Unexplained shoulder and hip pain , bloods good .

[Gaz227]

Hi all advice if possible , May 1st dropped to 6.5 mg Pred from 7, within 5 days pain in hips at the weekend my right arm/ shoulder which I had operated on for a cuff repair last November started to seize up was virtually back to new a week ago it felt really good. Blood tests show normal CRP and ESR . Taking aroxia for the pain , Rheumy nurse said don't increase Pred stay on Aroxia for a week then taper it off again and see if pain comes back ? Anybody experienced unexplained pain without blood figures increasing its so frustrating .

[PMRpro Ambassador]

If you are still on pred then the blood markers are often not reliable - they tend to lag behind the redevelopment of inflammation and sometimes never rise again. The symptoms ALWAYS trump blood tests!

However - I think your nurse is wrong. You are never reducing relentlessly to zero - you are seeking the lowest dose that manages the symptoms as well as the original starting dose did. Your longer term dose is probably 7 or 7.5mg - and yes, 1/2mg can make that much difference! That is a "physiological dose", about the same as the body makes anyway - most doctors are happy once you get there. Also, while arcoxia is said to be "less gastroirritant", less is not the same as "not" so be careful.

[Gaz227 in reply to PMRpro]

Thanks for the advice PMRpro, I am still in a little mental turmoil don't know what to do for the best, the pain has reduced some , but how long to take the Aroxia for I don't know. Feeling a little light headed and fatigued wheathet that is the flare or the Atoxia I have no idea . I want to get of the Pred but at what expense taking other anti-inflames might just tip my stomach over the Edgar as it doesn't feel good now . 😩

[Celtic PMRGCAuk volunteer]

Gaz, if you are sure you haven't caused yourself an injury that may have aggravated your muscles, such as lifting or pulling something heavy, if it were me, I would increase my steroid dose back up to 7.5mg to see if there was any improvement in the pain within a few days. I would have preferred to increase the steroids rather than add another drug into the mix, especially one that is a NSAID which are not generally recommended alongside steroids. However, as you have been told to take Arcoxia for just a week before slowly tapering off, hopefully it shouldn't cause any problems. But if there is no improvement in your pain with the Arcoxia, do consider that small increase in steroids. Good luck and do let us know how you get on.

[Gaz227 in reply to Celtic]

Thanks for the reply Celtic , I took one Aroxia yesterday with food and within hours my stomach was giving me trouble I don't get on with NSAIDs as I told the Rheumy nurse (not sure if they completely listen and work off some kind of question flow chart) I think I will try what PMRpro advised and just increase by half a mg and see if it helps , I did have a lot of stress last weekend and have a similar weekend in a fortnight so that can't be helping . Will let you all know the outcome for future experience . 👍

[PMRpro Ambassador in reply to Gaz227]

Nothing would induce me to take NSAIDs for more than the very occasional dose (for a headache for example) alongside pred, at any dose - and the cox-inhibitors are NSAIDs. I don't care what they claim - they are NOT good long term.

And no - stress and PMR make very uneasy bedfellows. It might well help a lot if you up your pred dose to tide you over the stress periods - you are at the borderline of needing cortisol to be made by your body and if it isn't being provided, you need to help it along a bit.

[Gaz227 in reply to PMRpro]

Thanks I will take your advice and just increase a half if that's no better 1mg

[Lafontainepam1]

Your symptoms mean usually that you need to increase your prednisone to be where you need to, to control the pain. I have flare ups, and my blood work is always fine. The steroid is what will take care of your pain with PMR, not all the others stuff!

[sealine30]

Have you had your vit d levels checked?, my pain becomes much worse and feels like a flare but is often down to decrease in vit d stores, and back on the little blue pills for 3 month!

[Gaz227 in reply to sealine30]

Hi , yes not that long ago , but I do take a vitD supplement also. But good point . 👍