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PMR Pain

Thought I'd posted this a couple of days ago, but must have failed!

Am interested to know whether PMR pain moves around to different locations in the body.

I ask this because, having come down from 30mg to 15mg over the last 3 months with virtually no pain, I now find that, after 4 weeks on 15mg, I am getting some discomfort at the back of my neck towards my shoulder. This area was clear of pain when I was first diagnosed. Pre PMR, I would have put it down to sitting in a draft, or something, but I don't think it is that. The pain does recede during the day, which indicates to me that the preds are having an effect.


8 Replies

Morning Charlie1.if it twas i, I would up my pred a tad & stay at dose that bring you abit of comfort.then taper down slowly. Good luck.Dave

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Thanks Dave. The pain is quite bearable at this stage. I will up the dose if it gets worse. Like all of us, I really want to get down if I can, and I see 15mg as quite a high dose for PMR; at least it is the normal starter, even though I was started at 30mg.



If you are having pain at 15mg it seems less likely it is PMR plain and simple. Especially if it is one-sided or very localised.

However, something called myofascial pain syndrome can lead to knots of inflamed muscle fibres in certain muscle groups and the shoulder is a common one. They are concentrations of cytokines, the substances that cause PMR inflammation, and higher doses of pred mask it. They can pinch or irritate a nerve and cause referred pain into the neck and arms in this case, and ribs or low back in the other common presentations.

Local steroid injections help as does manual mobilisation of the knot during massage or by a physiotherapist. Bowen therapy also helps a lot. Dispersing it manually can make you feel worse before you feel better but in the end it is worth it!

I'm sure you've seen my pro-Bowen posts all over the place!

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Thank you PMR,pro, as always. It is localised, and I am very aware that the preds have masked other chronic pains, particularly in an ankle, where I have had arthritis symptoms for years. When I started at 30mg that ankle pain cleared completely, but now it is coming back.

Re the shoulder I have shiatsu every 4 to 6 weeks, and if the pain persists, I am optimistic that this treatment will resolve the problem.

Thank you again.


The pain certainly moved for me. Strangely, it started in the backs of my knees first, then in the pelvic area. I had started pred for quite a while before it moved to arms, shoulders and neck , which are the worst affected now.


yes it defo moves around. neck groin buttocks. hips knees. but try not to over do things. but then again don't sit around doing nothing, and reduce very carefully. I reduced by quarter at a time taking around 6 weeks to reduce by 1 mg. it worked

for me. only 1 flare at 1 mg went back to 2 mg 1 month back.


Just to thank you all for your replies. This forum is really helpful.


Just noticed this post of yours. My pain started in neck and legs and hardly any arm pain now it's mostly arm pain and some neck pain


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