PMR and tai chi

[Fernan]

I was diagnosed with pmr 10 months ago with a very high ESR and swift response to steroids. Now down to 6mg of deflazacort a day I feel it is more under control although I still have pain and stiffness in my thighs pelvic area hips and shoulders. Some days are better than others. Yet, even before the steroids when I could hardly move, I kept doing tai chi and chi kung, albeit in a limited way. Not only am I able to perform these gentle exercises without pain but they actually re - energise me when I'm not feeling good, eg after reducing the dose, and reduce the pain. I'm not sure exactly how it works but the exercises do aim to increase flexibility in the muscles and joints and perhaps through the emphasis on breathing do improve blood circulation. Maybe just the psychological boost of being active does it. I'm afraid though I still can't run across the road or perform many of the tasks around farm!

[piglette]

Tai Chi seems to be really good for PMR. As you say it is gentle and also I think it allows us to keep our balance better and our flexibility.

[Rose54]

Hi

I have been practicing Tia Chia for many years it is a martial art and all the moves in the form are self defence  moves .I am sure I am not telling you anything you don't already know. It is all core based so being grounded is important Chi is the energy which is all around us .Harnessing this energy  is what also helps heal so hence the feel good factor after practising Tia Chi.

Best Wishes Rose

It

[PMRpro Ambassador]

Having a very swift response to steroids doesn't mean though that you will need pred for a shorter time or at a lower dose. Were the pains you mention better at a slightly higher dose? If so - consider not continuing to reduce so fast and even maybe going back up a bit. I had a dramatic response to 15mg: in less than 6 hours the only pain that was left was the bursitis in feet and hips, the rest was gone. I wasn't able to reduce to below 9mg for a very long time and until after another massive flare. To get to 6mg in 10 months is pretty fast.

I had PMR for 5 years without pred at all but did aquaerobics every morning - and Pilates or yoga 2 or 3 times a week after the aqua class, once I could move! I couldn't have managed tai chi at that stage even if I could have found a class, I'd have fallen over, but I did find the adapted Pilates and Iyengha yoga classes very helpful in being able to move.

[HeronNS]

Fernan, I too think that you've been reducing a little fast.  I've been similarly "speedy" with my reduction, but I don't have the pain and stiffness you are describing - if I did I'd be increasing my dose.  You don't want to end up back where you started.  BTW I've started with tai chi also, and really enjoy it, although I'm having trouble mastering the sequence of moves - it's exercise for the brain as well as the body.  💃

[Fernan in reply to HeronNS]

Thanks to both of you for the advice on not reducing the steroids too quickly. In fact I understand deflazacort is probably less effective than prednisone although with less adverse side effects, so 6mg is quite a low dose. When the doctor has seen the blood tests continue to improve it's easy to take his advice on dose reduction, especially when close family members have suffered so badly from long term steroid treatment.

Thanks also for comments about tai chi. It is a martial art and I too enjoy this aspect of it, including partner work with both empty hands and weapons. But many people just practise for health. Some people still benefit when practising from a chair and standing chi kung can be surprisingly effective when not moving at all! 

[HeronNS in reply to Fernan]

The doctor should be treating the symptoms, not the bloodwork.  Blood markers vary widely from person to person and while they can be useful for some purposes, symptoms always trump numbers!

[Celtic PMRGCAuk volunteer]

Fernan, if the pain and stiffness you are experiencing in all the areas you mention have continued throughout your reduction process, then you may need to consider slowing down your rate of reduction and/or even increasing the dose a little. If increasing makes you feel more comfortable then you will know that you previously reduced too soon and by too much to both get and keep the inflammation under control. I'm a great advocate of Tai Chi and Qi Gong once at the manageable stages of PMR/GCA. That, together with a Nordic Walking course, helped me in so many ways, not least with my balance which had been knocked out of kilter probably due to being bedridden for so many months prior to diagnosis. Tai Chi is a low impact movement which flexes the muscles and relaxes the body. We were taught that when you move you internalise your energy (Tai Chi meaning central energy) so that explains why you feel energised and good after your exercises. Keep up the Tai Chi but forget attempting "to run across the road" for a while yet!

[cliveM]

My RA Doctor said I can use weights cans of cat food 400grams when I get down to Predinos 5 gram per day. I tried to do similar exercises before. It was painful for days.

I felt Phathic!

[44humphreyst]

what is ESR?