I am not sure anyone may want to comment on this, but i will ask anyway. I'm posting for my 89 year old sister who has been on 10mg of Prednisone for at least 3 years for back pain. She is suffering now from sciatic pain which is causing her not to be able to sleep because of the pain. Her GP has prescribed 1000mg of aspirin twice daily along with omeprazole to coat her stomach while taking the aspirin. She has been in the hospital within the past 2 years because of stomach bleeding and was told by her GI doctor that she should not take aspirin any longer for pain because of her bleeding issues. Would it be safe for her to up her prednisone intake from 10mg daily to 60mg daily for a few days to see if it relieves the pain? Her doctor has already tried Hydrocodone which didn't help and she doesn't like taking it. Thank you for her!
Sciatic Nerve and Prednisone: I am not sure anyone... - PMRGCAuk
Sciatic Nerve and Prednisone
I would not have thought steroids a good pain killer for back pain. I would have thought something like Tylenol or Tramadol or are the US trying to cut back on opioids?
TY--Yes, I think they are trying to control it.
I despair of the medical profession sometimes
For sure!
My mind boggles that they weren’t worried about bleeding with that sort of dose of aspirin along with Pred. The UK’s NICE guidelines suggest considering inappropriate prescribing with doses above 160mg aspirin per day long term in the elderly.
What is her actual diagnosis both for the long term back pain and the sciatica? Have they established where the sciatic pain is being caused? For example it could be or more muscular problems causing compression of the sciatic nerve in the buttock. Presumably they’ve done scans and blood tests? I wonder why they are applying a kitchen sink approach to her pain relief.
We have questioned him before, I guess it is time to move on.
If it is Degenerative Disc Disease /bone spurs causing the pain, then in my opinion, yes more Pred very well may help..it actually is what they prescribe for Radiculopathy pain (well, a Medrol Pack). BUT 60 mg may be way more than she needs. Maybe try 25 mg first? I know my DDD lumbar back pains are much lesser on the Prednisone, a nice side effect for me. All just my opinion, but I 100% understand the desire to try it.
Thank you! She has been diagnosed with DDD and I just found out this am that he did recommend she try 20mg for 5 days, but that didn't help her. My daughter had sciatica pain and her doctor hit it with 60mg for 5 days and it helped. She is 60years of age. That is where I got the 60mg from. Thank you!!!!!
I understand the high doses. I have been a tough, atypical case and needed 35 mg for many months on end to get pain relief, every time I tried a taper it all came back within 5 days. I am finally down to 25 mg and honestly scared when they try lower it again- which will becoming next week. I have been lucky my GP has approved this and lucky I have no side effects other than the moonface, really. I feel very good when on it. Everyone is different. I am 55. I have a theory that the younger one is, the more they need for relief. Just my own personal thought, obviously!! Glad it is getting better!
She might have vertebral compression FROM the steroids. Best she have an ortho, perhaps do an MRI as x Rays miss a lot. If she has vertebral compression / ie fracture that would give nerve pain. A vertebroplasty where they inject a cement / same day- no general anesthesia can give excellent results.
Is she in Medicare or Medicare Advantage?
Medicare Advantage just blow patients off sometimes. Then you have to fight. Another alternative would be a good pain management doc who could do an epidural after thoroughly finding the real cause.
What state are you in?
Why prednisone for back pain? Is it thought it is due to PMR or the like? Or as sidra asks, is it DDD? If so, yes more may well help but like sidra I think 60mg is too much to start with trying 25mg first would be sensible.
Anyway - I think, as others do, that that dose of aspirin is totally out of order at her age, irrespective of her history but given her history it is downright negligent. Is all her care from the GP? If so, I think a new one may be called for.
I agree, that is why i have reached out to the experts! TY
I have nerve pain and have found that pregabalin is quite effective for me. In the UK, they might also prescribe gabapentin or amitriptyline rather than opioids. Not sure how much help this might be, but I have to say that for me, it is more effective than the opioids I usually take for RA pain.
Raisin, that treatment for a poor 89-yr-old with a history of stomach bleeding sounds like malpractice fodder. Maybe she needs pain meds and physical therapy. Heavy-duty opioids have their place as do meds like Tramadol and Hydrocortisone. If the doc is hesitant, argue. As I have noted in previous posts, no need to suffer in agony.
TY Merryfield, I agree completely.
Thank you!
Hi, I have to completely agree with the other comments re your Sisters present treatment as Snazzy says "mind boggling". Sadly I can't help much on the way forward. I have sever OA in my lower back and get excruciating and debilitating Sciatica/Neuropathy pain, when it's feeling grumpy. I haven't yet found anything that helps with it. Heavy duty opioids and steroids have little or no effect. I do have Amitriptyline, but haven't actually tried it yet. Best wishes to you and your sister and I hope you manage to get something sorted out soon.
I can recommend Amitriptylene for your back pain, my rheumie tried me on several things then offered op to fuse lower vertebrae which I’d heard bad reports of so declined. She suggested Amitriptylene to calm the nerves in my back and it helped tremendously, I’ve been on it for over 10 years with no Ill effects and on tramadol for occasional bad episodes.
I wil be trying it next time it appears. Tramadol has no effect on mine at all.
I went to a chiropractor recently to see if he could achieve anything with my low back pain - probably also OA underlying it. He commented he sleeps with 6 (yes, SIX) pillows! I seem to have achieved a pain-free wake up using 3 of my rather elderly pillows to keep me on my left side and with one between my knees but basically in the recovery position. May have to experiment some more! I knew that it is far worse when I have a night where I don't get to sleep and wriggle about trying to find a comfortable position, including lying on my back - seems to fit,
Worth a try?
do you mean so you are propped up at a 45° angle. I'm very interested this. You have reminded me that I used to sleep with a pillow between my knees and stopped for some reason.
No, not at all, that seems poison. Picture lying in the recovery position on the floor. 2 of the pillows are almost forming the v-shape pillow to support my head but one is stopping me rolling onto my back and the other is stopping me going further forward, The 3rd is between my knees.
It is achieving a similar support to this
thewhitewillow.in/products/...
but using ordinary pillows. I've always slept on my stomach but that isn't comfortable now - the pillow between the knees/thighs does the trick.
I need support to keep my neck and spine in a line and stop my right knee falling too far forwards.
ah I see. A bit like I used to when my daughter was first born when I wrapped her up like a burrito to sleep on her side and rolled a blanket up and put it next to her to stop her rolling back. Now all babies sleep on their front so very different. Thanks for explaining I'm going to give it a go.
No - mine slept on their fronts, with their bums in the air, hangover from NICU days! But now it is frowned on, backs only. Supposed to reduce the risks of SIDS
I know. It changes all the time. My daughter had baby rice at 6 weeks, now it's 6 months and only if they can support their head!
Breast fed exclusively for 6 months - despite both being 6 weeks in NICU. Think Nat's first solids were apricots - we were on holiday in Switzerland in an apricot area!
Thank you for this info Pro. I need something to keep me from rolling onto my back. This morning I awoke on my back with arms straight up over my head.😱 Also need spinal support. Pillow between knees for this. Sleeping on my left side may help with the constipation I experience from the codeine and also stretch some muscles. For many months I've been on my right side only and there is no pain. I do notice when I try lying on my left, there is pulling pain in the muscles through the lumbar area right, but these muscles may need to be stretched.
There are pregancy pillows too - google them. They surround you and can't slip away
I had never seen these before but they look amazing. Def better than 5 or 6 regular pillows, which I'm going to try anyway. Thanks again.
I have a knee pillow, which I like a lot and use two pillows - 1 either side - to wedge me onto my side. This allows my back to relax because I'm not needing to hold myself in position because the pillows do it for me (and keep my back warm too).
Forgot to mention my trusty Tens machine - I've had one for years and find it nothing short of miraculous for back pain.
Can't use one - I have a pacemaker.
What sort of knee pillow do you use?
Sorry PMRpro, just saw your message. My knee pillow is called Contour and I bought it in a cheaper shop that had a stand of things you never knew you needed. Things like a battery operated gadget to rub hard skin off your feet and a thingy to "shave" your woollies to remove knobbly bits. It's so good that I bought two, so that I can pack one in my suitcase and still have one on the bed.
Shame about not being able to use Tens. I would be a junkie without mine!
Pillows in various combinations never seem to help me much with OA or my back problems but will try various combinations when next needed. Getting up and moving around for a bit seems to be the most effective, with comfortable recliner chair also in the mix.
I had a severe pain with slipped disc and found amitriptaline was a great help. Good luck. Like some others pred is encouraging my back to behave much better than in the past
About a week after I started low-dose naltrexone my neuropathy and sciatica disappeared. Not everyone is helped by LDN, but I sure was. Others take LDN for pain (usually requires 8-10mg, compared to my standard 4.5mg/day).
A little known drug which has many applications. I have used it for years.
I’ve had sciatica on & off for4 years now…worse in autumn, winter. At one point I was on 17mg pred, & it didn’t help the sciatica at all. Just for info. I have been on Tramadol for other back problems, & that didn’t stop it either, but I’ve been on it too long (15 years) & it’s ceased to work for me! With Bursitis on one side & sciatica on the other, I’ve been on 3 hrs sleep for a very long time! My Dr is now ‘attacking’ my situation…Butec patches for pain, non addictive sleeping tablets, & depo medrone injection for Bursitis. I take amitryptylline at night & it relaxes me sufficiently to get me off to sleep, but pain wakes me up! But the Butec is at a low level to start & isn’t helping the sciatica, sadly. The things I’ve found that ease it a bit, heat pads during day, heated blanket in bed at night, specific stretches & exercises (but often I have other medical issues which prevent me doing them). Bear it in mind that I have a lot of other medical issues & im not sure a doctor would prescribe Butec patches purely for sciatica. I’ve only been on them a week, so don’t know about that! I just wish I could find something to help sciatica the pain is dreadful, & it makes me dread the cooler seasons!! In summer, it’s more of a dull ache which i can live with!
I also have had sciatica in the past. So painful. I recently attended a group session / talk about positional therapy at Kripalu Yoga Center in Massachusetts The therapist asked if anyone had sciatica. She helped the lady by having her do the yoga pose called half frog ( Google it) after doing it for two minutes the pain went away. She also had someone else lie on back with legs stretched out toes to ceiling. Her one leg was shorter than the other. She took hold of the ankle on the shorter leg a leaned back ( rather than just pulling leg). She also was relieved from pain.
I don’t know if this will help you mother. Can’t hurt to try !
Hi Author. This is exactly what I was going to suggest. There are very simple effective exercises on the floor that help relieve and release the sciatic nerve. Then it’s all about sitting correctly. Few months ago mine was terrible so for first time I got guided steroid ultrasound injection deep into my hip. God save the Queen and King it worked. And the use of lidocaine shot before injection made it almost painless. I have to do my floor exercises every day.
Sciatic pain is terrible. I have had surgery to decompress my nerve and it has given me some relief. I still get sciatic pain but now it's from the muscles tensing up so heat/massage helps to release them.There's lots of better painkillers your mother could have. The GP is negligent to tell someone to take aspirin if they have had stomach bleeding! I would go with your mum and insist on some better pain relief. I take Tapentadol, paracetamol and amitriptyline for my back/sciatic pain. I only take anti inflammatory drugs for a very short time if necessary. Using a hot water bottle/heat pad on the glutes helps ease the pain for me too
I agree with PMRPro on the sleeping position. I try to sleep in the recovery position with pillow between knees. I usually wake up on my tummy though as that's how I've slept for years and my body seems to automatically turn onto my front 😄
Hope you can get something sorted for your mum. Sciatic pain is agony 😢
Hi Raisin Bran. I'm not sure about the increased Pred, but def worth a try. As far as aspirin - that's a ludicrous dose, for anyone, nevermind someone with your sister's history. I stopped taking Ibuprofen even though it was helping the pain from all these vertebral fractures. Stomach issues, plus hypertension so bye bye IB plus paracetamol. Haven't found anything that worked so well. Time for a move away from that GP.
I had sciatica for several years until I had a disc decompression procedure. The only thing that touched the pain before the procedure was Gabapentin which is also called Neurontin. My doctor started me slowly, and I eventually took 100mgs at lunch and 200 before bed. The only side effect was that it helped me sleep(great side effect as far as I was concerned). No pain killers, Tramadol, Ibuprofen, Tylenol helped at all. The pillow between the knees was beneficial. Best of luck to your Mom.
Does your sister have Polymyalgia Rheumatica? Has she had any X-ray or MRI of her back? Has she seen a pain clinician for shots? Does she live at home on her own or in assisted living? I would encourage her to seek out a new physician. This one sounds dangerous. You need to advocate for her by the sounds of it. You are a good brother.
I had to re read your question I was so shocked did her doctor happen to have a seeing eye dog? Crazy! I recently suffered from sciatica for several months I was at 16mg of prednisone for my PMR it did nothing to help only serious pain meds I still needed crutches to walk I took the surgery route I knew the second I woke up from anesthesia it worked. Heating pad then ice and sleeping with a pillow between my legs I used thermocare patches while at work I feel her pain make someone listen to get her some relief
My husband, who also had PMR, had terrible sciatica pain. He tried the standard medical route without success, but found almost immediate relief with acupuncture. Big improvement with the first session and complete relief without it returning after 2 or 3 sessions. His acupuncturist (who is also an MD) said that acupuncture is frequently effective for sciatica. If you live in an area with a good acupuncturist it might be worth a try and could keep her from having to increase her pain medications
Thats good to know
Hi there - well for nerve pain which I have a lot I am prescribed 10ml of Amatryptaline each night, it was originally prescribed as an anti depressant but is now found to be more effective for nerve pain, not sure where you are but if you can get you sister on a course of this it should help her tremendously. Good luck.
Your poor sister..I am so sorry. What a nightmare for her. I would seriously consider changing my GP.
I am in my early eighties,have had PMR since 2016 and regularly attempt to reduce my 5 mg per day dose.
I had a horrible episode of sciatica earlier in the year..I was prescribed various painkillers which had no effect at all..I kept returning to the GP to request a stronger more effective drug.
After three sleepless truly agonising weeks I was at last given Buprenophine patches (5 mcg per hour) ..it took a couple of days to kick in and the relief was utter bliss.
I was slightly concerned about becoming addicted,however after using them for five weeks,I was quite happy to leave the last three patches.
(They are tucked away should it strike again)
I see this post is ove 3 weeks ago now, but....have you tried a TENS machine. I have found it effective for my 89year old mother who had terrible back pain due to metastasis from a previous breast cancer...probably ...or osteoporotic collapse. I have also had caudal epidural injections for spinal stenosis and degenerative scoliosis, and that was also effective for around 2 years. Wonderful after years hardly being able to stand or walk. Like the others, I think giving high dose aspirin is negligent.
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