Lower back pain muscle or flare?

[Januzzi]

Hi everyone……Has anyone had lower back pain when tapering ….I was doing great Doctor lowered my prednisone by 1mg a month I’m down to 5 mg day wondering if I’m going too fast?……I had X-rays on my lower back didn’t show anything gave me some Naproxen I’m wondering should I treat this as flare and up my 5 mg to 10mg for 7 days then cut back to 6mg ……I just don’t know if back pain is PMR related…….I appreciate any advice. Thanks

[SnazzyD]

There isn’t enough to go on really. If you fill in some blanks, we can try to help. How would you describe the pain ? Where exactly is it? Is it there all the time? What makes it worse? What makes it better? Is the pain in the same place all the time or does it travel? How long have you had it? From what dose? Have you done anything unusual no matter how easy? Have a crack at those.

1mg per month can seem great on paper, but the experienced reality might not be so easy. 0.5mg might be easier.

[Januzzi in reply to SnazzyD]

Hi started Prednisone Sept 2023 from about 15mg got down to 7-1/2mg about 3 mths ago using 1/2mg month decrease….then doctor then said go from 7-1/2 to 6mg than continue 1mg per month decrease which I did …..Im now on 5mg for 6wks but a week ago I started having lower back pain …X-rays showed nothing …was prescribed Naproxen but I’m trying to figure out if it’s a flare and should I up Prednisone another 5mg for 7days ……or try Naproxen first to see if that works…..Thanks for your help I really appreciate it

[Januzzi in reply to SnazzyD]

I agree with you I should have stuck with 1/2mg month

[PMRpro Ambassador in reply to Januzzi]

Why did he suddenly increase the rate of decrease? Crackers ...

[DorsetLady PMRGCAuk volunteer in reply to Januzzi]

Yes you should have.. why do some doctors think they need to change something that’s working — and increasing the amount reduced as you get lower in dose goes against all logic… should be visa versa…

[Missus835 in reply to DorsetLady]

Just thinking exactly that, as I have the same issues with my docs.

[piglette]

Does the Naproxen work? If so I would not increase. If not you could increase and see if it helps. If it doesn’t the problem is probably not PMR.

[SnazzyD in reply to piglette]

Ah yes, the simple answer; the antidote to my characteristic deep dive.

[Januzzi in reply to SnazzyD]

Hi I need some advice….my lower back pain doesn’t seem to be getting any better I’ve been taking Naproxen which helps very little…but the hot jets in the Jacuzzi takes the pain completely away for couple hours…….when I walk around I have very little pain but getting out of bed is impossible by myself …I did lift a lot of heavy boxes a few weeks ago but I’m thinking maybe it’s time to up my Prednisone any suggestions would be greatly appreciated

[PMRpro Ambassador in reply to Januzzi]

That sounds muscular and probably due to muscle spasm if the heat of the jacuzzi helps and changing position from lying to sitting and standing out of bed is difficult. Have you sought medical advice - though they almost always say time and pain relief? They may offer muscle relaxants or even physio for the tight muscles.

I had something similar and it has taken months to ease but there has been a sudden massive improvement with sleeping on much softer mattresses while I am away from home. Ironic as in the past that always caused problems and why I have a firm mattress.

[SnazzyD in reply to Januzzi]

I have found that if I tweak something pain killers don’t really help as opposed to say, broadly aching muscles. A damaging event doesn’t necessarily show up on the day or soon after either. If the jets work well, I would look to a non-Pred solution first. However, being still makes it stiffen up which can be both PMR or an injury. If possible I’d try to find a physio or gentle osteopath to take a look and see if you have set up a wonky back since your injury before jumping on the Pred. X-rays don’t show up nasty soft tissue niggles very well. If there is no joy from that then I’d ask the doctor to take another look because there are other causes. Anyway, that’s just how I would approach it if it were.

[PMRpro Ambassador]

Impossible to say in the basis of what you've said. If you could provide the info Snazzy has asked for it may help make a more related suggestion.

PMR can contribute to back pain but usually in association with other factors but there are so many possible factors involved. I have such problems but increasing oral pred rarely helps me - pred MAY help but used in a more targeted manner with injections but there are other possibilities.