After a fall

[Lyndaki]

I fell 9 days ago & pulled the muscles across my back. Pretty painful for a few days but then on Saturday, when the back felt much easier, I got referred pain down my right leg, which comes in spasms & is agonising. (I had this problem almost 6 years ago at the start of my PMR journey) It started to ease off yesterday & I managed to get a physio appointment. Unfortunately it’s set it off again! My question is regarding my Prednisolone dose. I’m currently down to 1mg. Is it worth…or advisable…to increase the dose? Painkillers aren’t doing much! Sorry for long post. TIA

[DorsetLady PMRGCAuk volunteer]

Sounds very sensible to up dose … about right timescale for your PMR to react to your fall, especially if painkillers aren’t helping.

You could follow just try a small increase and hope it works [sometimes it’s does, sometimes it doesn’t], but I’d be inclined to follow flare protocol and make sure -

healthunlocked.com/pmrgcauk...

You should then be able to drop back down to current dose.

[Lyndaki in reply to DorsetLady]

Thank you, I’ll give it a go!

[DorsetLady PMRGCAuk volunteer in reply to Lyndaki]

Hope it sorts itself out -and maybe give the physio a miss… maybe just a bit of warmth on affected muscles.

[Lyndaki in reply to DorsetLady]

Yes, the hot water bottle is my best friend & I’m cancelling tomorrow’s appointment!!

[PMRpro Ambassador in reply to Lyndaki]

What did she diagnose it as? It is presumably pinching the sciatic nerve ...

[Lyndaki in reply to PMRpro]

Nothing was said. I had a similar problem years ago & it’s like referred pain from my back. Really not sure. I don’t think it’s sciatica…but I’m no expert!

[PMRpro Ambassador in reply to Lyndaki]

The spasms of pain down your leg sound very like the piriformis muscle pinching your sciatic nerve - it passes through the middle of the muscle in some people. Sciatica isn't always a disc problem.

[Lyndaki in reply to PMRpro]

Thank you. Do you know what the best treatment would be? I daren’t go back to physio just yet as it’s so awful!

[PMRpro Ambassador in reply to Lyndaki]

Tell her, very clearly!!! There are stretches but what did you do with her? I'm just off out for a walk, will think about it later.

[Lyndaki in reply to PMRpro]

Thank you!

[PMRpro Ambassador in reply to Lyndaki]

What did the physio do that was so painful? Was it painful at the time or after a while?

[Lyndaki in reply to PMRpro]

She massaged back first then my buttock & top of leg. It didn’t hurt while she was doing (apart from being quite “deep”) it but kicked in when I got off the bed. I originally had back pain for 4/5 days then the leg issue started at weekend.

[powerwalk in reply to Lyndaki]

Did physio think you might need an xray or anything? Having been through the mill with leg/back issues im probably a bit paranoid. If its not improving in a decent time, maybe get it checked. I hope you get sorted, let us know how it goes.

[Lyndaki in reply to powerwalk]

No, nothing mentioned but I’ll certainly bear that in mind if it doesn’t improve! Thank you

[PMRpro Ambassador in reply to Lyndaki]

Have you contacted her to tell her the result of her treatment? I remember having a similar effect in a physio treatment, as I stood up, my back muscles went into spasm and it was excruciating. Trouble is - I can't remember what was done to sort it out. I think I had some needling done by my rheumy but can't be sure. But she DOES need to know, don't just not turn up.

[Lyndaki in reply to PMRpro]

No I haven’t. Unfortunately she doesn’t speak English & although I managed to convey they problems ok in Spanish, I’m not yet fluent! I had another appointment booked for tomorrow which I’ve cancelled & I go back on Monday now, so I’ll try to see the other physio who does speak English to explain. Thankfully this afternoon it’s been easier 🫰

[PMRpro Ambassador in reply to Lyndaki]

Fingers crossed!!

[Lyndaki in reply to PMRpro]

Thank you!

[HeronNS]

If it is a spasmed muscle, I had same and what my physio called dry needling helped.

Another thing, though: back in 2020 I came off pred briefly, but had to go back on after symptoms returned. Spent months after that dealing with what I considered was arthritic pain in my neck. Then one day in early 2021 realized I was beginning to feel just like I had prior to PMR diagnosis. Instead of my usual 2 mg, I gave myself 10 and it was a miracle. Turned out CRP was higher than it had ever been. Didn't need to stay at what I considered a high dose very long, but it took months before I was back down to my usual very low dose. Touch wood, this problem has not re-emerged and I've now been off pred again since February '24! So, just to suggest that if other treatments (including ordinary painkillers) don't seem helpful, a pred increase is worth trying. (I responded overnight.)

[Lyndaki in reply to HeronNS]

Thanks for that! The last time I had a similar problem they did acupuncture & yes, that really helped. And I upped my dose of Pred this morning & will do so for a few days. Thanks.