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The Catch-All Treatment: Prednisone

December was rough for me in a lot of ways. Besides having increased migraines and an extremely busy schedule with Zo’s Nutcracker Ballet performances, I did something to my left wrist. While driving I felt a strange twinge, and then the area between my thumb and forefinger tingled bizarrely and started hurting really badly. And I have a pretty high pain tolerance, as I’m sure most of you do, as we live with migraine disease.

I bought some topical pain relieving gel, did some research, and came to the conclusion I maybe had developed carpal tunnel syndrome. I bought a brace. The inside of my thumb had gone completely numb. I waited a week, and then with Nutcracker performance weekend approaching, I decided to go to urgent care. Meanwhile, my migraines were bad as well, with my worst one since last year (and nearly on the same date in mid-December) hitting the weekend prior, requiring two separate ER visits. I will be writing about that experience in another post.

Prednisone for wrist pain

The urgent care doctor maneuvered my hand and wrist and said that one movement he did would have caused severe pain if it were carpal tunnel, and it hadn’t. He said it was likely to be another type of twisted nerve issue or maybe the beginnings of arthritis, and prescribed 5 days of Prednisone. He said that the steroid would help inflammation and decrease pain, possibly solving the problem altogether, but he referred me to an orthopedist as well. Prednisone! It had been awhile, but my headache specialist used to prescribe Prednisone “burst and taper” therapy for intractable migraines. I also receive IV steroids (either Solu-Medrol or Decadron) every time I go to the ER.

I filled the prescription, which was for one 20 mg tablet three times per day. I was pleased, hoping that I would have better use of my hand during the Nutcracker quick changes, and maybe my daily migraine situation would improve as well. And actually, my migraines improved more quickly than my hand did. With the help of Imitrex, I made it through all the Nutcracker performances with few problems. I wore the brace in between shows and still dealt with more discomfort than I would have preferred, but I will take hand pain over head pain any day. By the time I had finished the Prednisone prescription, my hand was much improved.

Sinus infection relief

However, by Monday I felt flattened. I had made it through the weekend, and then got hit by some sort of sinus/cold situation. I had muscle aches too, and I could only wait three days of barely being able to move before returning to urgent care. We have a wonderful facility associated with our local hospital and the university where John teaches, and since I’m between family doctors due to the new insurance it is my go-to for everything except migraine. I got a different doctor this time, and he was also very sympathetic. I described my symptoms, particularly the sinus pain and how it was exacerbating my migraines, and that Sudafed wasn’t working. He diagnosed me with probable influenza and a sinus infection, and prescribed Amoxicillin and – what do you know? – Prednisone. For the sinus inflammation. 5 days, again, but this time two 20 mg tablets per day.

Once again, the Prednisone was a huge help. The bricks of pain in my cheeks and forehead felt diminished immediately, and I spent all of Christmas Eve cleaning, organizing, wrapping, throwing together additional gifts, and generally feeling fantastic. With the former burst and taper therapy, the initial high dose “burst” would hit me so hard that the side effects were nearly unbearable. My face would redden and be painful to the touch, and I wouldn’t be able to sleep. I do think that it occasionally helped break a bad migraine cycle, but similar to DHE (a rescue intra-muscular injection which I no longer use, partially due to its lack of availability), it was unpleasant to nearly intolerable. I am hoping maybe a five day course of 20 mg tablets, either two or three times per day, could be something that might decrease my ER visits, and I feel grateful that the other health situations I had re-introduced me to the drug and showed that 20 mg tablets didn’t cause the uncomfortable side effects I’d had in the past.

Talking with your doctor

Prednisone has long been a common treatment for intractable migraine and rebound headaches. Like all medications used for migraine, it is a virtual life saver for some; for others it doesn’t work or merely reduces the pain during the course of treatment rather than breaking the whole migraine. Recent research has shown evidence that corticosteroids are not effective long term, and using them has risks and side effects, so if this is something you might like to try, make sure to do research and ask your doctor, neurologist, or headache specialist lots of questions to determine whether it might be a good option for you.

I myself see my neurologist next week, and I plan to ask him for a prescription I can keep on hand for migraines I’m unable to break with my current home treatments and rescue medications, particularly since I have had to visit the ER so often and seem to be out of the statistical norm in a few ways already. Here’s hoping!

**Update: my neurologist did give me a Medrol burst and taper pack, but it didn’t seem as effective as the 20 mg Prednisone. I am keeping it in mind as something to talk to my new family doctor about in March!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • olivyvo
    2 months ago

    I have had migraines since I was 21 and in college. And had most symptoms at one time or another. In this last year I have had a problem with sinus pain. My sinuses become super clear to the point that it causes pain. Along with this my hearing becomes super sensitive to noise along with sensitivity to smells. I walk around cringing with my senses feeling inflamed. Has anyone else felt this?

  • Peggy Artman moderator
    2 months ago

    Hi Olivivo,
    Thank you for visiting our community! I have experienced this type of pain before and my doctors always assumed I had sinus problems.

    I had been prescribed steroids for my sinus issues until gradually they worsened my headaches. Sensitivity to sound, sounds and smells are often part of a migraine attack. Here is an article that may be of help.

    https://migraine.com/headache-types/sinus-headaches/

  • BrownT
    1 year ago

    Hi Elizabeth
    A number of years ago I would go to urgent care with an unmanageable migraine and the doctor would give me an injection of something that would make my migraine go away in seconds. After this happening a number of times I finally asked what it was. It was an experimental approach using prednisone. I talked to my family doctor who would not give me a perscription. After a number of discussions it was because he was not comfortable prescribing that dose amount. Hmmmmm. I asked what dose he would be comfortable with? 50mg was the most he was comfortable with. My thinking was that if I could catch it soon enough 50mg might work. The last place I want to be is in urgent care with an unmanageable migraine.
    Ever since it is my last drug if my choice is urgent care. I have found that if caught soon enough 20mg is enough to break this migraine. “This” migraine is one that starts with swelling at the back of the head making any movement excruciating. Apparently imitrex injections also help with this migraine. Nothing else works. However, prednisone also works on other migraines once I have run out of other options.
    Prednisone has serious side affects at high doses and if taken over a long time at a lower dose so it is my last choice drug. If I get a particularly bad run then it must be tapered.
    I know someone who was prescribed prednisone as a first option. He also had diabetes and had to go into urgent care every time he took it as it messes up glucose. As we all know that in cases of unmanageable migraines we will choose relief even if there are other unwanted side effects.
    To me prednisone is better than a trip to urgent care.
    Glad to hear it helped you through the Nutcracker

  • Elizabeth Roberts-Zibbel moderator author
    9 months ago

    Interestingly, my new (old) neurologist prescribled solumedrol instead of prednisone recently. That worked also! Steroids: definitely not great longterm, as you pointed out. GREAT for bad migraine cycles. Thanks for your comment! ~elizabeth

  • tlocker
    2 years ago

    This is interesting; and timely for me. I am just completing week 4 of a Prednisone taper for GI inflammation. For past several years, they have worsened (move, hormones, stress, who knows?) increased to average 9-16 days/month in 2-6 day runs) in 2016. Despite working from home, unable to work average 4 days per month (FMLA leave is a saving grace). Doc is running out of ideas: do not tolerate tryptans, Botox, all the regular meds; preventative and episode specific don’t seem to help; phernegan and painkillers knock me out long enough to sleep off migraine. Since I’ve been on prednisone, the migraines have nearly disappeared, and when they do come, are much lower in pain and word loss, foggy brain, etc. I had talked to my neurologist about steroids, like you, I’m going to ask at next appointment for the 3-day options. ANYTHING to avoid the ER (we think ER means “Expect Resistance”) despite the fact that I have a specific protocol written out from my Neurologist/Migraine specialist. It does include a narcotic if other four meds fail; about half the time the docs won’t do it. Thanks for sharing, I am, as you noted, worried about the end of this, and if the migraines will then rebound. Fingers crossed for us all.

  • Elizabeth Roberts-Zibbel moderator author
    2 years ago

    I am SO glad this article helped you identify that the Prednisone may work for you as it did me! I am disappointed that my appointment with my new family doctor didn’t go as well as I’d hoped – I didn’t end up asking him about it. I hope that you have better luck. Let us know! Thanks for being here.

  • Karen Klink
    2 years ago

    My new doctor suggested I try a couple steroid shots in my neck, but he hasn’t said what kind yet. I’ll try anything at this point, as botox doesn’t seem to be doing a whole lot.

  • Elizabeth Roberts-Zibbel moderator author
    2 years ago

    Karen, good luck! I haven’t often heard of local steroid shots being given for migraine in the manner of, say, a nerve block, but I know for things like joint pain / arthritis it can work wonders. If you think of it, come back and let us know how they worked! We’re glad you’re here

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