Good evening / morning to all in this community and thanks to everyone for their postings which I have found so reassuring. A little knowledge is such a helpful thing, not dangerous at all!
I have been reading posts which mention peritendonitis and piriformis with interest and just want to run some queries into the forum.
Diagnosed in April this year, starting on 15mg Pred and now down to 7.5. From an early stage, even say a month pre-diagnosis, I have had an intermittent pain along my left thigh which I put down to my forcing my leg into a position through frustration trying to do some things in the garden, not realising why I was so stiff. Thought then that I had strained a muscle or ligament. Then classic PMR appeared, fortunately I had a swift diagnosis and Pred. Thigh pain came and went, no particular pattern, and as far as I can make out, not responding to paracetamol. Over the last few weeks though it has been nasty and more pernicious, and particularly unpleasant when I am sitting in a chair for any length of time and also when climbing stairs. Generally not a problem when I'm walking. It has relocated to my bum and less on the thigh, still mainly on left side.
Should I wait for it to settle and go away or increase the Pred for a while? If so, by how much?
Did the PMR get to work on a tendon that I might have strained earlier on in the year?
Have I just reduced Pred to a level which is unsustainable for the moment? I'm having an (unrelated) blood test tomorrow, and requested that ESR and CRP to be done at the same time. If these markers are raised, do I take it as indicative of a flare?
A number of possible hypotheses there and any ideas would be welcome.
Good news is that I am much less tired, sleeping well, doing more (in bursts) and generally feeling lucky. Headaches / migraine seem to have disappeared. Best wishes to everyone and sorry for the long post, but trying to sort out what best to do and why..
Written by
Ryeland
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It sounds a bit like sciatica that coincided with PMR onset. I had it once from enthusiastic Granny duties with my first grandchild, it was agonising. Nothing much helped except some stretches and no more strenuous activities. If PMR reactivated an old injury it may be more tricky to sort out. My left shoulder that I broke a couple of years prior to PMR onset, was always more painful. A good physio maybe able to help. As you know PMR pains are bilateral. This sounds different, I would seek physical therapy for it and exercises recommended by a physio. You do say your current dose of Pred is too low to be sustainable - what do you mean?
You reduced much faster than me from April to now, but it some areas you seem to be doing well. If your symptoms get generally worse I would increase. 7 mgs and thereabouts is a tricky stage. I was stuck there for a year. Your Adrenals can add symptoms.
Which area of the thigh does it come from? Inner or Outer?It could be Sciatica, but could also be caused by a tightening , compression or some trapped nerve damage of your femoral or obturator nerve and working out which nerve has had the issue helps in knowing which gentle exercise would help to reduce the problem.
If it is inner thigh pain and also radiates through the groin , not just the lower back and leg my feeling would be the often forgotten obturator nerve.
Do you find more relief using warmth , or ice , or a combination of both?
Try each out for a short period and see which gives the best relief. About 5 minutes only at first , followed by a few steps around . If you use ice , make sure it is well covered and don't use it for more than 10 minutes on one area at a time.
A combination treatment is usually balanced with one third of time ice ( 5 mins) followed by two thirds warmth ( 10 minutes.
Ice usually works better on inflammation , warmth on nerve damage if it is following a strain , compression or injury.
Getting to a physio or trying to build up gentle thigh muscle relaxation and loosening exercises could help.
These exercises are often easier in warm water , like a hydro pool or even carefully done in the warm pool of the swimming baths or a bath.
If you are experiencing a lot of pain , and are not currently on any nerve pain medication , and get no relief from paracetamol, getting to the GP discussing the nerve issue and getting a short term course of nerve pain medication may do the trick to ease it , and hold off this problem causing a PMR flare while the nerve issue is treated and heals. A referral to a Chiropractor would possibly benefit you too.
Even if a nerve has stopped being compressed or damaged it can take a number of months for it to heal , and you can get periods of intense pain , numbness and twinges as it gets back to normal.
It's important to pace yourself , just as it is with PMR , but also do some exercise to prevent the tightening of the muscle area.
You know what you did wrong , holding your leg in a funny way to keep doing a job while trying to make sure you didn't cause more PMR pain.
We've all done it.
Now you know what position not to use your body in.
With all of our conditions it's important to try to keep good posture and not compress our muscles in a funny way to compensate for the pain.
It sometimes means we have to accept not doing certain jobs or activities until our body can cope with those things again without pain. Or doing certain jobs more slowly or from a seated position with regular breaks.
That's important while your trying to heal this thigh problem as well as for coping while you still have active PMR.
Have had similar pain in my thighs & this morning, because I'm finding it very difficult to walk, have decided to up my Pred from 10mg to 20mg which is about where I started two years ago. I went down to 10mg but then trying to go lower is when problems began getting to 8/7mg, so I tried going back to 10mg but that hasn't seemed to do the the trick. Am I doing the right thing & how quickly should I try to go down from the 20mg, given that it will work? I haven't spoken to my rheumy consultant about this as he has been pressing me to lower my Press - I'm not too sure what he would say!
gives advice on dealing with a flare. Going back up to 20mg seems an awful lot. Have you considered 15mg?
Wow, seems you have reduced far too quickly. I too get pain in my bottom and thighs and knees....recentlyI had a small flare, so upped from 5mg to 6.5mg. I was started on 15mg back in Nov 2019....GCA appeared so had to increase to 40mg where I've been very slowly tapring every since with a few incrases with Pred in between. Seems my PMR/GCA isn't happy once I reach 5mg. If this continues I will have no choice but try a sparing drug, which I'm loathe to do, but may have to.
Hope you manage to get it under control. But slowly does it is the motto
Buttock pain is typical for piriformis syndrome as is it worsening when sitting or climbing stairs - and where on the thigh is the pain? There are so many causes of thigh pain it is important to know where and what type of pain it is.
In addition to neck, shoulder, and arm pain that I was experiencing, I also had pain in the buttocks and it went down the back of both sides of my thighs which made walking, dressing, and using the bathroom unbearably difficult. Then the pain also started in my hips and that's when I started to panic and went to the ER where they referred me to a rheumatologist who then diagnosed me with PMR and put me on a steroid.
A pinched nerve in the L1/L2 and L2/L3 vertebrae can cause pain in the upper thigh area. The pinched nerve can be due to inflammation, a bulging or herniated disc or bone spurs. If adding some more pred doesn't do the trick, you might want to see a back Dr.
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