Has anyone had a steroid injection for ischial bursitis, or pains in each buttock?

[Pr0jection]

My PMR started with pains in each buttock as a result of sitting on a wrought iron chair (without cushion) for a couple of hours at a friend's birthday party. Looking back I now realise how daft that was. After several months I was diagnosed and put onto 15mg prednisolone. This was reduced over the 8 weeks to 7.5mg. I remained on that dose until a couple of months ago when I started to taper - 7.5mg/6.5mg on alternate days. I'm now on 6.25mg every day and so far so good. I've had a couple of niggles and my CRP was elevated at my last blood test in September but I've decided to continue on 6.25mg until my next blood test in November, and see how things are then. The pain in my buttocks has returned, after a recent long car journey and a bout of extra activities, i.e. helping a neighbour cut back a tree. I'm thinking of requesting a steroid injection, which was mentioned by my rheumatologist back in the early days. Would be interested to hear if anyone else has had one and, if so, did it work.....thanks in advance and have a good day.

[PMRpro Ambassador]

I have in the past - I have had quite a lot of problems with piriformis syndrome as part of wider greater trochanteric pain syndrome. The pain specialist here is very reticent with steroid injections because I am on anticoagulant therapy and she is concerned about bleeding. My rheumy and the GP have done them though.

They are very good at the time for the acute pain - and mine is excruciating - but in the long run other approaches are really useful to encourage the relaxation of the muscle spasm that underlies the acute pain. I've had physio for 3 weeks - manual mobilisation has made as much difference as a steroid jab to be honest.

[Pr0jection in reply to PMRpro]

Thank PMRpro, I had a feeling this would be the case. My pain isn't excruciating just unrelenting until I stand up. I think I'll try some of the piriformis exercises to see of they help. On the plus side I can still walk! We just walked along one of the river valleys collecting some white stones for the garden. So it's not all bad! Enjoy your day....

[PMRpro Ambassador in reply to Pr0jection]

I couldn't stand up! Never mind walk - I was using crutches for a time! 800mg ibuprofen and sitting against a hot water bottle helped a lot.

[123-go]

I had the horrible 'sitting on rocks' buttock pain pre-diagnosis and nothing relieved it until I was diagnosed and started on 15mg Pred when it miraculously disappeared.

Your reduction from 15mg to 7.5mg was, in my opinion, too fast and heavy activity like cutting trees back at this stage in your treatment is, frankly, a mistake not to be repeated!

I'm not able to say whether or not steroid injections will help but I most certainly would advise you to slow down your tapering regime. Take a look here for comments:

healthunlocked.com/pmrgcauk...

[Pr0jection in reply to 123-go]

Thanks for your reply. I should have given a bit more detail in my post. I was diagnosed in 2020, put on 15mg, then dropped to 10mg after 3 weeks, then dropped to 7.5mg after another 4 weeks. I had my life back and was in no pain throughout this initial taper. I was on 7.5mg for almost 2 years until I started this taper 7.5mg/6.25mg 2 months ago. I can't get 1mg or 2.5mg tabletsin Cyprus so I have to cut the tablets into quarters for my tapering programme. Yes, helping with the tree was probably foolish at any stage throughout the PMR journey, but I just wanted to feel normal and do normal things........

[PMRpro Ambassador in reply to Pr0jection]

Don't we all! If it is any consolation - my last episode happened because I didn't so much sit into the driver's seat of the car as topple over as I caught my calf against the door sill!!!

[123-go]

Thank you for the explanation.

Not having access to 1mg tablets must be really inconvenient.

Take care and only gentle exercise for the time being 😞.

[Janetknit]

I just had an epidural injection in my Lumbar vertebrates, L3 and L4-5 two weeks ago. The steroids have done miracles for impingement of nerves that was leaving me sleepless for periods of 48 hours. It was something I had to do as my PMR was raging being egged on by the stress of the inflammation in the nerves. Two huge prednisone blasts back to back calmed the problem, the injections did the final help. I would do this again as the relief has allowed me to reduce my prednisone and sleep through the night. Good luck with finding relief. These decisions are never easy.

[Pr0jection in reply to Janetknit]

Many thanks for replying.