Pain Relief

[caz3333]

Hi I am having a bad PMR flare up which started last weekend and spent all day Sunday in bed. Unable to move both arms without extreme pain, can't lift anything or even wash & blow dry my hair. I went to see the gp on Monday who advised increasing steroids up to 15-20mg which I had already done. Was on 7mg daily and take painkillers, was in codeine 15/500 mg which were doing nothing so got a new prescription for 30/500 mg. Thought these would have made a difference to my pain but no relief. I have rung gp and can't get a telephone consultation till Monday now as I explained to receptionist I think I need something stronger for this flare up. Please can other PMR sufferers advise what pain relief they take? This is the worst i have felt since diagnosed 2 & a half years ago.

[Celtic PMRGCAuk volunteer]

Caz, if your pain hasn't responded to the increase in steroid dose to 15-20mgs since last weekend, then it sounds as though there could be something else going on and you need urgent referral to a rheumatologist. Did your GP not consider rotator cuff injuries when you saw him on Monday - that can be quite a common side effect due to the long-term steroids damaging the tendons and ligaments around the shoulder joint. In this case, a physio should be able to help with exercises to relieve the pain. But firstly you need an expert examination and opinion.

[caz3333 in reply to Celtic]

Hi Celtic & Polkadotcom, I appreciate your replies. Gp never mentioned rotator cuff injury although I have seen it mentioned in other posts. I will see how I get on this weekend and will discuss with gp on Monday and ask for a referral again to see rheumatologist as not seen her since first diagnosed. It has come on very suddenly and it is the tops of my arms/shoulders that are so sore & painful to move. Even dressing and getting a shower is painful and taking so long! Plus holding down a job without taking any time off sick! Just need the pain to go away now as its a week and no better.

[PMRpro Ambassador in reply to caz3333]

What were you doing in the last week? Have you done something: lifted/carried/pushed/cleaned? It really does sound like something other than PMR which should respond at least some to 15-20mg pred after a week. Myofascial pain syndrome springs to mind - pred should also help that but an injection or two would be far better than oral since then it would be where it is needed.

To add to what the others said - PMR rarely responds to ordinary painkillers. Pred acts as the painkiller by attacking the cause of the pain.

[caz3333 in reply to PMRpro]

Hi PMRpro thanks for your reply, I am going to mention all of this to my GP on Monday as i think I will need another assessment as I can't cope with the pain like this. Not heard of myofascial but will also mention. I am wondering if I should up my steroids to 30mg?

[piglette in reply to caz3333]

Caz I think going from 7mg of pred up to 30mg is inadvisable unless recommended by your doctor. As others say, it could be something other than PMR causing the pain.

[caz3333 in reply to piglette]

Hi Piglette you are probably right, just getting desperate I suppose. I don't think I have been doing any extra lifting or carrying than normal so can't understand this bad flare up but I guess that's PMR plus this damp weather isn't helping. Going to rest up this weekend and do as little as poss!

[piglette in reply to caz3333]

Good idea, take it easy. I have had a disaster, I go swimming a couple of times a week but the facility has caught fire and burnt down the ladies and gents changing rooms are destroyed. Apparently it started in the steam room.

[PMRpro Ambassador in reply to piglette]

That's a bit rough - hope you find a replacement soon!

[polkadotcom]

Agree with Celtic - you need some re-assessment as the increase in Pred has not touched the pain. Co-codamol doesn't do much for me, either, unless I have some mechanical pain, it is very good for that.

I don't take anything for PMR pain relief because there is nothing which works on the pain except of course Pred - and that helps because it is targeting the inflammation, not the pain as such.

I do hope you can get some help soon.