Spinal steroid injections while on Prednisone

Hi @queenie2030, I have experience with PMR but have not had any spinal steroid injections while on prednisone. While you wait for others with experience to respond, I thought I would share this article from 2019 that discusses the topic:

"Despite concerns about complications of repeated steroid injection, few studies reported on the adrenal function of spine disease patients undergoing surgery after ESI."
--- Influence of Epidural Steroid Injection on Adrenal Function: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526135/.

I do think it would be a great question to discuss with your surgeon prior to having surgery.

I had them about 2 mths ago because I have similar back issues & I was convinced my back caused the pain. It confirmed I had PMR because they were of no help to my pain. I had to wean off oral pred. to get injections. My rheumatologist says 15-20 mg is standard dose & you are pretty low. No idea if this is any help. Maybe your injections will work.

It has been hard for me to determine what is truly back pain and what is PMR. Thank you for sharing your experience. Every bit of info helps us make better decisions and pose smarter questions to our medical care team. I think it is sad you had to have the injection to find out if you had PMR. I just had high Sed rate and CRP and Prednisone worked like a miracle after 24 hours on it.

CRP is always high, but sed rate is pretty normal. Negative for RA, lupus, most cancers, etc. This pain was hanging in my buttock hip area that even pain injection doc questioned if back or pmr. I was in so much pain on methyltrexate! Then the pain added to my shoulder, so now I couldn't lift my arms and legs. Rheumatologist said told you so. I started questioning what was left in life with this pain. I finally asked to be off MTX & he agreed that after 2+ months it wasnt working. I insisted I get something else. So glad to be on adequate dose of prednisone & able to maneuver & find joy. I sure learned we must strongly advocate for ourselves! Reach out any time & good luck on injections!

I can see why it was confusing attaining your diagnosis. My sed rate has remained above 80 for two years and crp goes up and down at times it is 25. I tried methotrexate for 4 months and although it did help reduce my pain and I got down to 10.5 mg prednisone, I became sicker and sicker on it and had to quit. When I quit I had a terrible flare of pain and went right back up on prednisone dose to control it. Prednisone has side effects yes, but I have been able to control them pretty well. Thinning skin is most bothersome right now. Glad you have some pain relief on prednisone. I think it takes a lot of patience on the slow path to recovery from PMR. You are right we must advocate for ourselves. I refused taking Lefluomide after trying MTX. I would be unable to do anything without prednisone. I am hoping the spinal injections will allow me to drive again. I have not driven since January and my husband is not well and having a hard time doing all the errands I used to do. I hope things continue to improve for you.

I received an email about a comment or response you made...and being new to the site...I couldn't fine it. DUH. You mentioned that your rheumatologist wanted you to try Actemra. I did and still take the painless EpiPen shot every week. I've never had any side effects....and it made a world of difference and has enabled me to taper my prednisone. I have a friend in Maine, 86, she takes Actemra every two weeks and it is server her just fine; PMR and GCA. I am just a GCA-er.

Also, I sure hope your steroid injection goes well Monday!! Last year I had back issues, I could only stand up for about 2-3 minutes, pinched nerve. I had a nerve ablation, stayed with my usual meds....and now I can walk around two to three residential blocks. All my best...Good Luck💞

Thank you for your encouraging reply. I will try Actemra and if the steroid injection does not relieve my back pain I will ask about nerve ablation. I hope you continue to do well. Best regards to you.

Since a 2nd flare up recently of Polymyalgia, I am currently on 12.5 mg of Prednisone down from 15 mg which has significantly helped with pain everywhere except my lower back. I have had serious back issues which have always been managed with epidurals. As mentioned in an earlier posting, it is so difficult to tell the difference from lower back stenosis pain and PMR back pain. Has anyone had epidurals while on prednisone and are there additional risks?

The MRI of my back made it possible to tell that my pain was from spinal compression and not PMR. I was pretty sure because higher doses of prednisone did nothing to help the pain. I had my first epidural injection today and it’s too soon to know how much help I will have but I m hopeful for any relief. The surgeon who gave me the injection said there was no problem with adrenal insufficiency since he was injecting 80 mg of steroids. Since I am diabetic they advised me to test my blood sugar 4 times a day for 5 days because this dose can raise blood sugar. I feel fine tonight but it is early post-injection at this point. I am on 13 mg of prednisone currently.

My best to you...I'm a believer in doing what we can to be comfortable and enable us to get some exercise, just walking. My best💞