Leg pain

[Stracaks]

I was diagnosed with PMR in February. My first dosage of prednisone was 40 mg. I am down to 25 now but my shoulder pain has returned. For several weeks I have had pain in my right leg, mainly the back of the thigh. On Friday my doctor said she thinks I might have a pinched nerve that is not related to the PMR. Tomorrow I am having an MRI to check for a problem with a disc. My question is this: Could the severe back and right leg pain just be PMR related? I tried a 30 mg dose of Pred for a few days, but perhaps I should try 40. Thanks.

[SheffieldJane]

To be honest Stracaks, these do not sound like typical PMR pains which tend to be bilateral. I would be inclined to wait for the results of the MRI which may provide a clue. Although Prednisalone tends to improve most muscular skeletal pain at high doses, it is not advisable to take it for that. The side effects tend to outweigh the benefit. It could be that a physio might be able to help once you’ve got a clearer idea what is causing this. A trapped nerve is a credible idea. Good luck, it sounds miserable.

[Stracaks in reply to SheffieldJane]

Thank you. I have read about bilateral symptoms with interest because it seems as if the right side of my body is more painful and symptomatic from shoulder to leg.

[SheffieldJane in reply to Stracaks]

I have a very painful right shoulder that has recently come on. I think it’s bursitis . My PMR pains did seem to be both shoulders and the tops of both legs in the groin area for the most part. Although sometimes you can just feel generally in pain , well I can. You are on quite high doses for PMR. Do you have any GCA symptoms ie head, visual symptoms, pain while chewing.

My PMR symptoms were mopped up by 20 mgs initially, an average start dose.

[stellafmdm in reply to Stracaks]

Hi Stracaks! My PMR is atypical (very) and the worst pain when it is not controlled is on the left side, but I find the right side is always tender to the touch as well!, Neck and shoulders worse on the left, and the right leg worse than the left!! My worst problem is the tiredness and lack of stamina, but the left neck and shoulder come a close second!

We are all so different aren't we? When Rheumy first told me I was atypical I opened my mouth to tell him I was a number 4 on the Enneagram. (have you heard of it? it is one of those character and personality things one can do) Number 4 is the one who is always unique. Anyway I shut my mouth again fast in case he sent me to the Psychiatrist!!! Ha Ha 😌

[Hidden]

Wow that's a high dose for PMR. Most people start at 15mg and some have to go to 25mg but 40mg and above is more common for GCA. If you have pain on one side then, as Sheffield Jane says, it could be trapped nerve. The issue now is that 40mg of pred can help numerous inflammatory conditions. I suspect if it is a trapped nerve(s) then it's pointless raising from 30mg and you should try painkillers for at least a week to see if it helps pain at all. Co-codamol might be a place to start if you can take it. You need to build it up in your system to help nerve pain. If it helps at all then it's not PMR pain. I hope the MRI sheds light on it. But you should discuss guidelines of pred dosages for PMR with your GP.

J R Coll Physicians Edinb 2012; 42:341–9

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© 2012 Royal College of Physicians of Edinburgh

[PMRpro Ambassador]

It COULD be PMR-related - and it COULD be a pinched nerve but NOT caused by bone/disc problems. It is possible to have similar symptoms as a result of myofascial pain syndrome and that is more common in people with PMR. It is caused by the same inflammatory substances but they are concentrated in trigger points in the back muscles that can be felt as a knot of hardened muscle fibres - which can irritate nearby nerves and cause referred pain in a similar way to how a disc does. In PMR theinflammatory substances are all through the body, so called systemic, and that causes pain on both sides of the body.

I have it and when it is really bad and not dealt with it gives me sciatic pain right down my leg. I keep it under control with therapeutic massage from a physiotherapist. When I lived in the UK I used Bowen therapy with good results too - but you do need the right therapist. When it gets REALLY bad the doctor here gives me a local steroid injection.

[Stracaks in reply to PMRpro]

Thanks—the knot makes sense because sometimes it feels like that in the tailbone area. I think I would appreciate a steroid injection right now.

[Soraya_PMR in reply to Stracaks]

Could be your piriformus muscle has grabbed your sciatic nerve. I’m working my way through this currently with help of chiropractor. Had pains in back of right leg, but I knew it wasn’t quite the same as the sciatica I had when I had extruded discs. Last week I said to the chiro that I knew it wasn’t possible for my sacrum (bone) to be tight, but that’s what it felt like. I also had pains in my hip, quite severe at times, but that has eased some. On Saturday though my hip was nasty, I went for a walk and refused to limp! I consciously tried to keep my head/spine/feet in good alignment and to walk ‘properly’. It did help.

I think it’s very easy to get unhappy tight muscles with PMR, and once one muscle tightens it’s not long before another gets pulled or tries to compensate. Then it’s difficult to know what is TRUE PMR, and what is a pain caused BY PMR, if you see what I mean?