painful shoulders

I have over 2-3 years (GCA halfway through this time) managed now to get down to 1mg pred and have been on this dose for two months and hoping to stop taking it after Christmas. I have had sore shoulders for some months but don't know if this is anything to do with polymyalgia. My left shoulder is now so sore that I have to lie flat on my back in bed and take co-codamols to get any sleep and it still wakes me up in a lot of pain several times a night. I finally went to GP yesterday and he has done a blood test, results tomorrow. He thinks probably I'll have to go on a higher dose of preds. Although he is testing me for he says a couple of other things. As the pain is now very much worse in the left shoulder than the right, is this a symptom of polymyalgia. I had a feeling the pain should be equal on both sides. I was so sure I had got over this illness! If my ESR level is not OK how high a dose of pred is the minimum I might need to get things in control again.

4 Replies

  • No, it doesn't have to be equal, it is just more likely to be PMR if it is bilateral - in contrast to a shoulder injury such as rotator cuff injury. It is also possible to have inflamed shoulder tendons in PMR that is worse on one side than the other

    The usual suggestion for a flare is go back to current dose plus 5 but if this is a flare it sounds as if you ignored the warning signs a while ago at a much higher dose - what rate have you been reducing at? If you get ANY signs that are reminiscent of PMR you should stop right there at that dose and go back to where you were last comfortable until you see if it is PMR (which should go away if you act quickly) or something else like rotator cuff injury or that sort of thing. So if your symptoms first appeared at, say, 4mg you will need to go back to maybe 9mg at least. Some doctors like to hit it really hard, taking patients back to 15mg and then reducing faster than before to somewhere closer to the last dose you were well at so you don't stay at the higher doses as long at the first time round.

    To be honest - if you had GCA 18 months ago you have got to a very low dose in that time. The Bristol group would have you at about 10mg at this stage after 18 months.

  • Hi Rosalinda, I was with Bristol Eye Hosp thru GCA after losing sight in one eye. Biopsy positive so 2 yrs after am in Club Zero as they just kept reducing preds all the way. Still have stiff shoulder but take painkiller a day and manage it that way. Don't want to go back on steroids unless temporal arteritis comes back so am saving my crash dose just in case! Just grin and bear it is my strategy but can sympathise with you if you cant even lie on it. Good luck with the paracetamol if you go that route, at least there aren't any side-effects! Best of luck, raymck

  • lucky person. 7 years in and now on 5mg, but have also had shoulder pain for the last 6 months much like yourself. Mine had all the indications of frozen shoulder so once the pain was too great and sleep almost impossible I asked the doctor for cortisone jabs, which he duly obliged with. Made life much more bearable, although pain has lingered for last two months, but appears to be slowly receding. Must say, I don't want to keep increasing and decreasing the prednisolone; it is already taking a long time to get down.

    Good luck with managing the problem.

  • Thanks for the replies. The GP took blood tests and ESR was raised, but not dramatically but he was more concerned that I am suddenly very anaemic. I have been back today and he has taken blood for lots of tests. He suspects another inflammatory disease. I took your advice PMR pro and last weekend upped my pred to 10mg daily and the improvement was almost immediate and can now sleep without pain killers. However GP, who is very good, wants to check other things and will ring me tomorrow with the findings. The real reason I have ignored the sore shoulders is that when I last saw the rheumatologist in Spring last year I told her about this and she said as I had recently had two knee replacement ops the arms and shoulders were sore because I was hauling myself in and out of chairs and up the stairs, which was true. She wrote to my GP that she was happy that I had no signs of polymyalgia.

    I am due to see her again in February.

    Thanks for this helpful site. It has given me so much useful information over the years.

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