Steroid use, back issues

[Janniew]

Has anyone heard or suffered from chronic low back ache after ending steroids for pmrgca? Four years on pred, eventually now steroid free for 6 months, one month after discontinuing am left with chronic back ache!

[DorsetLady PMRGCAuk volunteer]

I have lower back pain - but don’t know that I can blame it on the Pred.

Think it’s more likely osteoarthritis and connected to hip I’ve just had replaced. Plus I did have it pre GCA - although high doses of steroids masked the pain - and I would imagine deterioration took place whilst on the Pred and I hadn’t realised. Certainly found that with other arthritic joints!

[SheffieldJane]

I have this symptom when I am on my feet for any length of time, I am still on 6 mgs and was diagnosed with PMR just under 3 years ago. An X Ray showed deterioration in my lower spine which I presume is arthritic and wear and tear ( that awful phrase) no one has suggested that it is PMR or Prednisalone linked. I imagine that it’s part of the wear and tear though. Physiotherapy may help you. I would seek a diagnosis.

[PMRpro Ambassador]

Did/do you also have spasmed muscles? I develop chronic low back pain even on pred as the dose goes down - much as SJ describes. One doctor claimed it is OA/wear and tear (hadn't done any imaging mind) but after putting up with it for a year or so, my back just went into meltdown and I ended up in hospital unable to move without excruciating sacroiliac pain. It was all caused by spasmed back muscle, making the joints too tight and setting up inflammation. Sorting the muscles out resulted in a few years totally pain free. It gets worse in a PMR flare - and treating it as a separate issue means I can usually manage on a lower dose of pred. Myofascial pain syndrome is the usual source and it is found more often in people with PMR - the same inflammatory substances are involved, just they are located in discrete trigger points in pairs on either side of the spine in the shoulders, about rib level and in the low back where the baby's dimples are. They are also in the fascia, the transparent skin you will be familiar with from joints of meat and poultry and that causes more diffuse pain across the spasmed muscle when you touch it.

Bowen therapy and Pilates helped me a lot and now my physiotherapist does manual mobilisation of the trigger points and spasmed muscles (ouch but worth it) and the pain clinic does some needbling techniques which I don't think are available in the UK but you might find them in the USA.

But your back muscles will be weak after being on pred so long - Pilates would probably help if you can't get physio exercises (they will actually be very similar).

[Blearyeyed]

No Pred , The normal aches and pains I expect.

Does it ease with standard antiinflammatory or paracetamol medication?

Does it ease or get worse with light exercise of your back?

After a period of recovery with any ' self limiting' chronic pain illness everyone has to start the slow progress to regaining muscle and bone strength.

The lack of sustained activity on certain muscle groups , plus the effect that medication can have on muscle and bone health means that certain areas of your body have got weaker over time and if you were already suseptible to back or joint pain even before the PMR/ GCA or other chronic issue came in you are likely to suffer those aches and pains in those areas again until you have built your strength and nutritional health up again , and this can take time.

The Pred and steroid medication can hide all of those nerve and joint pains we may all normally get as we mature , now it's gone you may be drug free but general health or back issues may mean you won't becoming free everyday.

Swimming and water stretches can be a great low impact way to regain that back , joint and muscle strength. You can work all of your body at a gentle pace with the water to relax and support you. Hopefully , as you build you strength the intensity of your lower back pain will go over time.

Boosting your muscle healing nutrients with a vitamin and mineral supplement helps alot to repair the damage from PMR/ GCA and steroid use .

Some people stop taking their supplements as soon as they stop taking the medications but it is actually at that time they are most essential in repairing the damage done before.

Taking Vit A, D , E , C, and K , magnesium , zinc , copper and Omega 3 and garlic boosts repair . Take them mid meal for the greatest absorption.

Heat therapy can also ease the lower back pain after gentle stretching exercises.

If it carries on or gets worse it is worth getting a follow up check and some x-rays from the GP to make sure there is no other issues or long term damage.

But , unfortunately , in most cases it is just a matter of time ( and exercise) healing old wounds . I have been told by a good Occupational therapist that your full recovery time after an illness is usually the same length of time as the illness itself.

Take care and I hope this is some help , Bee xx

[ddaveo]

Jannie I seem to recall yo had a lot of back pain when you lived with me. Please contact me in Kansas so I can show you how I feel. You went to the hospital that one time.