Lower back pain. Tapering & Methotrexate

[Scotty7]

I am currently tapering 7mg 1 day 6.5mg next. I am on the 2nd week if 4,as per the consultant. When I walk more than 15min I get terrible lower back pain I can't work out if it is my PMR or my arthritis. Does anyone have similar problems. Also has anyone had any side effects from Methotrexate my consultant has said if I get stuck on 6mg ( again tried last oct ) he will put me on metho. Thanks in anticipation.

[PMRpro Ambassador]

Personally I do not understand why any doctor would want to add in another drug with potentially serious adverse effects when the patient has already reached what is called a physiological dose of pred - below about 7.5mg/day (that is the sort of amount of corticosteroid the body produces normally to enable it to function).

I had severe back pain like that after standing or walking for more than that sort of time. A private orthopaedic specialist informed me it was wear and tear and I'd have to learn to live with it. He hadn't done any imaging to support that opinion! Some time later my back muscles went into spasm and I had excruciating sacroiliac pain - so severe I couldn't move and went to the ED where other orthopaedic specialists recognised the muscle spasm and tackled that. The first line approach caused a cardiac problem so I was sent to the pain clinic who went about it in a different, slower but, in the long term, equally effective way. It isn't cured - but it is now manageable.

PS - mine is due to myofascial pain syndrome (MPS) which is often found alongside PMR. They are due to the same inflammatory substances, in PMR they are systemic (throughout the blood supply and body) in MPS they form hard knots of inflamed muscle fibres in large muscles.

[alvertta]

I have had bad lower back pain since I started prednisone. It starts if I walk or stand 10 minutes or more. Only relief is to sit down. I do water aerobics and recumbent biking to work out. Hoping the pain will subside when I am on lower dose of prednisone. Currently 17. GCA. SINCE October 2018.

[piglette]

Have you tried a painkiller to see if it helps your back? If it does it was not the PMR causing the pain!

[alvertta in reply to piglette]

Does not work for me.

[PMRpro Ambassador in reply to alvertta]

Have you tried heat? I found (and find) sitting with a hot water bottle over the bit that hurts helps. It relaxes the muscles.

[alvertta in reply to PMRpro]

The pain stops as soon as I sit. I will try hot water bottle at bedtime. Thanks.

[piglette in reply to alvertta]

Sounds like PMR causing the problem. As PMRPro says some sort of heat may help. I have one of those material things you put in the microwave, they are great.

[Marilyn1959]

I can empathise. Sounds very similar to what happens to me when walking. I am wondering if the lower back pain is deferred pain though, since it improved when I had 6 pain blocking injections in between my shoulder blades at base of neck. The injections helped me stand more upright which made me wonder if cause of lower back pain is to do with posture/ stance?

[alvertta in reply to Marilyn1959]

Interesting.

[Hellyowl]

I got low back pain for the first time in my life when I was on high doses of Pred 60mg for GCA. My Rheumy advised Pilates and within months it worked. I continue 4 years and my back is fine. I have been told after a scan that I have arthritis in my spine but my core muscle strength compensates and I don't notice. Can you see a physio to advice about exercises. Back pain is miserable.

[Noosat]

I have found, despite having osteoarthritis as well as PMR, that by strengthening my core muscles, those in my abdomen and the glutes (bottom) the pain is lessened. I try to walk with good posture, as if I had a hook in the top of my head pulling my body straight.

[Ciar]

I have been having something similar. The pain is so bad it just makes me stop completely.

Last spring I began having hip pain (both sides), and a flare up of my very low back pain from previous nerve damage from 10 years ago. It has slowly gotten worse over these months. In August had X-rays of my hips which showed bone spurs and some arthritis in both hips. As months went by, walking became more difficult and I had an MRI, which showed a lot more damage in my right hip. The doctor thought I could use a hip replacement. It’s so bad now that I sometimes can’t stand/walk more than 5 minutes, and I need to use crutches. If I rest awhile I can walk again for a short bit. It’s confusing because pain is through my leg, and in the sacroiliac area as well as the hip. It’s so intense it just stops me completely. I started physical therapy last week to rebuild strength I’ve lost living on the couch for so long, so I can do the hip replacement. I’m worried because I can’t tell how much is from my back and how much is from my hip.