PMR AND ITS ASSOCIATED AILMENTS

[Robinre]

Just a thought on Piriformis Syndrome. I have been on Prednisone for 3 years for PMR (undiagnosed for 2 years before start of Prednisone). Symptoms of PMR alleviated almost immediately on start of Prednisone (20mg). However, I had a lingering pain in the right buttock not like all of the other symptoms I eventually associated with PMR. The pain got worse, especially at night when I could not sleep on that side (my preferred side in which to sleep). Several doctors said it was from my back although all (3 of them) agreed that my back wasn't that bad at all but they kept sending me to PT for therapy on my back, then to a Chiropractor, who made it worse, and finally I went to an acupuncturist on my own and he immediately diagnosed my problem as the Piriformis Muscle. Which made sense because I had been doing a lot of Zumba and spinning (before onset of PMR) which aggravated that muscle. I had to stop acupuncture therapy because my insurance would not pay for it) and I was sent by my doctor who gave up on me to a Pain Management Clinic. At this time my PMR symptoms were completely absent and I was down to 1 mg but the other pain kept getting worse. I told the PMgmt doctor about the Piriformis muscle and he replied that only 1 percent of the population have Piriformis syndrome and since I did not have sciatic with it it was not likely I had this. He also added that my back Xray and MRIs were "not bad." He insisted that it was the SI joint and a trigger point injection in the hip and an epidural did nothing at all. Finally after about 3 months he agreed to an epidural directly into the Piriformis muscle although he still said it was probably not the reason for my pain but I said I was desperate and all my research only reinforced my theory. Well, you guessed it. I got up from that table after the epidural with no pain and no pain ever since. SO THE LONG STORY IS PIRIFORMIS MUSCLE can really cause a lot of pain and that pain is entirely different from any of the pain of PMR. Prednisone did not help that pain at all. And many of us are aware that hip bursitis somehow can go along with PMR and that pain can be incredible also. In fact, I had to be taken to the hospital by ambulance when I first experienced this. A cortisone shot directly into the hip stopped this immediately although at times I still might feel a little pain. Sounds so dismal. PMR, PIRIFORMIS MUSCLE, AND HIP BURSITIS ALL TOGETHER. I am able to recognize what pain is caused by what and can address that issue now. Sometimes have a flare and my Prednisone is increased. Now my hip bursitis is acting up and I will be seeing my doctor tomorrow for a trigger point injection there. I will be 80 in two weeks and I hate to think of what is yet to come. Oh, I forgot Pseudo Gout. All of these seem to be under the umbrella of PMR (I have seen a lot of articles on this theory). My best advice is try and isolate and recognize each pain because they are all different. Thanks for reading. I know this is long but I have not posted in a long time. Robin

[PMRpro Ambassador]

I also have the trifecta! If it gets bad enough it causes sacroiliitis - which can be excruciating as you know! I think the pain management chap is in cloud cuckoo land. And if 1% of the population has piriformis syndrome - that is a lot of piriformis syndrome patients if you ask me! It is only when it has been ignored for a very long time that I develop sciatica and mostly it is piriformis which responds to manual mobilisation though it does take longer.

[Daylily2000]

This is good information. Thanks! Glad you are getting your pains under control!

[ralinn52]

I was so happy to read your post! I too have been suffering with piriformis for years undiagnosed. Seen chiropractor after chiropractor, finally my rheumy is seeing me for f/u this week and hopefully will insist on a shot into that muscle, which would be a minor miracle for me!! fingers crossed.

[PMRpro Ambassador in reply to ralinn52]

There are good physical management techniques too.

[ralinn52 in reply to PMRpro]

I think I've tried everything, hoping to get relief this week from a shot. Pain is really getting me down, been going on for way too long. I have bilateral but both never hurt at the same time so I don't what rheumy will do. I'd like both injected but he's the boss.