RA and Polymyalgia

[Joodee]

Hi all, I have had RA for 32 years but lately have had a different sort of pain right across my shoulders and back and across lower back and buttocks especially first thing in the morning. Also my latest ESR inflammation was very high (120). Has anyone else had a diagnosis of PMR and RA and if so which drugs can help?

[oldtimer]

You can have both, but you can also have inflammation and pain in the muscles (myalgia) with Rheumatoid Disease. The ESR is high. This is a decision for the rheumatologist and you should be asking them urgently about that.

And you do know about Giant Cell Arteritis that can be associated with PMR? See someone urgently if you get temporal pain.

[Joodee in reply to oldtimer]

Thanks for your reply, Oldtimer, I didn't know about myalgia and RA, that would account for the muscle pains. I have a rheumy appointment next Wednesday and they have flagged up low platelets too so they are on the case. I have heard of arteritis and will keep it in mind.

[Shalf]

I wonder if I might have Polymyalgia.

I have terrible pain in my thighs and lower back muscles. I have been diagnosed with Fibromyalgia.

Anyone know how they diagnose Polymyalgia?

[oldtimer in reply to Shalf]

Polymyalgia Rhuematica is usually diagnosed by the symptoms of painful stiff muscles, especially the shoulder girdle, resulting in inability to raise the arms above the head (e.g. to do your hair), but involving other muscle groups also, fatigue (well there's a change) and a very high ESR. And it responds promptly to steroids.

[Fruitandnutcase]

Gosh, I could have written your post a few years ago. I had the sort of shoulder pains you have described before I had a three month course of steroids and started hydroxychloroquine for inflammatory arthritis. The first thing to go we’re the shoulder pains. I couldn’t get over what it felt like not to be in constant pain there. I used to get up in the morning feeling like a truck had driven over me then reversed back and forward for a bit of fun. The shoulder / muscular pains never really came back - well I get stiff and the muscles around my shoulders hurt if I spend too long hunched over my sewing machine - but the buttocks and lower back are still there.

I went totally gluten free when I got the inflammatory arthritis diagnosis five years ago. That massively reduced my thyroid antibodies and has really helped my IBS. The rest of my body still aches a bit - sometimes a lot - but I’m still managing on the same amount of hydroxychloroquine as I was when I started and I just top it up with some anti inflammatories if I need a bit more.

[Joodee in reply to Fruitandnutcase]

Yes, that run over by a truck feeling is spot on!! I have had RA for a LONG time and it has been fairly well controlled with Methotrexate and Humira but I haven't felt those shoulder and girdle pains before. My mum had PMR and those were her symptoms too. I know that a good dose of steroids would make me feel so much better but having just weaned myself down to 1mg a day from 10mg a few years ago I don't want to go back on them. Rheumatology are going to look at changing my biologic as my fortnightly Humira loses effectiveness after about 10 days.