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Prescribed Prednisone for severe back pain - Scared of side effects

TetraNitroCubaneTetraNitroCubane Registered User regular
Lately I've been experiencing severe back pain, to the point where it's getting actually hard to function in life (this morning getting out of bed and driving to work were excruciating). I've been talking with my doctor about it constantly, and in addition to physical therapy, I've been prescribed prednisone to take on a descending dose for the next 12 days.

At the moment I feel like I have very little option but to take it. However the listed side effects terrify me. Apparently "prednisone psychosis" is a real thing, and these drugs alter your mood and personality considerably. I'm already diagnosed with depression (though not taking medication for it), and the warnings about prednisone induced mania are really making me worried. Particularly since I feel that I may be at high risk of such episodes based on my history with anxiety, depression, and manic episodes.

It also looks like prednisone is extremely habit forming and has nasty withdrawl symptoms.

The duration of the dose is short-term, but I am nevertheless scared. At the same time, I feel like I am out of options, given that it is hard to even move these days, and I don't know how I can go through living like this.

Does anyone have any experience or advice about prednisone, or experience taking it for a short-term duration? I'm not sure if it is worth the risk at this point, or if there is anything I can do to mitigate the potential side effects. Or at the very least any advice about what to look out for?

Sorry if this is all very non-specific and sounds over reactive.

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Posts

  • bowenbowen How you doin'? Registered User regular
    These are concerns best addressed by your doctor, ultimately.

    Is this your first time taking a corticosteroid?

    Ladies.
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  • TetraNitroCubaneTetraNitroCubane Registered User regular
    Absolutely - forgive me if I'm seeming dismissive of that. I have consulted my doctor, and she indicated that the side effects shouldn't be serious. But I find myself anxious about it nevertheless seeing some of the statistics of the matter and doing some research of my own.

    And yes, this is my first time taking a corticosteroid.

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  • Fuzzy Cumulonimbus CloudFuzzy Cumulonimbus Cloud Communications expert for the millennial generation Registered User regular
    Tell your friends and family to keep an eye on your behavior during the 12 days. But honestly, I think you will be fine.

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  • urahonkyurahonky Registered User regular
    I've taken prednisone MANY times over the course of my adult life so I feel like I can weigh in on this for once. How much prednisone are you going to be taking per dose?

    I can confirm the following (I've had upwards of 100mg of prednisone a day at one point in my life):

    1. You WILL be hungry all the time and you cannot satiate that hunger.
    2. You WILL get annoyed at the smallest things. Something about this medication makes the little things really grate on you. It essentially makes whatever fuse you have much, much shorter. I usually warn anyone around me if I have to take it.
    3. The irritation and hunger will be worse if you don't taper. I've had 8 days of prednisone and stopped completely on the 8th day and had the side effects last me a week or so.
    4. Keep exercise to a minimum. It's hard to tell whether or not the medication is giving you extra energy and you'll end up hurting yourself.
    5. Be very careful about the times you take it. If you take it at night you probably won't be able to sleep. If I had to do 2 times a day I usually took it as soon as I get home from work at 5pm just to keep myself from staying up too late.

    However the drug is amazing. If he prescribed prednisone it's probably because of swelling on your back and this stuff will help that. (I'm not a doctor, etc. etc but I have used it for my asthma and any sort of swelling I have goes away immediately)

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  • SoggybiscuitSoggybiscuit At the edge of spacetime lies a path with no end.Registered User regular
    You can always ask your doctor or pharmacist about side effects of the medicine you are taking.

    I will say this: if any part of your body begins feeling numb in any way, especially the groin, buttocks, or legs, DEMAND AN MRI. DEMAND AN MRI FROM YOUR DOCTOR. If you lose bladder or bowel control, GO TO THE EMERGENCY ROOM IMMEDIATELY. Permanent paralysis is possible here, do not mess around.

    My wife just went through this. She had severe back pain, that over a period of a couple of weeks progressed to general numbness while sitting and severe excruciating pain in her buttocks and leg while standing or walking. It turned out she had a ~15 mm disk herniation that was pressing on the spinal cord, and it was only caught by an MRI. She nearly couldn't stand or walk. She finally got her doctor to listen to her and schedule an emergency MRI, which caught the herniation. She had to be rushed to back to the emergency room and transferred to a neurological unit at a large hospital. She had a successful discectomy, still has numbness in her leg, and walks with a limp.

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  • bowenbowen How you doin'? Registered User regular
    Tell your friends and family to keep an eye on your behavior during the 12 days. But honestly, I think you will be fine.

    Yup this is what you want to do.

    If your doctor isn't concerned you're probably fine.

    Good luck!

    Ladies.
  • TetraNitroCubaneTetraNitroCubane Registered User regular
    Thanks very much for the input, all. This is making me anxious, and I'm appreciative of any advice. I will confirm I've been talking to my doctor, and I will likely also ask the pharmacist a number of questions too.
    urahonky wrote: »
    I've taken prednisone MANY times over the course of my adult life so I feel like I can weigh in on this for once. How much prednisone are you going to be taking per dose?

    I believe that I'll be taking a 12-day descending dose. I don't know the actual dose at the moment, but judging from the situation it may be 60 mg for 4 days, 40 mg for 4 days, and then 20 mg for 4 days, and then stopping after that. Thank you for the tips regarding the side effects. The hunger sounds awful, but I appreciate being alerted to it. Also, it sounds like the time of day when you take it is important. I'm losing sleep due to pain, so I'd hate to lose it to medication and just make the problem worse.
    I will say this: if any part of your body begins feeling numb in any way, especially the groin, buttocks, or legs, DEMAND AN MRI. DEMAND AN MRI FROM YOUR DOCTOR. If you lose bladder or bowel control, GO TO THE EMERGENCY ROOM IMMEDIATELY. Permanent paralysis is possible here, do not mess around.

    Absolutely, and thank you! I will say I've had an MRI done just last week. The findings were that I have two herniated disks and spinal stenosis. The MRI shows only slight worsening compared to an MRI from three years ago.

    Surgery may be the ultimate answer, but I am trying everything I can to avoid surgery first.

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  • EncEnc A Fool with Compassion The Land of Flowers (and Dragons)Registered User regular
    Stay off of WebMD, stay in contact with your Doctor with any changes, follow your perscription as assigned by a professional, and keep in contact with friends and loved ones so someone knows where you are.

    It'll be fine.

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  • tynictynic PICNIC BADASS Registered User, ClubPA regular
    You might retain a bit of water weight (though probably not significantly for that short a dose). But don't worry about it, it will go away once you're off the meds - just a heads up to keep you from worrying.

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  • Magic PinkMagic Pink Tur-Boner-Fed Registered User regular
    Thanks very much for the input, all. This is making me anxious, and I'm appreciative of any advice. I will confirm I've been talking to my doctor, and I will likely also ask the pharmacist a number of questions too.
    urahonky wrote: »
    I've taken prednisone MANY times over the course of my adult life so I feel like I can weigh in on this for once. How much prednisone are you going to be taking per dose?

    I believe that I'll be taking a 12-day descending dose. I don't know the actual dose at the moment, but judging from the situation it may be 60 mg for 4 days, 40 mg for 4 days, and then 20 mg for 4 days, and then stopping after that. Thank you for the tips regarding the side effects. The hunger sounds awful, but I appreciate being alerted to it. Also, it sounds like the time of day when you take it is important. I'm losing sleep due to pain, so I'd hate to lose it to medication and just make the problem worse.
    I will say this: if any part of your body begins feeling numb in any way, especially the groin, buttocks, or legs, DEMAND AN MRI. DEMAND AN MRI FROM YOUR DOCTOR. If you lose bladder or bowel control, GO TO THE EMERGENCY ROOM IMMEDIATELY. Permanent paralysis is possible here, do not mess around.

    Absolutely, and thank you! I will say I've had an MRI done just last week. The findings were that I have two herniated disks and spinal stenosis. The MRI shows only slight worsening compared to an MRI from three years ago.

    Surgery may be the ultimate answer, but I am trying everything I can to avoid surgery first.

    I just went through all of what you had and get the surgery. There's really no avoiding it; the pain will just get worse. I tried to put mine off as long as possible as well but the sooner the better.

    SoggybiscuitKetarAustinP0027
  • KetarKetar Lacks the basic intelligence required for pretty much everythingRegistered User regular
    edited August 8
    I have a long history of severe anxiety and depression. I did a similar course of prednisone when I was having lower back issues years ago, and it was fine. The only noticeable side effect for me was increased appetite, and that was easy enough to put up with for a short period of time.

    edit: I also put off the microdiscectomy surgery for over a year while trying physical therapy and cortisone shots and anything else I could try. I wish I'd gotten the surgery done sooner. Nothing ever helped for more than a few months at best, and even that was just the first shot. Meanwhile, I'd go through periods of pain so bad at times that I couldn't walk more than maybe 50-100 feet without stopping to ease the pain and mentally brace myself for the next stretch. The surgery went perfectly when I finally got it done and I was pain free afterward.

    Ketar on
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  • Magic PinkMagic Pink Tur-Boner-Fed Registered User regular
    I put mine off for almost 10 years. Don't. Put. It. Off.

  • AustinP0027AustinP0027 Registered User regular
    Just to jump in to add more weight to "Get the surgery". What hits me the most is your comment on losing sleep. My hernia worsened quickly (went from slight pain to can't walk in a little under 3 months), and at the end, I was unable to sleep at night due to the pain.

    Out of everything, that was the part that hit me the hardest, and it really messed with my head in a bad way. If you're at the point where you've started losing sleep, things can turn south overall without you even realizing why it's happening, so you should really consider pushing forward towards surgery.

  • Magic PinkMagic Pink Tur-Boner-Fed Registered User regular
    Plus, you should decide when to get your surgery while you still can have options to decide the date and get things ready rather than suddenly one day when you can't stand anymore and it's emergency surgery.

    AustinP0027
  • AustinP0027AustinP0027 Registered User regular
    Magic Pink wrote: »
    Plus, you should decide when to get your surgery while you still can have options to decide the date and get things ready rather than suddenly one day when you can't stand anymore and it's emergency surgery.

    Quite literally what happened to me. Financially, the ER/Hospital stay bill I ended up with wasn't fun, considering a planned surgery would have been significantly less.

  • DeathwingDeathwing Registered User regular
    I had to take prednisone starting at a fairly high dose (I think it was 80 mg or something?) over the course of about 3 weeks for a godawful case of poison ivy a couple years ago.

    Stuff I noticed -

    The hunger is real. I wanted to eat pretty much everything all the time, especially at the start...i'm not one given to late night snacking, but I was up raiding the pantry in the middle of the night several times.

    I didn't notice being irritable that much (well, allowing for having ivy rash on about half my body), what did happen was a lot of briefly staring off into space and not being able to find the right word for things. It didn't affect me enough to not be able to do my job duties (sysadmin), although I think my boss got a good laugh a few times :)

    It really screwed with my sleep pattern, either I woke up 2-3 hours before my normal time and couldn't get back to sleep, or had trouble getting to sleep at all. The artificial boost from the drug was very noticeable and I guess helped counteract the loss of sleep to some degree though.

    I have a history of some depression and anxiety issues, but honestly it didn't really exacerbate those at all that I felt.

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  • L Ron HowardL Ron Howard Registered User regular
    While you should talk to a doc, here are the things I've experienced:
    • Constant hunger. Always hungry, all the time
    • Can't sleep for shit
    • I'm more intense due to the lack of sleep, and easier to anger because it'll be 5 AM before falling asleep when I'd have to be up at 7, maybe 8
    • Too fidgety. My legs constantly have to move
    • Leg cramps. This might be specific to me, but I've read it affects others elsewhere on the internet. The steroid saps your body of Potassium. So I just eat bananas like they're my favorite food and I'm stuck on an island with them for the rest of my life.

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  • CambiataCambiata Commander Shepard The likes of which even GAWD has never seenRegistered User regular
    edited August 9
    Disclaimer: IANAD, and all health decisions should be discussed with your doctor and not a video game forum.

    I can't answer to prednisone or it's side effects, but I'm someone who has chronic lower back pain, which at one time was so severe as to need surgery, and my doctor prescribed me duloxetine/cymbalta. This of course is going to be between you and your doctor, and I believe that drug works specifically on *lower* back pain so if that's not what you have it's no use, but I mention it for several reasons, namely 1) It's also an anti-depressant 2) it's one of the few anti-depressants that can decrease appetite instead of increasing it. I believe it is also not habit-forming, but googling this topic shows there is some controversy to that. I think the problem may be that both starting up the medication and stopping with it includes an adjustment period, during which time you'll feel sick and potentially have weird emotions, which if you get it your pharmacist will probably warn you about.

    That said it also does have other potential side effects - though I personally only experienced those in the first week or so of taking it, after which I've never noticed any besides dry mouth.

    I would also like to mention that submitting a accommodation request at work and them getting me a better chair helped reduce my pain immensely as well. Also around the time where my pain was at it's worst, @Strikor and I got a tuft and needle mattress which I found also helped a lot.

    General advice regarding any drugs you take: notice how you feel on it, notice how you react to it and you'll be fine. Listen to and follow your doctor's advice on when to take your medicine, and if there are time constraints on when to take or instructions about not driving a car or heavy equipment heed those. I've found that certain drugs I take definitely give me problems if I take them at the wrong time of day. Adderall, for example, if I take it first thing in the morning right after breakfast, it makes me dizzy and queasy almost to the point of vomiting. Once I started taking it later in the morning I stopped having that problem. Duloxetine used to make me extremely sleepy until I got used to it, so I made it a habit to only take it at night near bedtime.

    Cambiata on
  • urahonkyurahonky Registered User regular
    While you should talk to a doc, here are the things I've experienced:
    • Constant hunger. Always hungry, all the time
    • Can't sleep for shit
    • I'm more intense due to the lack of sleep, and easier to anger because it'll be 5 AM before falling asleep when I'd have to be up at 7, maybe 8
    • Too fidgety. My legs constantly have to move
    • Leg cramps. This might be specific to me, but I've read it affects others elsewhere on the internet. The steroid saps your body of Potassium. So I just eat bananas like they're my favorite food and I'm stuck on an island with them for the rest of my life.

    Oh yes the leg cramps. I would get them when I was laying in bed at night... They are the worst!

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  • TetraNitroCubaneTetraNitroCubane Registered User regular
    Thanks to everyone for the advice and guidance. It's very much appreciated! I feel better knowing that others have gone through this.

    I've been on the prednisone for about 24 hours now. Nothing serious in terms of side-effects so far. I was a little spacey in the afternoon yesterday, and maybe a little curt, but it's hard to know if that's because of the drugs or the pain. I'm still bracing myself for the inevitable hunger to hit me - I'm thinking based on the advice here I'll try to combat it with bananas to reduce cramping. Thanks for those tips!

    It's helping a little bit. By the end of the day yesterday I was feeling okay-ish, though I still had pain when standing up from a sitting position. But I did wake up in the middle of the night, and by this morning I was feeling considerable pain again. Putting on socks and shoes remains a herculean task, and driving in the car is a special kind of hell. But it's slightly reduced pain from where I was three days ago, so I'm hopeful that moving forward things will subside.

    I'm fully anticipating this is likely a non or temporary solution, and so I'm starting to take the surgery option seriously. I hope folks won't mind if I drag out the thread a bit to ask about that?

    For those of you who had the surgery, how did they pinpoint where the surgery needed to happen? My last MRI came back, and the doctor didn't really know which of a few areas might be causing my pain. There were three point that might be where the pain originates. Is there anything they do prior to surgery to locate the area where they know they need to operate?

    Also, after the surgery, what was the recovery like, in terms of how miserable was it, and how long did you need to take (Planning for time off work, etc.)? After recovery is finished, how is your life limited? I presume with such a drastic operation you don't get full range of motion back, and there are some activities that are strictly off-limits.

    Thanks again to everyone. I really do appreciate it.

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  • AustinP0027AustinP0027 Registered User regular
    Caveat obviously being that everyone's situation is different.

    The surgery itself is supposed to be a one day thing. For me, I was in the hospital for a couple days because I came in via ER, and surgery couldn't get done that day or next day, then they kept me overnight since I came in through the ER.

    Once the surgery was done (on a Friday), I was actually out of work all the next week. If I really had to, I could have gone in maybe a day or two, but the first 4 or 5 days, I didn't have the strength/energy to. The official recommendation from the surgeon was to be out 2 weeks.

    Post surgery, my nerve pain was gone immediately. The incision location had some general pain, but nothing significant in comparison to the nerve pain I had. Recovery in general takes time, though. I had almost no strength in that leg at that point, and it takes a while for that to come back. Post-op rules were no bending/twisting and no lifting anything over 5 lbs for 6 weeks. Once I got past that, I got PT to rebuild strength. I'm still actually in PT, it's been maybe 3 months, and I'm just hitting the point where we're starting the conversation on when it can be done. So, post surgery, I'd expect ~5months where you aren't fully back to normal, and definitely for at least 6 weeks of being pretty limited in what you're able to do.

    All that said, I don't know I can put into words how much better I felt after the surgery. Even with all the soreness of recovery and PT, it's nothing compared to how bad the nerve pain was, so I have no regrets in any way about getting the surgery.

    Again, this is just how mine worked out, I've talked to and read other reports where people didn't recover as quickly, or the pain didn't go away as quickly, so everyone is different.

  • JaysonFourJaysonFour Classy Monster Kitteh Registered User regular
    Enc wrote: »
    Stay off of WebMD, stay in contact with your Doctor with any changes, follow your perscription as assigned by a professional, and keep in contact with friends and loved ones so someone knows where you are.

    It'll be fine.

    Definately seconding the "stay off WebMD" stuff, especially about side effects. It's a damned good way to give yourself a whole bunch of unneeded anxiety and panic when things might not actually be so bad. Do not Google anything about your prescriptions, because the horror stories will rise to the top, and it's a damn good way to not get any sleep for a night and to over-analyze every little twinge and ache and everything as leading up to something overly horrible. Just ask your doc what to look out for and leave it at that.

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  • AresProphetAresProphet I see a darkness in my fate I'll drive my car without the brakesRegistered User regular
    edited August 13
    I've done multi week courses of prednisone as part of chemo two separate times in the last decade.

    The hunger is definitely a thing. I don't have any advice here except to note you aren't taking the drug to lose weight and you should be in better condition to exercise after it's over. You need your body healthy before weight loss is a priority.

    Prednisone withdrawal is only a real danger if you are on it for an extended time and if you don't taper. You're on a short tapered pulse so just follow your doctor's orders to the letter and you should be fine.

    I had a couple of prescription sleep meds because I might not be all that tired until the sun was coming up. These ended up being a bigger problem to wean off of than the prednisone. I was glad to have them at the time but given another chance I'd try other non medicinal ways to sleep better. I recommend taking it as early in the day as you can, always with food. It definitely messed with an empty stomach.

    I rather enjoyed steroid mania. I was working full time and in school so the extra energy was welcome. Not a bad idea to have someone checking in on your mood. I'm familiar with the 'shorter fuse' sensation from being on testosterone (...my body has a series of interesting failstates) but I don't recall it with prednisone. Everyone is different though. The big mental challenge was in getting enough sleep.

    Just because you're feeling better doesn't mean your body is better. Use the lack of pain to get good rest and don't over exert. You can easily injure yourself by thinking you're all good after a week.

    Good luck with prednisone. It's a miracle drug for a lot of people.

    Edit: you're having non localized back pain and they haven't identified a structural thing like a disc as the culprit?

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  • TetraNitroCubaneTetraNitroCubane Registered User regular
    You're having non localized back pain and they haven't identified a structural thing like a disc as the culprit?

    My last MRI revealed a herniated disc and spinal stenosis as the two possible locations where this all could be going down, but the doctors don't know which is the one responsible for the pain. They were planning to give me an epidural injection, but I bowed out of that after reading up on the FDA's stance on the procedure. Oral prednisone wound up being the most viable non-surgery option available, though I concede it's less than ideal.

    Just as an update: Had a bit of a rough go with the medication for a day or two there, mostly because of gastrointestinal distress. It hit me super hard on Friday, which made me afraid that I was losing some control of my faculties. I consulted with the doctor, and it was determined that it was probably unrelated to neurological concerns, and that I should just rest up. I've started the taper for the medication at this point, and I have less than a week to go.

    Symptoms are improving, if slowly. I spent pretty much the entire weekend trying to recover, and now I can transition from sitting to standing without feeling like I'm about to topple over. Driving in the car is still murder, though!

    Just wanted to send another note of thanks to everyone in this thread. The advice has been extremely helpful, particularly when to take the medication and what to expect. I think it's helping, so knowing what's normal and what's not has been very useful.

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