More advice please

[Pocketdog]

Hi, I asked last week about PMR re-surfacing - after 3 weeks on 20 mg and feeling great then reducing to 15 mg and 2 weeks later crashed and burned. Your advice and knowledge before speaking to my GP was invaluable and he agreed to up the dose to 20 mg for 2 weeks and slower taper to 17.5 thereafter. However, after 1 week on the 20 mg I feel a little disappointed and disheartened as I am still getting pain in both buttocks and my walking is very limited but the PMR hasn't surfaced in the thighs or upper body. I'm seeking advice as to whether to stay for another week on the 20 mg and see what happens or possibly increase the dose and, if so, by how much for how long. I would appreciate your views before approaching the GP again. Can't thank you all enough for your knowledge, experience and advice.

[SheffieldJane]

Has Piriformis syndrome been suggested to you at all? It causes sickening pain in the buttocks extending to the sciatic nerve. The treatment consists of icing and manipulation by a physiotherapist. Unfortunately PMR trails some very unpleasant companions. Of course this would impact negatively on your walking. I would be very cautious about my taper until this subsides.

[Pocketdog in reply to SheffieldJane]

Thank you Sheffield Jane - it was your helpful advice to go back on the 20 mg for 2 weeks. After a very slow shuffle to the shop and back I'mnot sure the pain is in the buttocks - I think maybe more in the hips? It's so difficult to pinpoint

[PMRpro Ambassador]

I agree with SJ - my immediate thought is piriformis syndrome which may be linked to the PMR but can exist in its own right as well. It might respond to more pred - but that may be using the proverbial sledge hammer because while it might help in the short term it will be a longer term problem that will crop up repeatedly unless approached in a more targeted manner.

I find sitting with heat over the tight muscles helps a lot but I get physio intermittently (never enough!) and usually the pain clinic is invaluable but Covid put the mockers on that!

[Pocketdog in reply to PMRpro]

ThanksPMRPro. Will focus today on exactly where the pain is and maybe get a consultation with the GP

[PMRpro Ambassador in reply to Pocketdog]

Identifying exactly where the pain is is quite crucial - I can just about manage to identify it myself now but it is after a lot of experience with physio and rheumy who have done unerring fingertip searches!!!

[Pocketdog in reply to PMRpro]

I have the great fortune of having a sports masseur/conditioner as a (much younger )neighbour, who I stalked and pointed explicitly to the areas that hurt - am reliably informed that it's buttocks not hip and how the 3 glute muscles work. So more research underway Thanks again so much ladies. Your knowledge and advice second to none.

[PMRpro Ambassador in reply to Pocketdog]

Now THERE is a desirable neighbour to have!!!! I suspect that access to a good sports masseur/therapist would be the best option for most of us!

[Pocketdog in reply to PMRpro]

Am just negotiating my champagne order as part payment/bribery fees

[PMRpro Ambassador in reply to Pocketdog]

Sounds good to me!!!