfortunately it started to return and they couldn't understand why it didn't last longer - until I had a squint upper wisdom tooth removed. It had been affecting my bite. After that I have gone nearly 4 years without a return - it isn't as bad but i didn't leave it, my GP referred me for physio (which took a few months) but in the meantime did a couple of sessions of wet needling which kept me going.

In my experience just single treatments rarely work - you need a long term approach. I had had problems before and it was particularly bad in the first 5 years of PMR when I wasn't on any pred at all. Then I kept upright and mobile using Bowen therapy and Pilates classes. It was after I moved here where neither are available at an affordable price that it all started to come back. This time I have had 3 sessions of manual mobilisation by a rheumy and already 5 sessions of massage and mobilisation by a physio with more to come. We are getting there - I think.

[Joyful13 in reply to PMRpro]

PMRpro,

Thanks so much for sharing your ongoing experience. I am going to see my PCP tomorrow about this. I have seen a pain specialist and may need to return to him. I have also started the process to join a pain management clinic.

Sometimes, the pain is just overwhelming, isn't it. I am so glad you have found some techniques that are helping you. This encourages me to keep searching.

I will let you know how things progress. Grateful as always for your input.

[Doralouise77 in reply to PMRpro]

That was me this morning....progressively painful lower back...today can't walk without using walker ....using ice and heat alternatively.....and upped Pred just in case related....hate going to our ER, but thinking I might have to.....have taken my allotment of pain meds and hasn't helped....

[Tonysue]

I had lower back pain which was so severe I needed two elbow crutches to move the shortest distance. MRI scan showed fractured sacrum. Physio sorted me out, neither GP or Spine specialist helped much.But my physio knew what to do and sorted out a plan of exercises, rest and heat pads. It took twelve weeks but I am able to walk again.

[Joyful13]

Thanks or sharing Tonysue. So glad you are doing better now.

Take care.

[Annie1001]

Hi joyful,

I too am suffering mid and upper back pain. I start the day reasonably o.k. but by the end of the day very painful mid and upper back. The only slight relief is to lie down which seems to ease it. I'm told the pain is probably due to wear and tear. Maybe I should consult Doc. again. I have had GCA for two years. Am now trying to reduce preds. from 5mg. to ? 4mg.

Annie 1001

[PMRpro Ambassador in reply to Annie1001]

That is what I was told by an orthopaedic specialist! In fact it is due to spasmed muscles from myofascial pain syndrome and having it treated as such does relive the pain a LOT! The pain clinic doctor and the physio were appalled he didn't know how painful muscle problems could be - the physio said it must be because orthopods look for bone problems and forget the muscles.

Before I moved here to Italy I had a very good Bowen therapist who kept me upright in combination with the occasional osteopath session and Pilates. A good sports physio or massage therapist are also useful.

[Hindags]

I have had lower back problems for years. They went away with monthly osteopathic manip. and Qigong exercises. But now on Pred for six months my muscles are weakening and there is pain again. I don't think it's from the taper. I'm still at 13.5 and my markers are great. I think it's the muscle wasting. Also, I'm hypermobile which makes me limber but sometimes unstable. I think the Pred has loosened me up even more. Out of alignment means pain for me.

[PMRpro Ambassador in reply to Hindags]

Or the muscles are tight - you sound the same as me. But if you are hypermobile - is your doctor SURE it is PMR that is the problem?