Sciatica

[Elmadon]

I’ve had PMR for 18 months and had got down to 8mg. Pain in one hip and assumed it was a spike so went back to 12mg as advised by doctor. However symptoms still there after 3 weeks and appear to be sciatica. As only in one hip. Very painful and no painkiller helps . Could this be PMR but only in one hip. No pain in shoulders either. Has anyone else had this? Thanks

Have not seen my doctor since diagnosed with PMR and sort of self diagnosed sciatica. Spoke on phone to doctor who said he had not had sciatica and I would know as I’d had it before! Gave me Tramadol for pain relief. — had no effect.

Tomorrow I’m going for acupuncture as friends have recommended it. Anyone out there had success with this treatment?

[PMRpro Ambassador]

Hi and welcome.

What a shame you didn't post asking about it, It is quite common really - and we do tend to say that is a problem is only one sided that it is less likely to be PMR.

Where is the pain? Is it low back and then running down the back of your thigh? As shown in the image here:

pennmedicine.org/for-patien...

Or is it on the outer aspect of your hip. over the bone and spreading into the rest of the side of your thigh?

my.clevelandclinic.org/heal...

Which fits better?

[Elmadon in reply to PMRpro]

second option so think might be bursitis.. if so I’ve been doing the wrong thing.. maybe I should be resting rather than trying to keep moving.? Trouble is I can’t get face to face appointment.. will acupuncture help?

[PMRpro Ambassador in reply to Elmadon]

I suspected it might - bursitis is a part of PMR for many so just rest often doesn't do the trick because the PMR inflammation sort of feeds it. The article gives some info about management and it is worth trying icing. You are already on the best antiinflammatory medication there is - pred. It isn't advised to mix things like ibuprofen with pred but taken with food and possibly stomach medication such as a PPI (omeprazole or the like) it might help the pain and add to the antiinflammatory effect.

There are stretches on the internet - try them if they aren't too painful. Careful about doing them on the floor though - think about whether you can get up again after! And not if they make the pain worse.

myhealth.alberta.ca/Health/...

gomberamd.com/blog/4-hip-bu...

You can do the clam and the side leg raises on the bed. The second link has an iliotibial stretch you can do standing up.

In the meantime, ask for a f2f appointment and start the process - no doubt a triage phone call? Does your practice have self-referral to a physiotherapist?

If the measures here don't help, then the GP needs to consider a local steroid injection to take the inflammation down (providing you aren't on anticoagulant therapy for any reason). I get a treatment called extracorporeal shockwave therapy - no idea how common it is in the UK but does work It is an adaptation of the lithotripsy they use for kidney stones - hurts a bit at the time and is very noisy but worth the 3 or 4 session it usually takes.

If it isn't helping you might as well go back to the lower dose of pred. You can go straight there if it wasn't more than 10 days or so at the higher dose.

I'm assuming you are in the UK - could you please complete your profile with that sort of info as it makes such a difference to us advising what can be done.

[herdysheep in reply to Elmadon]

If doctor can only respond in light of what he has had...... has he had pmr/gca?!!

[DorsetLady PMRGCAuk volunteer]

If the increase in Pred didn't help at all, then unlikely to be PMR - and are you still on 12mg or have you reduced back down to 8mg?

Now you have posted there are loads of related posts about sciatica... but could also be bursitis - both seems to be friends with PMR...

nhs.uk/conditions/bursitis/

also look for exercises online ...

[PMRpro Ambassador in reply to DorsetLady]

PMR not pred the second time!!! Predictive text and a typo???

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Ta...

[Elmadon in reply to DorsetLady]

I’m still on 12 ..dr says have to be 4 weeks pain free before coming down by 1 mg at a time..

[DorsetLady PMRGCAuk volunteer in reply to Elmadon]

…sensible for PMR … but if it’s not that, not sure you are going to be painfree…

[piglette]

Sciatica is very different in pain to PMR. I find it can quite take my breath away. In my case it normally starts at the top of my thigh at the back of my leg and goes up a bit and down the back of the leg. Basically along the sciatic nerve.

[Bcol]

I get hit with sciatica at intervals if I manage to do something that upsets my lower back where I have severe OA etc. Bending down to open the wine cupboard did it last time!! (not sure if there is some sort of moral there!). When it hits, pain through lower back, hip, back of leg to the foot usually. Can be either side but usually my right side. it is debilitating and excruciatingly painful, walking even with one or two walking sticks is "difficult". Lying down is usually not good but my reclining chair is wonderful as I can usually find some sort of position which makes things vaguely acceptable. None of our usual pain relief or Pred has any effect at all. My doc has given me some Amitryptiline for night time use when it next strikes, but I haven't yet tried or needed to try using it. If only there was a little white pill that worked as well as our Pred does for PMR!!! The specialist who read my MRI report has asked that I get referred to the Salford Royal when it hits me again.

[PMRpro Ambassador in reply to Bcol]

The moral is to raise the level of the wine cupboard!!!!!

He think it is a disc? Mine is muscular ...

[Bcol in reply to PMRpro]

Yey, L5-S1 severely dehydrated, (perhaps more wine would help with hydrating!!!!) severe arthritis, plus a few other things. L4 - L5 severe bilateral joint arthritis, hypertrophic facets and impaired nerves. Similar for L3 and L4.Apparently L1-L3 are satisfactory for my age!!!

Like the idea re the cupboard.

[DorsetLady PMRGCAuk volunteer in reply to Bcol]

Ditto re wine cupboard -must get priorities right!