is it a flare?

[Reddev]

severe back pain on Wednesday. Started on codeine. Not working Friday started on tramadol plus bloods taken. ESR 35 CRP 8 white blood count raised. Is it a flare or an infection?? You’r help is greatly needed. Never had pain this bad with PMR GCA before.

[fmkkm]

Well that sounds pretty bad! Have you ever had back problems? If so, in the same location? Have you been diagnosed with osteoporosis?

[Reddev in reply to fmkkm]

Pretty horrendous the pain is. No back problems. I have osteopenia. Which is close.

[PMRpro Ambassador in reply to Reddev]

Not necessarily. Osteopenia ranges from almost normal to almost osteoporosis so it is important to know the t-score. It is a matter of degree ...

[Jigsawlass]

Any other symptoms like a UTI ? Kidney infection can cause severe pain

[piglette]

Have you talked to a doctor? If so did they have any suggestions as to the cause?

[PMRpro Ambassador]

Where exactly is the back pain? Does the tramadol help? Otherwise - difficult to say although the raised white cells MIGHT mean infection - how raised are they? They can be raised just because of pred too.

[Reddev in reply to PMRpro]

No the tramadol didn’t really help. Just spaced me out. The pain is in my Buttock. I’m leaning on the side of it being a flare 😔😔My whit cell count was about 13,000 ish. I’m in

A &E now. Going to keep me in for pain relief and an MRI. Thank you for replying. It’s always reassuring.

[PMRpro Ambassador in reply to Reddev]

Sounds like piriformis syndrome - often found alongside PMR. Look online for some stretches - in fact, here is the link to the ones I usually suggest:

myhealth.alberta.ca/Health/...

Several people have found them helpful. The MRI will rule out other causes - but muscle problems rarely show on imaging. The exercises are always worth the try

[Reddev in reply to PMRpro]

That’s the one I was thinking of. But so stiff and in so much pain can’t do them yet. Xx

[PMRpro Ambassador in reply to Reddev]

Try heat over the sore bit - and grit your teeth, The ED option for pain relief didn't do me any good - took my rheumy's technique!!!

[Reddev in reply to PMRpro]

No pain killers work on it. I’ve just had morphine. Not touched it.

[PMRpro Ambassador in reply to Reddev]

Yup - sounds familiar! My rheumy uses high dose NSAID infusions daily for a week (bit bruising, literally) and something he calls neural therapy -seems to be a German thing and he trained in Austria:

caringmedical.com/huneke-ne...

This the first time I've found something about it in English-speaking articles - perhaps for this reason:

"The information provided is largely based upon scientific research done in Germany. Some American physicians might disagree with this information because of ethocentric bias or unfamiliarity with the subject matter."

But it works. I have to pay for it but it has been worth it!

[SheffieldJane]

What kind of investigations have been done?If you aren’t satisfied and it’s really severe. I would be prepared to spend the day in A&E. My husband experiences the occasional, agonising back spasm that lays him out completely. He has to wait it out with the aid of diazepam. It was properly diagnosed though.