I have severe spinal stenosis that was discovered while I was being treated with Prednisone for PMR. My rheumatologist was very interested in my lumbar CT scan that clearly showed the severe spinal stenosis. While surgery was strongly recommended by a spine surgeon, it became a rheumatology problem since I was taking a high dose of Prednisone.

My rheumatologist tried to address my problem with spinal stenosis but said I shouldn't have taken so much Prednisone to relieve the rather severe radicular leg pain (sciatica) I experienced.

"Patients with symptoms persisting for over 6 weeks can benefit from an epidural corticosteroid injection. Suppose lumbar radicular pain symptoms continue to worsen, and the patient develops numbness and tingling between their legs, bowel or bladder incontinence, difficulty walking, and or sexual dysfunction. In that case, this warrants an immediate emergent evaluation and surgical consultation."

Spinal stenosis shouldn't be treated the same as a PMR problem according to my rheumatologist. My spinal stenosis seems to be manageable as long as my systemic inflammation is kept in check. I still get referred to the spine surgeon occasionally. The surgeon says surgery is "warranted" since I'm off Prednisone. Actemra is now controlling my inflammation but Actemra can be stopped for the time needed in case I decide to pursue the surgical option.