Massage and PMR

[Underlee]

Hi all, I'm just wondering on people's thoughts regarding massage? My legs are very stiff in the morning when I wake up and I'm wondering whether a massage would help. Thanks

[DorsetLady PMRGCAuk volunteer]

Hi Underlee. 

Never gone down that route so can't say. However, think you need to make sure it's very gentle otherwise it could just make things worse. Most of us have that problem, maybe some gentle exercising and a stroll might help. Not too repetitive or strenuous exercise though, just enough to keep things moving. Unfortunately Pred has an adverse effect on our muscles, and if you were particularly active prior to diagnosis it's probably affecting you more. 

Sorry can't be more helpful - but whatever you do - remember gently! 

[Underlee in reply to DorsetLady]

Thanks DorsetLady, whatever I do I'll do it gently

[DorsetLady PMRGCAuk volunteer in reply to Underlee]

Hi again,

Forgot to say before, I did see Physio (not GCA related) and he suggested doing some gentle (that word again) exercise in bed before you get up in the morning. Similar to warming up or cooling down but all done lying down whilst your muscles are relaxed and warm. 

I do about ten - fifteen minutes work and then have a warm shower before thinking about anything else. 

As others have said either an electric blanket, or smaller version can be good, I use a small heat pad for my arthritic knee and/or back if they play up in the evenings. As least that can be moved about and can be used anywhere you have a electric supply. 

Of course, you may then be liable to being compared to your grandad!😉 

[Underlee in reply to DorsetLady]

Haha, I do feel like a grandad at the moment! I have a reheat able pad that I can use so will give that a go. Thanks

[Celtic PMRGCAuk volunteer]

Underlee, although it is important not to get involved in undergoing the usual manual techniques of physiotherapy, especially in the early days of treatment, some people have found that a gentle massage can help.  Anything stronger can aggravate the inflammation of PMR, as DL has said.  I'm not sure that massage will help with the early morning stiffness in your legs though.  Early morning leg stiffness is very common, probably due to the effects of the anti-inflammatory effect of the steroids not lasting from one daily morning dose to the next.  What some people have found has helped with this problem is to split their steroid dose, taking two-thirds in the morning and one-third at night.  If you do decide to try massage, just make sure to tell the therapist that you have PMR and the treatment needs to be gentle. 

[Underlee in reply to Celtic]

Thanks Celtic, appreciate the advice. I think I'll hold off from any massage for the time being.

[PMRpro Ambassador in reply to Underlee]

I like massage - but I do expect that I might feel worse before feeling better. Massage can release the same cytokines that cause PMR from the tissue into the general circulation - the result is an apparent flare though it will go quite quickly.

I'd fiddle with my dose a bit - taking it earlier or part of it at night might help with the morning stiffness which is actually perfectly normal in PMR. Some people take their pred very early and settle down for another couple of hours - by which time it will have started to work.

[Underlee in reply to PMRpro]

Thanks PMRpro, the past few days I have been taking 10mg when I wake up with the pain at 4am (along with a couple of paracetamol) and can manage to get back to sleep usually 45 mins later. I'm still stiff when I wake up a few hours later but I'm loathe to use my other 10mg as I like to save it for later.

[PMRpro Ambassador in reply to Underlee]

Some people find an electric blanket before getting out of bed warms the muscles to get them moving first and then a warm shower and gentle stretching completes the effect. And maybe splitting the dose more like 2/3 morning and 1/3 later rather than half and half might help?

[HeronNS in reply to PMRpro]

I agree about the application of warmth.  My feet, which I had not considered were cold, had been cramping and making it hard to fall asleep (in spite of bedtime calcium dose).  So I used a hot water bottle to see if that would help and it was like magic. 

[Underlee in reply to HeronNS]

Thanks I'll try that

[Underlee in reply to PMRpro]

Yes I'll try that, thanks

[Suetum in reply to Celtic]

I cannot manage a massage but I do treat myself to a special facial. This involves lying on a warm bed, hot towels on the feet an acupuncture type pressure on the ankles to start and then a thorough facial. It really relaxes me and I think we deserve to be pampered sometimes!

[trish29 in reply to Suetum]

Good Morning  Suetum ..this treatment you are describing is very similar to 1 of the treatments I get at my Bowen Therapists which I had yesterday but it's to the neck and head and when I have the warm towels put over my body ,particularly my feet it's Heaven . I have a small heat mat that I use as a mini electric blanket and take it away with me when I go anywhere and it is a comfort and eases stiffness .I hope you improve soon ..Best wishes trish 29

[piglette]

I have leg and foot massage and love it. Although it has been a bit disastrous recently in that the place I go to caught fire and the wonderful girl who did it has disappeared. The place has been cobbled together so I can now start again with someone else, but then I fell and got pretty bruised so am waiting to heal before going back to it. I was having it as often as I could afford before the bad luck stepped in. In fact I sometimes had a double session.

[HeronNS]

Before diagnosis after my former physiotherapist had given up on me I had at her recommendation a few sessions of massage which I found not only useless but kind of irritating - not relaxing at all.  So "different strokes (literally) for different folks"!

[Underlee in reply to HeronNS]

Agreed, I think I'll hold off for the time being. 

[leeman49]

Underlee I had PMR just a few months from now. I did tried to kneed the stiff parts of the body and I found that helps a lot. Kneed as hard as your can go for the sore legs after a few minutes the muscle will loosen. I do it ten times a go. Then I do it to neck, shoulders, arms and thighs. Self massage is better than therapist as you know the pain wise. I still do that everyday pain or not. Hope that help your poor legs. Good luck 

Lee

[nickm001]

If you are lucky to find a place which has treated PMR patients before, then it seems that massage helps. Reading about on this and other forums leads me to believe that is not very often PT knows about PMR and most people dislike massage and find it not helpful. I for one, am very partial, and consider proper, gentle massage very important in recovery. I used to have them 2 times a week during the first month of my PMR recovery. Now (5th month since start) I have massage every second week.

In addition to massage, I would suggest two things that helps me. First one is that every evening, before going to sleep, I have a hot bath for 15-20 minutes. Temperature is about 40-41C.  This relaxes muscles. In the morning I take 2-3Km walk and some light stretching afterwards... Those two things should help you with morning stiffens.

[Underlee in reply to nickm001]

Thanks Nick, I have been having a hot bath which definitely helps me, but usually have it earlier in the day so will try last thing at night. I'm still in two minds about a massage so I think I'll hold off until I'm feeling a little braver. Thanks for your advice.

[Hidden in reply to Underlee]

Before my trip to Mexico which went well physically I went in for my first ever pedicure. I did d not know massaging my calfs would be part of the routine. She did the first calf as I sat puzzled over all the pain by the time she got to my second leg I finally asked her to stop.

I already knew about my back and no massage there.

I do however have this electric back massage that I use for less than a minute as it hurts but it feels better after.

I have also been putting ice pad on my neck which feels good to me as I always run hot.

Good luck!

Lin

[elainemwh]

I was having a sports massage on a regular basis and I think it made a big difference. I am not having a massage as often now and I do ache more.

[Parijm]

For years, before PMR, I indulged and enjoyed a daily massage on the beach when on holiday in Italy, given by Chinese ladies. However, last Summer I found the massage was much too intense and in fact hurt in places; I was willing it to finish. Language difficulties did not allow any discussion and I stopped further massage. While there is inflammation in arms and legs I prefer to avoid massage and prefer to do gentle Pilates exercises for 15 minutes once I get up, followed by walking dog for 15 mins.

[Noosat]

I try to stretch my lega a little before getting up and while in the morning hot shower have it trained on my back while I touch my toes - seems to help with the stiffness/discomfit.