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Pred and Muscle problems

I have seem people commenting on long term pred and muscle wasting or muscle problems. I am really struggling to hold my camera it is not that heavy I used to quite happily lug it around hold it for shots for ages, my arms specifically the muscles hurt like hell and they spasm. Could this be yet another pred side effect, is it reversable and can I do anything to help it get better.


9 Replies

Long-term steroids can cause a proximal myopathy (weakening of the proximal muscles of arms and legs) which usually comes on gradually and is often first noticed as difficulty climbing stairs and getting up out of chairs. It tends to reverse over weeks or months after the steroids have been stopped.

See emedicine.com/pmr/topic35.htm for a really good summary.

Could it just be deconditioning though? I've found over the last few weeks that my muscles are really weak, and get tired and achey very easily, for example when holding my hands to my head to wash or brush my hair, climbing stairs or even typing. I don't think in my case that this is due to proximal myopathy (though I suppose it could be) just general deconditioning, poor fitness and the effects of being unwell.

Both steroid myopathy and general deconditioning have been shown in the literature to respond to light resistance training, eg doing biceps curls with baked bean tins, if you can bear it/are able to!

The spasm also makes me think of some kind of side effect related to the subcut, can't that cause msucle spasm? Have you had your potassium and calcium checked recently? I'm guessing here, don't know a lot about subcut, someone else might want to put me right? I've noticed when I've had a lot of nebs and try to write, my hand and wrist tend to spasm, although that could just be because I'm holding the pen so tight to try to overcome the tremor!

Sorry I can't come up with anything more brilliant than baked bean tins!

Em H


EmilyH, it could be de-conditioning it is only the last couple of weeks that I have picked up a camera again or tried to. The spasm probably is the S/C just like if you move awkardly the associated muscle will cramp up. I guess over-doing it will also cause the spasm.

I am going to get some weights and try to build up the muscles again and chat with the OT and physio at the RBH to see if they can suggest anything.



Hi Bex,

I'm coming off the pred, like countless times before, and I always notice a weakness in my arm muscles during this time and for a couple of months afterwards. I don't do any resistance sports using my arms, but I have always managed to maintain some sort of running, using legs and also other major muscle groups like abdominals. I don't suffer from any sort of muscular feelings of weakness in large muscle groups like quad, hamstrings even glutes ( your bum!) and so have always put down the weakness in my arms to, not only deconditioning as EmilyH has pointed out but also to the 'muscle wasting effect' of pred.

It's certainly worth doing some high rep and building up to long sets, but lowish weight resistance training exercises for the arms and shoulders, and using nothing heavier than the proverbial cans of baked beans, - LOL EmilyH - if nothing else you will boost your metabolic rate, might even lose some weight, and best of all you will be able to lug your camera around again!

There are many gyms that employ instructors who are very used to dealing with people with all sorts of disabilities.



Muscle weakness.

After two years of steroids and getting weaker as time goes by, aches pains in the arms and legs and especially in the back of the right lung. What i have trouble with is asking anybody else to help me after years of my own independence. Never realied on anybody else in life before, always helped others but now i struggle mentally to ask others. To move forward i need to master this problem. My mother made us independent but now i am suffering secretly. Old fashioned pride i have been told. Any advice.


Yet another lovely side effect....

...and considering my vanishing self.....I have not the foggiest of ideas why my Con hasn't entirely agreed to why my muscle wastage is so severe, although I keep on nagging him about long term pred.....he has tried to put his point across as being that my lying in bed sick for so long has caused my muscles to waste away, but surely not this much, or this markedly. I have legs that are just knees, and a floppy flat something or other formerly known as a bottom...

He also came out with a great line, which I was reminded of yesterday...""my illness has me needing as many calories as a marathon runner, yet whilst lying in bed"" But he used that to describe the laboured breathing, gunk producing, cough cough coughing side of my asthma.

It's not just the muscle wastage, it's the problems that have occurred because of lack of muscle strength etc. Apparently my pelvis has tilted forwards, because my lower back is so tiny muscle wise, and so my body has been unable to compensate. This is causing me horrendous pain in both my back and right leg.

Again, this is purely because the Pred has sped up my muscle deterioration.

How on earth do you get it back, when your lungs don't let you exercise. I am longing to do some gentle swimming....

Bex and Ken, you both mentioned the lack of strength in your arms.

This has become all the more apparent for me this week when trying to write on the board at school. I can hardly lift them up to manage a few words at a time.

I had thought it was lack of muscle tone in my chest but of course, I have now worked out that isn't just the case.

The Occy Health Doc told me, long term pred causes a classic body shape like a lemon with limbs like string beans......ie where did all the muscle go to....

unfortunately my body is another string bean too!

Don't you feel like you are constantly losing in this battle, head and brick wall spring to mind all too often here.


Owing to the pred muscle problems my heads hitting the brick wall at the bottom of my stairs on a regular basis as i fall while attempting to get up/down them!

Trying to get about anywhere where there are steps up or down i either look drunk or because i'm covered in bruises like i've been beaten up and about to keel over or both. You have to laugh at how daft it is that because of some tiny innocent looking but life saving little pills my 87 yr old nan who's had knee replacements is currently more mobile than me (age 30)or you'd go mad! The way i see it at the minute i can live without sensible legs but not without sensible lungs!

Stay hopeful


(by the way rosemary conely i think it is does dvd with a sit down workout for those with limited mobility/v unfit will investigate and see if it's any good- might just have to watch it not do it at minute!)


Sus- love the lemon analogy very true. Despite being on crutches for the last 3 years i still have weak arms and i often too land in a heap the bottm of the stairs is one of my most frequented places too.

I find just brushing my hair and tying it back extremly tiring.

Despite having trained as a dancer and competitive swimmer in my late teens i find my muscles now annoyingly weak and when i saw the physio post op she was surprised too . She suggested to get back to some strength get one of the foam noodles , go swimming and just float initially then build up to gentle kicking or cycling. I did this on hols and did notice a slight improvement, so maybe worth trying peeps.

But yes banging head on wall seems about right what bliss it would be to get out of this viscious circle.


No good without the pred

Who can match the slowness of my breathing. Normal breathing when sitting down or even moving, i only breath in and out 8 or 9 times per minute. So dam slow and laboured. how can this be classed as asthma. What is the average inhalations per minute, sometimes i think they will stop . I have to force myself to breath. Only 40 mg of steroids get me moving a bit. Copd i have been told as well as asthma. Does any body else suffer like this.


Hi Ken,

In answer, -well a try - to your questions respiration rate is the number of breaths taken each minute (a breath is one inhalation and one exhalation). The average respiration rate for a healthy adult is 12 to 15 breaths per minute.

Human respiration rate is controlled by a part of the brain called the medulla. It(medulla) sends signals to the body to adjust the breathing speed to provide enough oxygen for every activity sleeping, eating, exercising, etc. The level of carbon dioxide, not oxygen, in the blood is measured by the brain, which in turn makes needed adjustments in the respiration rate. Try this web ref for more info.


I’m no doctor, well not of medicine, but do you think your breathing rate is affected by the level of carbon dioxide in your blood? Let alone all the other complications such as age, gender, meds and ....!

I have a resting breathing rate of about 12 breaths per minute, when on full meds.

I’m trying to practise deep meditative type of breathing exercises, but not having much success atm because having just come off the pred my SOB is really starting to get the better of me. Just glad I’m seeing the doc next week. But please no more pred!

Before I forget Ken, I was taught to keep the stiff proverbial upper lip and not ask for help. Like you I was always too busy helping family, friends and students, and ignoring my own state of health in a very ostrich like fashion It was only when I ‘came out’ about my asthma and copd and started asking for help and accepting that help that I started to regain some sort of control. I’m still not little Miss Perfect, but working towards that state!

Hope you are feeling better today.




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