PMR and Sciatica with Back Pain

I found that using an inversion table was helpful in stretching my spine and giving me some relief from stenosis issues.

I agree with @polykendancer. As I am a retired registered massage therapists and holistic practitioner I always advocate quality of life. I have been on prednisone three times in the past 30 years for PMR. It has saved my life emotionally and physically . I am fortunate to have a doctor Who works with me to discuss my return to health and it is important to me to have someone that you can talk to the understands who you are as a whole person

I couldn't agree more..

I am 63, male, 5ft 8, 140 lbs, a former medical lab tech, and I self-diagnosed myself with Poly a few years ago after experiencing chronic shoulder pain, in the top of one shoulder, and then the other. I also had new periodic pain in the outer hip of both sides. Sometimes my neck would become stiff and it was difficult to turn my head with ease and my range of motion would be limited. At all times, the pain would evolve or worsen during the evening or when I would be sleeping in bed. More recently I have had outer wrist pain and some swelling at different times in both wrists. The pain would be so severe it felt like I had broken my wrists. I have had right side sciatica in the past and now it's been chronic for at least 6 months. It's much worse in the AM when I first get out of bed and try to walk for any length of time. Walking seems to make it much worse. Sitting and stretching helps relieve the spasms. I take 10 mg of prednisone a day and it helps take away most of all my pains. 15 mg will usually take out any residual pain everywhere. The prednisone never cures the POLY, but it does rapidly resolve certain "hot" spots, like my wrists, both of which felt broken at different times. I'm reluctant to take long term steroids due to bone weakening issues, BUT I have to be able to walk and use my limbs. Taking testosterone might help combat some of these prednisone side effects, but primary care docs simply won't prescribe long term steroids of any kind to any patients, so they are essentially useless in these situations.

I don't know how I missed this thread.

I have severe spinal stenosis and just returned from a neurosurgery appointment. About 5 years ago, I had severe sciatica with acute neurological changes. My lumbar spine had many problems. I was being prepped for urgent surgery but the surgeon said I was not a good surgical candidate because of my long term use prednisone to treat PMR. I was having a PMR flare in addition to the sciatica so everything was looking bleak.

The spine surgeon 5 years ago wanted to do a multi-level lumbar fusion. I was willing to do anything to make the pain stop. Ironically, 60 mg of prednisone relieved most of the pain and surgery was postponed since the surgeon was reluctant to do the lumbar fusion. The agreement 5 years ago was to let pain be the deciding factor for surgery in the future.

Five years later, the spinal stenosis is still severe. I still have flares of lower back pain but I no longer take prednisone. I believe that the systemic inflammation caused by PMR does cause more pain radiating from my lower back. That was evidenced by the formation of a synovial cyst that was inflammation related. The synovial cyst was taking up additional space and impinging on my nerves exiting at the L4-5 level. I wanted to delay having surgery as long as possible and the neurosurgeon documented that I was "downplaying" the pain I felt.

Today, the neurosurgeon said the synovial cyst has resorbed and the nerves have more space. No surgery is being planned currently but I have an open invitation to return when I'm ready to have surgery.

I'm off prednisone so I'm not a poor surgical risk anymore. Today the neurosurgeon was very interested in the biologic that I have taken for 4 years now. The surgeon says the spinal stenosis is still severe but it is remarkably stable compared to 5 years ago. When the synovial cyst formed a year ago, I needed 10 mg of prednisone because I wasn't able to get the biologic I needed because of supply chain problems.

It is all about quality of life but I now have a better option than prednisone. The biologic works exceptionally well for me at least.

I also have had sciatica pain. My doctor gave me exercises to do which help. I was diagnosed with PMR in August of 2021, started on 20 mg of Prednisone but the sciatica pain only developed when I got down to 3 mg of Prednisone. I increased to 4 of Prednisone mg for PMR pain management and haven’t had sciatica for a couple months now.

At 74 I incurred a herniated disc from hauling wheels of oak for splitting. One night my wife took me to the emergency room as I was howling in pain from sciatica on my right side that had grown worse steadily. Dexamethesone followed by a Medrol pack got the pain under control, and since then (five years) I have generally kept it under control, but not gone, through the McKenzie exercises. In March I began taking low-dose naltrexone. Now the sciatica has disappeared. Gone. Maybe it's coincidental but I'm a believer and I love being able to step into my pants in the morning.

I'm 85 and have always been very active. 7 months ago I was riding my bike, walking, jogging, and shot the lowest round of golf in my life. 6 1/2 months ago I started on my journy with PMR. I have had a few scaitic problems over the last 3 years, but have gotten them to go away with basic excersises. 3 months ago my scaitic begain to give me problems again, but this time, my own exercising, and then physical therapy, didn't seem to be making a difference. Although, they help for that day, the next morning starts it all over again. Acetaminophen keeps it tolerable, especially on golf days and before I go walking. But without it, I can barely walk.
I'm on 10mg perdisone, and should drop to 7.5 this week. Not sure if I should be more aggressive with the sciatic problem, like taking a shot, or something. Or just ride it out, with the hope I can get rid of PMR and then scaitic along with it.
My PMR symptoms have almost gone away. Over the last 30 days, I have had 2 mornings that my upper body stiffness was there for the first 10 minutes or so.
All input would be welcome.

Hello @gman254 this is a more recent conversation about back pain that is now of interest to me . https://connect.mayoclinic.org/discussion/cortisone-injection-while-taking-prednisone/

I am in 'sustained recovery' from PMR .
I have a history of low back and cervical spine issues , and I already have an MRI of the lumbar spine from March of last year ( long story about that).
Shoveling snow about 3 weeks ago might have started the ball rolling this time : ( I've been managing with Motrin, flexeril and Tylenol 8hr for last 15 days. Now that I'm retired I don't have to figure out out to sit and drive to work anymore , so I am taking it slow. I will see a physiatrist tomorrow and thanks to @linda7 , I might not to be too afraid of having a cortisone shot.
I do wonder if while on higher doses of Prednisone in 2023 I was too aggressive while gardening by moving rocks and digging !

Dropping 2.5 mg from 10 mg of prednisone sounds kind of risky to me. I have GCA and PMR, and I've been receiving treatment for a little over 7 months. In addition to prednisone I also take weekly Actemra injections. I dropped from 10 mg of prednisone to 9 a week and a half ago, and I had a couple of bad days that concerned me. I felt really flat those days, like I had been hit by a truck. But I have felt better since then, so I'm going to drop another mg later this week. I'm supposed to taper 1 mg every 2 weeks, but I might have to adjust that plan.

On a side note, I haven't had any symptoms of GCA or PMR since I started treatment 7 months ago.