What’s going on

[Carathedog]

Hello, I’m currently on 10 mgs, have been for a few weeks now, although I’ve previously been as low as 6.5.

I have spinal stenosis and three herniated disc’s, so am never sure what causes my pain

I have pain turning over in bed, I have pain in the morning, I have no pain while sitting doing nothing, painkillers don’t seem to help. Pain gets easier as the day goes on, although, it seems to ease if I do some walking.

I just don’t know what I should be doing, also very tired and depressed

Would welcome your advice

Many thanks

[DorsetLady PMRGCAuk volunteer]

Sounds as if your PMR is grumbling.

In your last post, PMRpro did advise you followed the flare protocol - did you?

If not and only returned to 10mg as you sort of implied in your response then that probably gives you the answer.

An increase of just one mg rarely sorts things out - you need a higher dose for a least a week, very often 2 week. Then drop,down to just above the dose that caused the problem.

See here for advice-

healthunlocked.com/pmrgcauk...

At least give it a try… if it doesn’t work, then you may need to rethink what it is.

[Carathedog in reply to DorsetLady]

Thank you, what do you suggest I go to and for how long, willing to try anything

[DorsetLady PMRGCAuk volunteer in reply to Carathedog]

Try going up to 15mg for 10 days at least- but you’ll be okay for 14 days - then drop back to 10mg.. stay there for 3-4 weeks before you consider tapering.

Hope it works for you, but if it doesn’t, you know where we are.

[Carathedog in reply to DorsetLady]

Thank you, will start tonight

[PMRpro Ambassador]

It doesn't matter where you have been in the past - PMR can flare, it can flare in response to other pain as you must have with the spinal stenosis. And if that can be managed better - and yes, I do know the problem - then you may need less pred.

Just read an article on the massive benefits of just walking for low back pain. Trouble is, you have to get through the initial pain to get the benefit. And it is hard. I also have no pain sitting in front of the computer!!

[Carathedog in reply to PMRpro]

Thanks, yes, I need to make more effort to walk, but I never know where the pain comes from

[PMRpro Ambassador in reply to Carathedog]

And it is worrying isn't it? I sometimes go out feeling quite good and then end up wondering if I am going to get home OK! I do carry an elbow crutch - I have some and I find it easier on my hands than a walking stick - discourages bus drivers from shooting off before I sit down as well!! I find it seems to stabilise my back a bit because slight changes in balance can give rise to pain.

[Carathedog in reply to PMRpro]

Thanks, will look into that

[Northernarcher]

I also have spinal stenosis it affects my right leg and foot and I also have a Claudication behind the knee of the right leg as well I find that an early morning walk and then an evening walk really help but it can be painful at the start I am also currently taking 10mg Pred and sometimes it find it hard to know if some lingering pain is PMR or from the other issues I find that I have had to remember what the pain from the others were like and compare it to PMR

[Carathedog in reply to Northernarcher]

Thanks, can relate to that, when you don’t know what’s causing your pain, you’re hesitant to up your pred. I feel I’m going backwards

[AtopicGuy]

Spinal stenosis and herniated discs mean the vertebrae of the backbone press against the spinal cord, or the large nerves that branch off it, during movement. Perhaps this is what you feel when you turn over in bed? It's possible the bones do not realign themselves until you get up, move about, and adopt a good posture. Keeping pressure off the spinal cord and nerves is the key.

There may also be inflammation around the damaged areas of the spine. The steroids you take for PMR will also reduce that.

[Carathedog in reply to AtopicGuy]

Thank you, unfortunately, I can’t have an operation for my spinal problems, neurosurgeon has advised that it’s too dangerous, and nerve painkillers have had no effect

Just have to get on with things I suspect

[AtopicGuy in reply to Carathedog]

Hopefully, by understanding what is happening with your spine, you can spot what aggravates it and what helps to keep it aligned and pain free.

[Carathedog in reply to AtopicGuy]

Thank you, yes, I’m pretty sure it’s not Polymyalgia pain , and yes, I think a short walk easies things, I need to push myself more, but sometimes it just gets me down, suppose it’s striking a balance between too much, and sitting around, when I have no pain