Back pain and spasms

[Ladybay0]

I was diagnosed with PMR in 2020. I have been on prednisolone since then trying to type it off but only actually managed to get off of the drug for about three weeks before having to restart. I’ve only really had pain in my lower body and legs, only occasionally in my arms. Recently I have had acute back pain radiating around the ribs to the front, which goes into spasm. I have done nothing to cause this so my GP has just put me on Co-Codamol and diazepam. This has been going on now for the last three weeks and is getting no better. I’m now wondering whether it is my PMR. My doctor has not done any scans x-rays to see if it’s anything else. I’m not sure if I’ve done the right thing, but I have increased my prednisolone to 20 mg to see if this helps. I’m wondering if anyone else has had this and if I have made the right decision to increase. It would be nice to get some thoughts as trying to speak to a doctor is impossible thank you.

[SnazzyD]

If you have tried the co-codamol and diazepam and it doesn’t work, plus it’s still there after 3 weeks an x-ray is a reasonable request. Even more so if 20mg Pred isn’t helping either. Perhaps try one thing at a time otherwise you won’t know what did the trick. Have you ever had a DEXA scan?

Is the pain on both sides of the back equally? Does the pain come from the centre of the back or does it start somewhere else? Where on the back is it?

[Ladybay0 in reply to SnazzyD]

It comes from upper central back and radiates to both sides to ribs and chest bone . Pain is the same a on both sides. It also makes me breathless when moving.

[SnazzyD in reply to Ladybay0]

The symmetry makes me worry that it is coming from the spine as opposed to a muscle spasm, but I’m not an expert. Have you ever had a DEXA scan for bone density? I’d be trying to get an x-ray sooner rather than later. If your surgery is no good, try 111 for advice and describe it as you have here, stating you’ve been on long term steroids.

[Ladybay0 in reply to SnazzyD]

I called 111 who sent out an ambulance and just told me to double up diazepam. I had a dexa scan about 6 years ago and was told I was borderline oesteoporesis . Went to A&E and they just prescribed gabapentin and naproxen which I was then told couldn’t take with the meds I am on. They wouldn’t do an X-ray. Just don’t know who to turn to x

[SnazzyD in reply to Ladybay0]

Goodness! Which part of the country are you? The mind boggles. Did you double up on Diazepam there and then so that you arrived in A&E ‘loaded up’? If so, did it help? What was their reasoning not to do an x-ray? Did you ask? Did they have a very good reason not to bother given that you were borderline osteoporosis 6 years ago and also been on Pred?

I am surprised that they have left you hanging with no meds and no theories. Nightingales has a point with costochondritis but even so…

[PMRpro Ambassador in reply to Ladybay0]

The ED wouldn't do an x-ray for sudden onset back pain? Was it an ED and not an MIU?

[Ladybay0 in reply to PMRpro]

No they just gave me pain killers. Said it want an emergency. Don’t know what to do to get them to do something

[PMRpro Ambassador in reply to Ladybay0]

Your GP should be able to give you a prescription for a walk-in x-ray at a local hospital. Might be a wait in the NHS these days but it will depend where you go. Go to the practice and say how bad the pain is.

[PMRpro Ambassador]

I think at an early point you need a spinal x-ray to rule out a spinal fracture. It is the first thing my rheumy demands if I have new back pain.

I have similar symptoms but they did pre-date a spinal compression fracture which ISN'T causing any pain but I do have what is now called greater trochanteric pain syndrome (GTPS) which is basically hip bursitis but acknowledging it is compounded by other factors. In my case, I have sacroiliitis, myofascial pain syndrome and arthrosis of the lower spine and pelvic joints. Personally, I think the sacroiliac problem is the basis of the rest of mine - an ultrasound-guided steroid injection has caused an almost miraculous improvement! It probably needs a very curious rheumy or physio who isn't being lazy - like your GP.

[Nightingales]

I have had a similar thing for different reasons. First was costochondritis which I think was a sign of PMR developing. It required a high dose of pred to get it under control. Second, if I get these symptoms it’s usually a warning I am an about to have a flare, and third an MRI shows thoracic disc degeneration, steroid injections helped with this. Either way, it’s not normal, it’s excruciatingly painful and you need a good examination and imaging. So sorry you don’t have good access to a dr. Be the squeaky wheel.