to "up", or not to "up "? that is the question

[seamaid]

Sorry, this must be a basic question but I do not know the answer. I am 81 years young and was diagnosed with PMR in August starting on 15mg of Preds, I have been tapering 1mg per month as told by Rheumy, all has been well, and I am now down to 11 mg daily now due to taper down to 10 mg and feeling so proud of myself ( Pride come before a fall ) however the last few days I have been suffering from really bad lower back pain when I am standing _ I can manage 15-20 mins and it starts to hurt again , upon sitting down , the pain vanishes until I stand again, this so reminds me of when all this started last year before I ceded the fact I had better see my GP , the only difference being .the pain then was in the upper back of my thighs rather than the back now. , ,I am now in a quandary wondering if this was a "flare "- not knowing what a flare feels like, so, should |I up my preds, and, if so, by how many ? Paracetamol or Ibuprofen are not touching it which also makes me wonder. Thank you very much,for you help, I know everyone is busy with Christmas preparations so not expecting rapid results to this Happy Christmas to everyone, onwards and upwards ( not preds ) for nest year,

[PMRpro Ambassador]

Sorry to hear this - these things always happen at a weekend anyway! And you have hit the biggest weekend of the year!

I would be more likely to wonder if it is piriformis syndrome causing sacroiliac problems - which is something that can happen in its own right but isn't uncommon alongside PMR. I have had it - and the absolutely typical thing was being unable to stand or walk for more than a short time. When it happens to me I take 800mg ibuprofen - what is called a flooding dose and the way ibuprofen is meant to be used - and then sit upright with my back well supported and a hot water bottle across the painful area. It isn't something you can deal with in five minutes - sometimes it takes me a few days of heat treatment to be anywhere near pain-free. Lower doses of ibuprofen to start don't achieve anything for me at all - but using 800mg as a single dose often lasts up to 24 hours and then as little as 200mg at a time maintains the effect. In the meantime, there are stretches you can find on the internet that may help relax the muscle that causes the problem and help relieve the pain until you can get a doctor to help (not that they usually do much!!). The most effective treatment I get here where I live is steroid injections but I also get physiotherapy to work on the tight muscles. But here, physiotherapy is hands-on, not "here's a list of exercises" ...

[seamaid in reply to PMRpro]

Thank you very much I will go and try the flooding dose of Ibuprofen and hot water bottle. I have never heard of Piriformis Syndrome so we live and learn every day ! neither had I heard of PMR before I got it all part of life's rich pattern I suppose .

[PMRpro Ambassador in reply to seamaid]

Have you looked it up? Do you want some links expalining it?

cedars-sinai.org/health-lib...

spine-health.com/conditions...

Read all the pages - and watch the video!

[DorsetLady PMRGCAuk volunteer]

Hi

Firstly don’t taper- and you may find that just an extra 1mg might help as ordinary painkillers aren’t helping.

Try a bit of TLC as well - warmth on back.

If all else fails it may be a flare - see this post of how to deal with it - but unless is full blown you may get away with just a small increase -

healthunlocked.com/pmrgcauk...

[seamaid in reply to DorsetLady]

Thank you very much for your speedy reply , I have just read the link you gave me, it certainly gives a lot of helpful information. hopefully my back will be feeling more kindly towards me soon as the GP will not be open again before next Wednesday as Monday and Tuesday are Bank holidays here !!! I like to pick my moments !

[cranberryt]

PMR pain is typically the opposite (improves with movement, more painful with rest). So I would think it is not PMR related but something else going on. Rest, heat and a call to the doctor after Christmas if it’s not improving would be what I would do.