Taking Pred for recently diagnosed PMR

[Mintymow]

Am taking 15mg pred daily for recently diagnosed PMR. Thought I was doing ok after 7 days, pain largely under control, but have a painful shoulder again today plus could this cause a intermittent pinching pain in my neck? Is this how it works with PMR ok for a while then not so good again. Feeling a bit in the dark, not very much explanation about the condition from the GP.

[PMRpro Ambassador]

Have you been doing a load more because you felt better? Catching up on what you hadn't been able to do? That is something that happens to a lot of people who haven't been warned.

Or it may be you have something called myofascial pain syndrome affecting your shoulder - an inflamed area of muscle fibres causes knots in certain muscles, one is the shoulder, just about between where your bra strap sits and your neck. This often is found alongside PMR and can cause spasms in the muscle that pinch nerves and cause referred pain into your neck or arm. Before pred it was all mixed up with the PMR symptoms, those are less so this is now more obvious.

Often longer courses of higher dose pred will ease it but it is better to sort it separately - you can try cortisone shots to reduce the inflammation locally, massage or a physio can mobilise the hard knotty bit of muscle and my personal favourite is Bowen therapy.

[Celtic PMRGCAuk volunteer]

Mintymow, as you haven't been on your 15mg Pred starting dose for very long, then it could still need longer before you feel any long-lasting relief. It can take 4-6 weeks for the starting dose to get and maintain control over the inflammation. Even if your original symptoms improved within a few days to a couple of weeks of starting on steroids, it doesn't mean to say that the inflammation is gone and that you can continue as normal - you do have to give yourself plenty of TLC to give the steroids every chance to maintain the improvement. You also have quite a lot of stress in your life which doesn't help but I know such stresses are unavoidable. Occasionally, patients need a slightly higher starting dose of 20mg to get better control of their level of inflammation. As you had a raised ESR at diagnosis, then perhaps the blood test should be repeated to see whether the levels are returning to within normal range - that should provide an answer as to whether you need a slightly higher dose at this stage.

[1Purplecrow]

Hi Minty, the pros have weighed in regarding technical stuff, so here's my non-pro suggestion...

I have used a warm pack on my shoulders for relief. Also over-the-counter arnica rub, hot shower and paracetomal. This forum is a lifeline for finding your way through the maze that is PMR. You will get better. Jerri