I am now on 4 mg on a very slow taper and a low blow has knocked me sideways - sciatica /, sacroilliac origin of some form yet to be confirmed but agonising pain. I am aware of the non compatibility of some pain killers but I can't sleep or walk with this pain. What is the strongest one advisable?
Yes, I can refer to the surgery if I want to wait to speak to an AP but I trust this forum more. Thank you for all efforts on this great site.
You should not take a NSAID, but you can take co-codamol alongside Pred… but it does require a GP’s input, especially if it’s likely to be a long term issue.
Does your surgery have the eConsult facility as a means of communication- if not then suggest you discuss with your local pharmacist
Icing initially, then heat after 3 days, gentle stretches. It maybe that the surgery can inject Pred into the nerve route. It took me 6 weeks to recover from the condition. Fortunately for me, I’d just become a first time grandma so the ecstasy was a great help. Sorry, the pain is appalling.
Thanks. I have it too. Could you please give me detail on the icing and heat? Thanks.
I got a hot and cold pack from a medical equipment organisation that is out of stock at the moment. Less messy than peas and a hot water bottle. If you Google hot and cold pack you will get a number of options with instructions. I had a quick look and there are a number. Like everything, it gives temporary relief and may speed up recovery. my tall husband gets sciatica and other back issues. He bought a wedge cushion for his car and it really helps him.
That is terrific. Thanks. T
I too suffer with sciatica. I tried a tens machine but didn’t get much relief from that. I saw my doctor who prescribed a low dose of amitriptyline. This took a while to work.
Mine did go of its own accord but does come back. The very first time I had it I could hardly walk and since then it has appeared in a way that lets me walk it off. I do use cocodamol as prescribed by my doctor but just the 8/500mg.
Good luck with it
Unfortunately OTC painkillers don't really do much for sciatica. However, you don't seem entirely sure it is sciatica, sacroiliac pain is often different to deal with.
Have you looked up stretches for either? I know it sounds harsh - but they do often help a lot.
Here I was given lignocaine patches for sacroiliac pain and they did work well. You can get lower percentage patches OTC which might help though they are a bit pricey. If you try them, stick to the 12 hour limit on leaving them in position with a 12 hour gap. Do NOT use heat at the same time - it increases the amount of lignocaine released and can cause an overdose.
I find that when it is really bad, a single 800mg dose of ibuprofen and icing/heat over the painful area can work well over a few days. The 800mg dose is important - it is the flooding dose and actually reduces the amount you need in the longer term. Always take it with food, use a PPI such as lansoprazole or H2 antagonist like famotidine as stomach protection if you need it for a few days or more and aren't already using one.
I feel for you. My right buttock is still in agony from the sciatica which started in earlyJanuary. It has improved to the point that I manage with only one additional dose of a drug a day, normally paracetamol. I sometimes take Co-codamol at night but I am now having digestive issues (from all the pill popping I think).
I have been doing stretching and strengthening exercises regularly alongside a YouTube presentation and managing a good walk with the dogs but the pain can be severe. My GP refused to give me any strong pain meds because of the side effects and delayed effectiveness, now referred me for an endoscopy and started me on famotidine for acid reflux. Seems like if it’s not one thing it’s another sometimes, doesn’t it?
I have it, too, & this-prolonged winter cold has made it my worst winter for years. Not for me to comment as I take very strong pain killers due to 4 car crashes & 11 other ‘diseases’. But they don’t stop the sciatic pain! You have to ‘work at it’ too. The stretches are the best,but you have to keep doing them, all the time. Nothing I take is available over the counter, I’m afraid.
Interesting that so many people with PMR have this terrible debilitating butt and keg pain. Mine came on suddenly last week and I’m basically having to put my already limited life on hold. I have an appt with an orthopedist tomorrow whose specialty is spine. I’m guessing he’ll send me for an MRI. Meanwhile I’m taking ibuprofen once a day in spite of the contraindication with prednisone. Starting the stretches I found online.
Sure hope we all find relief soon.
There is only a small likelihood it is spinal - if it is alongside PMR, muscle problems are the most likely, especially if they are associated with piriformis syndrome. In many patients the sciatic nerve passes through the piriformis muscle and if it is spasmed, it pinches the sciatic nerve. Same effect as a disc but a very different underlying cause.
a further worry for me is that I have only ! Been diagnosed with GCA, not PMR and only! Have this supposed sciatica pain, no other so …. Questions to ask my rheumy who has arranged an MRI scan for eliminatory purposes. If I can walk !
Often the PMR side of GCA doesn't appear until the pred dose is down to low PMR levels. If GCA symptoms are first and treated quickly, then the high pred dose covers the PMR signs. My pain is only in the right buttock, none down my leg at all, and the sacroiliac joint is also involved.
Hi...I have a few vertebral fractures, but it's the back muscle pain that is excrutiating. I am prescribed acetaminophen/codeine 300/30. Two tabs 2x per day and 3x if needed. Last night was the first time I've needed the extra dose after supper. I overdid it yesterday. A me problem lately, with Spring being here. It does constipate terribly. The affect of the codeine is not lasting as long now and I'm waiting on approval for a time-released codeine. It is not normally covered by our pharmacare. If I could take ibuprofen, I would. Above all else, even opioids, it was what worked; along with acetaminophen. Hope your pain settles soon. Take care.
I have chronic sciatica kept under control by one nightly 300mg dose of Gabapentin. I can't take co-codamol which also works for others.
I really feel for you as I’m also going through similar pain. Initially self diagnosed & posted on here as bursitis. But it isn’t & so didn’t have planned steroid injection. My new physio, very knowledgeable & proactive, suggested Gabapentin & Doctor on phone appointment agreed but only gave me 100mg x 3 a day so not sure it’s helping at all. I am away on holiday now & trying as best I can to swim but it’s blooming painful. Switching between ibuprofen & co-codamol. I know there’s issues with lower spine & I'm sure nerve impingement going on. It’s a worry taking painkillers after years of pred etc!
What pain-killers did you take before diagnosis? (PMR)
Pain killers choice over side effects long term 
Ankle pain and knee pain 
Pain management and antidepressants/anxiolitics 
How much pain is reasonable?
