Do I take 5 extra for 5 days as advised? - PMRGCAuk

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Do I take 5 extra for 5 days as advised?

AnniesRyder5 profile image
37 Replies

I am down to 6mg per day from 25mg in March.

My GP advised me to take 5mg extra per day for 5 days if I get a flare up.

Im currently mulling over whether I am experiencing a flare up of PMR or just sciatic pain because for 2 days now I've been getting a sharp pain only on my right side through my buttock.

Does this warrant increasing the dosage?

I am a bit nervous about self diagnosing!

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AnniesRyder5 profile image
AnniesRyder5
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37 Replies
PMRpro profile image
PMRproAmbassador

That really sounds more like sciatica because PMR is typically on both sides. If it is pain on one side that runs down into your buttock it is most likely something called piriformis syndrome - the piriformis muscle is tight or in spasm and in some people the sciatic nerve runs through the muscle so it is pinched.

My approach to that (I get it quite often) is to take 800mg ibuprofen all at once (which is what is called a flooding dose) and sit with a hot water bottle over the painful area in my low back. I have approval from my rheumy to do that! It almost always works within 24 hours and doesn't come back for some time

AnniesRyder5 profile image
AnniesRyder5 in reply to PMRpro

Thank you

Marilyn1959 profile image
Marilyn1959 in reply to PMRpro

I thought we couldn't / shouldn't take Ibruprofen whilst taking steroids but I could just be confused and confusing.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to Marilyn1959

No you shouldn’t take it regularly - although I used Ibruprofen gel sparingly for osteoarthritis on lower doses of Pred.

But PMRpro’s recommendation is a “one-off” treatment - and therefore unlikely to cause stomach issues - which is the reason why Pred and NSAIDs shouldn’t be used together on a regular basis.

Marilyn1959 profile image
Marilyn1959 in reply to DorsetLady

Thanks for clarification. Reassuring to know I'm not losing it big time 🙈🙈🙈🙈

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to Marilyn1959

Shouldn’t worry about losing it....you’ll be in good company 🤦🏻‍♀️

PMRpro profile image
PMRproAmbassador in reply to Marilyn1959

Not regularly, no, you are quite right - and preferably you need to take the ibuprofen with food and if you are liable to indigestion with omeprazole or gavison would be fine too. As I said, I have cleared it with my rheumy - who also uses NSAIDs for patients if it is needed.

RoadTrip profile image
RoadTrip in reply to PMRpro

Good to know. May have tension headaches, for which NSAIDs are best pain relief.

piglette profile image
piglette

If you have sciatica, extra pred is a waste of time in my experience. In fact I have not really found a pain killer that is much good. Physiotherapy has helped a bit along with a TENS machine. Also stretching exercises. I find sciatica excruciatingly painful.

Yellowbluebell profile image
Yellowbluebell in reply to piglette

poops taught me the other day to pull my knees up to my chest or as close as is possible in my case!! It helps relieve some of the severe pain.

herdysheep profile image
herdysheep in reply to Yellowbluebell

That's a good one. Never arch your back with sciatica

Yellowbluebell profile image
Yellowbluebell

I get sciatica and am in full throw with an extended attack but its very different to my hip and groin pmr pain. I follow pros ibuprofen treatment when my prescribed meds for my sciatica need a top up. It does the job and I only use it sparingly.

PMRpro profile image
PMRproAmbassador in reply to Yellowbluebell

How often do you find you need it? If I get in early, before I can't move at all, I go probably 3 months between attacks. If I don't crack down hard though it just rumbles on and on.

Yellowbluebell profile image
Yellowbluebell in reply to PMRpro

About once a week atm. Normally just once but this attack has been non stop for over 5 weeks now. Started on pregabalin two weeks 4 weeks and getting some relief. Its not helped by the fact the mri showed damage to 4 vertebrae which are causing the problems.

PMRpro profile image
PMRproAmbassador in reply to Yellowbluebell

Ah - you need a spine transplant" At least mine is purely muscular ...

Yellowbluebell profile image
Yellowbluebell in reply to PMRpro

Oh one of those! No problem. I never like to do things by half!!

Viv54 profile image
Viv54

I have had this problem, i know how painful it can be. A fantastic Physio showed me a range of stretching movements , i have lots of muscle problems with my legs, some are even caused by Pred sadly ! Its painful to start with but it really helps after while . Loads on the internet . Safe ones of course ! Good Luck. Best wishes Viv x

PMRNewcomer profile image
PMRNewcomer in reply to Viv54

I also experiencing pain all down the outside of my right leg and it’s particularly bad in my calf. If I stand for too long it gets unbearable.

PMRpro profile image
PMRproAmbassador in reply to PMRNewcomer

I had that - sciatica due to severe piriformis syndrome - I couldn't stand or walk for more than about 10 minutes without low back ache that was so bad it made me feel sick.

PMRNewcomer profile image
PMRNewcomer in reply to PMRpro

Yes, that’s exactly what I have and I am also getting cramp at night in my right foot and down the outside of my leg.

PMRpro profile image
PMRproAmbassador in reply to PMRNewcomer

Yup - sounds very similar.

Viv54 profile image
Viv54 in reply to PMRNewcomer

Hi yes, awful I had tendonitis at some point as well ,another nasty side affect that takes ages for the Dr to pick up on .She's a great Dr but was in the dark about Pred and tendinitis .I told her if googled it . I have mentioned in my previous post , the stretching exercises help a lot . You just have to push through the pain at first , but it's well worth it for the results you get !

AnniesRyder5 profile image
AnniesRyder5 in reply to Viv54

Many thanks

AnniesRyder5 profile image
AnniesRyder5 in reply to Viv54

Thanks

PMRNewcomer profile image
PMRNewcomer in reply to Viv54

Did you ever get night cramps as well?

Viv54 profile image
Viv54 in reply to PMRNewcomer

Haha! Yes I forgot about them , it was really bad, when I had tendonitis ! I now take magnesium cilate as one of my vitamins , I googled it and someone on here recommend it.Can't say it's that, that has helped 100% but it has for me. It's very good for muscle pains etc .I'm now on Vit D ,Calcium and strong Cod liver oil.The balance of these seen to help. Good Luck .Viv 😊

Hi, why not phone your GP and ask for advice? Your choice re ibuprofen, personally I wouldn’t take the risk and would suggest you use a topical ibuprofen or Diclofenac gel. In many cases this is far more effective AND there is limited risk - anyone who has a gastric bleed will tell you it isn’t worth the risk.

Your call, but even over the counter medicines I treat with great respect, after all, ibuprofen was a prescription only drug until around 1986. Finally, why not have a chat with your pharmacist? Easier to access than your GP and just as knowledgeable about pain relief and drug interactions.

AnniesRyder5 profile image
AnniesRyder5 in reply to

Thank you much appreciated

PMRpro profile image
PMRproAmbassador in reply to

Topical ibuprofen is also considered a similar risk if used long term.

in reply to PMRpro

Quite, but it shouldn’t need to be used long term. If it is, then an advice should be taken regarding alternative treatment I.e. “try this for 14 days and if you get no joy, come back and see me”.

I have limited knowledge but having been asked for comment, that’s my advice and in that regard the pharmacist is ideally placed.

Noosat profile image
Noosat

Some of us cannot take ibuprofen because of stomach issues ulcer in my case. I take a 1000mg of Tylenol and if this relieves pain in any way, even mildly, I know it is not inflammation from PMR

in reply to Noosat

Absolutely. I now take 9 drugs, which 8 weeks ago I wasn’t. Ibuprofen was on the list to avoid - some people take it though with no ill effects. We are all different.

Linny3 profile image
Linny3

I have had sciatica and SI joint pain for years. The only thing I have found to help is 4 exercises I learned from two chiropractors on the internet. Brad and Bob.

Here is one link, from there you can find what you need.

youtube.com/watch?v=3sx9Bz4...

I can't believe the difference these make and how much less pain I have. They have to be done thru out the day to stay on top of the pain.

Good Luck

Noosat profile image
Noosat in reply to Linny3

I do exercises also, mostly for flexibility, so they are stretching motions, which I think help everything. Also I try to practice good posture. This helps align the whole body

Linny3 profile image
Linny3 in reply to Noosat

These are more like specific movements than exercises. They help to move whatever is restricting the nerve in sciatica and they move what ever is out of place in the SI joint.

Good for you being able to exercise. I was an avid exerciser until pmr struck. Now my muscles are so sensitive, there is very little I am able to do as far as exercise goes.

SusanEleven profile image
SusanEleven in reply to Linny3

I do a series of stretches every day that I learned from them. Mine help with my arthritis pain in the hips. Brad and Bob are goofy and I find it easy to follow them. My rheumatologist is amused by it. A few months ago we were talking about an ankle issue and she told me to check and see what Brad and Bob recommend🤣

Linny3 profile image
Linny3 in reply to SusanEleven

sometimes I tune into them for a little lift of my day. They have helped me a lot.

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