PMR and Sciatica with Back Pain

Dear John,
thank you for directing my question to others who may have similar experiences and possible ways of resolving the issue. Your role as mentor is very useful and helpful,
Kind regards.

I was originally diagnosed with bilateral sciatica. I had significant pain waist down and buldging discs. Treated with high dose Pred for 2 weeks but pain came back. Had epidural, both sides, that didn't work. It was neurosurgeon who finally said it was inflammatory. I thought pain in shoulders was from compensating for lower body pain and legs not working. It was an 8 month journey before I finally started treatment for PMR. Wish I'd said something about how badly my shoulders and neck hurt early on!

I think no coincidence. I also am experiencing sciatic pain down my right leg, however, I did have a herniated disc a couple of years ago (unsure if I still do, as there was never a follow-up scan). Also hip pain on both sides when trying to do my walk (or just below the hip joint). As everything gets attributed to "old age" or "just the normal pains coming" back, which I doubt (according to Rheumatologist), it gets a little discouraging. Tried stretching exercises for piriformis and hip rotator, but this exacerbated the pain. Perhaps I went at it too hard. At 12.5 mg. Prednisone. Trying to titrate down...had to go up .5...in one week going to try 12.0 mg. I know it's not a race and one day at a time. If I could level off at 12 mg. for a few weeks that would be a goal to reach. As of this morning, my get up and go, got up and went. Thank the gods for this group as they keep me going in times like these. Good thing I'm not working this morning as a nap seems in order. Ugh. LOL.

Hi all, I also suffer from left leg sciatica, which started about the same time that I experienced PMR pain in my thighs and arms (March 2020). BTW, my PMR pains began shortly after my second COVID vaccination, which my physician doesn't think is a coincidence. Is there anyone else who contracted PMR following a COVID vaccination?
It took 4 months to diagnose my PMR since my pain was only experienced while lying down. I started taking Prednisone (10 mg) in July 2020 and my leg pain flared up in August, so much so, that I had to sleep in a Lazy-Boy to find any comfortable position at all. I also used a walking stick at one point, but can now walk without much discomfort, especially in the morning. As the day wears on, my pain usually gets worse. I was very active prior to my PMR (cardio dancing, yoga, and walking about 5 miles/day). Now I'm currently walking about 4 to 5 miles per day and using a stationary bike, just in case this pain is related to my osteoarthritis (as visible on my x-ray). My prior physician thought I had sciatica emanating from my L4 -L5 vertebrae, so I went to PT to get the appropriate stretches/exercises for this. These exercises/stretches seemed to make my pain worse, so I eventually stopped. My current physician thinks it could be pyriformis syndrome, so I've tried stretches and exercises for this, but my pain at night gets worse when I do them. I am still taking 1 mg. prednisone since July 2020 and when I recently tried to stop it, my shoulders starting aching again while in bed.

Welcome @janiceem, I know that tapering can be difficult and overdoing exercises can sometimes make it worse. Here are a couple of related discussions that you might find helpful:

-- Tapering off of Prednisone: https://connect.mayoclinic.org/discussion/prednisone/
-- sciatica pain and exercise: https://connect.mayoclinic.org/discussion/sciatica-pain-and-exercise/

It sounds like you've seen a couple of doctors and the diagnosis changed. Was the PMR diagnosed by a rheumatologist?

John, Thank you for your reply. I will check out the links. My primary physician changed recently and she happens to be a DO. My prior physician was an MD and failed to diagnose my PMR until I saw a rheumatologist 4 months later. My case is mild, I guess, compared to others since I only felt pain when lying down. When I started taking 10 mg of Prednisone, my pain went away at night. Since on the prednisone, my pain has migrated to my deltoides and even towards my neck at one time, after I ceased the prednisone months ago for a short time. I'm only taking 1 mg. prednisone now, but I do want to get off of it entirely. I know that I'm eventually going to get COVID, like everyone else has, and I don't want my immune system to be compromised. I was an extremely healthy 66 year old woman when all of this started and hadn't had a cold or flu in decades! I'm also a registered dietitian, so I eat a whole foods, organic diet, high in anti-inflammatories, so this may be helping me somewhat with my PMR. Don't know.

Also have lower disc issues at the moment, sometimes going down my right leg. Yes....my PMR started a few days after my first Pfizer vax in May 2021, but was not aware of what it was. Neck and shoulder pain all summer. Fast forward to August 4, 2021, second Pfizer vax. Ten days later, tried to get up out of bed. Could not move. Got into the tub and my daughter had to help me out. It progressed to right hand (like carpel tunnel) except my hand looked like a claw and was going numb. Progressed to my hips and upper thighs. Finally, now-retired GP referred me for bloodwork in December 2021. Showed CRP at 42. Previously he'd blamed all this on old age. He retired in December, but managed to refer me to a Neurologist. Diagnosed with PMR in Jan. 2022, after 6 months of agony, still trying to work part time until I could no longer do that. Pyriformis exercises make everything worse, in my case. I have managed to get from 20mg Prednisone to 11.5 (just this week). Slowly tapering, but felt the difference on awakening this morning: neck and shoulders. Back to work part time. I will persevere to see if it levels off. If not, back up to 12 mg. 1 mg. is my goal for now and ultimately to be off it completely. All the best to you my friend.

Dear Friend.
I empathize with you. I wrote the wrong year in my initial post. I had my second Pfizer vaccine in March 2021 and that's when it all started, but I only hurt at night until the sciatica kicked in in August following a flu. My sciatica has improved since then, but all the PT and stretches seemed to make it worse, not better (and I used to be religious about yoga). Since I could lift my arms over my head without pain and my bloodwork was normal, it went undiagnosed for 4 months until I saw a rheumatologist. I started with 10 mg. of Prednisone and tapered down by 1 mg. every 2 weeks. I went off the prednisone twice, but the pain returned in my shoulders and my sciatica got worse, so I just took 6 mg. today, but plan to take 2 mg. for 2 weeks and then 1 mg again for who knows how long. It could be 5 years in some cases!! Hope not because it makes me more susceptible to diseases, like COVID. Prior to this I was rarely ever sick. All the best to you!

I developed PMR after a live vaccine for cholera for a trip to Africa. I was very sick the day after the vaccine and never felt good after that. The PMR came on four months later. That was four years ago. I still suffer from it. Both a doctor at Mayo and a doctor at the University of Iowa believe it may have been the cause.
Best wishes to you!

Yes. I'm 71 and have recently experienced right leg sciatica recently. I took prednisone when first diagnosed with PMR - it helped to resolve the inflammation and resolve the pain in my shoulder, arms, and back. Sciatic pain is new. I'm not taking prednisone at this time.

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