glute problem

[Saffronandblue]

I was diagnosed with polymyalgia in January and have reduced prednisone dose from 25 m/g to 4/5 m/g on alternate days. I exercise most days playing golf, doing aqua airobics or just walking. My right glute has been giving me a problem since August but after 10 physio sessions my physiotherapist has recommended a steroid injection so I’m having one next week. Is this a polymyalgia flare? Has anyone else experienced this? I’m 72 years old

[PMRpro Ambassador]

Buttock pain is a common sign of trochanteric bursitis and/or piriformis syndrome and both can be associated with PMR. I have had problems and usually the exercises help but I also have a very stubborn bit in the hip which is bursitis. A steroid injection is one of the options for that. Mine is always worse after walking a bit too far - did you modify your exercise as well as doing the physio?

[Saffronandblue in reply to PMRpro]

Thanks for that. Yes I modified a bit. I’ll report after jab

[PMRpro Ambassador in reply to Saffronandblue]

Hope it works. I have had extracorporeal shockwave therapy for it too - first time it worked really well, 4 sessions at the right intervals. The second time it worked but less well and I'm sure because the intervals were too irregular and the third time it improved but not as much, he only did 3 sessions and the effect hasn't lasted as long. It is done in the rehab department, not by the rheumy, I see him soon - I shall ask what he thinks.

[Pixix]

I have trochanteric bursitis, & have had steroid injections for it…in fact, I’m having one next week. Sometimes the help lasts a month, sometimes two, or, once, just 3 weeks! But always helpful. We’ve been looking after a friends dog a lot, as they have a family crisis, & walking more than usual, both in length & frequency. Walking is good, I find, but too much of it, or too far, seems to be an issue!

[AtopicGuy]

Were you taking 25 mg/day every day at the start, or only on alternate days?

Are you now on 4.5mg/day only on alternate days?

Is your physiotherapist aware that you are still taking prednisone pills?

Is your doctor aware of what the physio is planning?

If you go ahead with the injection, make sure they write down the name of the drug and the dose being injected for you.

Steroids not only reduce inflammation, they also slow down healing. If you are over-exercising a muscle, it make not repair itself before the next session.

[Saffronandblue in reply to AtopicGuy]

Yes I was on 25m/g per day at start but quickly reduced to 20. Now I’m on 5 one day and 4 the next day My physiotherapist is aware of me taking steroids but it is my rheumatologist who is now sending me for the injection to the hospital.. I will certainly take note of drug being injected. Thanks for your advise

[AtopicGuy in reply to Saffronandblue]

I don't understand: do you take 5mg one day, then 4mg the next day, then 5mg the third day, then 4mg on the fourth day, and so on? I've never heard of such a regime.

Perhaps it is intended to mimic a consistent 4.5mg dose without breaking pills in half? If so, it's not what doctors would call an "alternate day" dose. A proper "alternate day" dose is no steroids every other day.

[DorsetLady PMRGCAuk volunteer in reply to AtopicGuy]

Many Rheumies suggest the regime that Saffronandblue is using. Not one we particularly like -but it is mentioned as “alternate day reductions” in the relevant guidelines.

[Mfaepink1973]

Are you sure it isn’t your PMR flaring or affecting another area? You’ve got down to 4mg/5mg very quickly and once you get to 10mg it’s advisable to taper down in 0.5mg increments and I see you are tapering by 1mg from 5mg to 4mg. I’d be tempted to follow the flare advise then drop back to 5mg. You can’t rush PMR!