Dephead2

[dephead2]

Hi. I was diagnosed with PMR in July. I started on 15 mg of predinisolone then and had 2 failed attempts at tapering as I went too fast. I then tapered much more slowly and am still on 12.5 mg. I have major issues with pain in my neck,shoulders and back being the worst. I have put on a lot of weight with pred. I have the classic moon face and the hump. Pred.has also adversely affected my diabetes. So I'm in a dilemma.

Has anyone used a Tens machine to help with PMR pain? I'm desperate . It's like red hot needles in my back.. I need to reduce my pred.but can't handle the pain.

Thanks.

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Have they ruled out ankylosing spondylitis ( AS ) as a cause of your symptoms? As far as I am aware PMR doesn't cause back pain. You can get a Polymyalgic presensation of AS and it does respond to prednisolone.

[PMRpro Ambassador]

Not sure about AS - but PMR does come with back problems too Keyes! However - they are more likely to be due to something called myofascial pain syndrome which is often found alongside PMR since they are both caused by the same cytokines (inflammatory substances). The difference is that in PMR they are systemic (all through the body) and in MPS they tend to form concentrations in trigger spots which are situated either side of the spine in shoulders, about rib level and in the lower back. They can irritate nerves leading to referred pain into the arms, neck, ribs and legs depending which nerves - and this is a common cause of sciatica in fact. It tends to improve at higher doses of pred but then returns as the dose is reduced.

I have had treatment at the pain clinic here in Italy for mine - but here GPs are also able to give the cortisone injections that help a lot. They can also be worked on by physiotherapists or sports massage therapists - but a warning: if it is done with massage you may feel worse before you feel better as the cytokines are released into the circulation and it may feel like a flare of the PMR until they are washed out of your system.

Weight gain and fluid retention with pred can both be helped a lot by cutting processed carbs drastically - and obviously that is also a consideration for your diabetes.

If this is something other than PMR - and I would strongly suspect it is - then a TENS machine may help but you can only find out by trying. It probably won't help PMR though. The pain is due to swelling due to inflammation, only pred will deal with that, removing the inflammation that is the cause of the pain due to the swelling.

The other possibility is you either weren't left in peace at the starting dose until all the existing inflammation was under control before trying to reduce at all or you may have been better with a bit more to start with. 15 mg is generally enough - but for some people they need a bit more, especially if they are big and the starting dose is therefore recommended as 15-20mg.