Sharp dragging pain lower right abdomen

[SheffieldJane]

I am on 15 mgs of Pred. 25 mg of Atenolol ( culprit?) and Tramadol ( more lately due to reducing Pred. I have an almost constant pain in my right lower abdomen, actually just above the groin area. It is the kind of pain a boil would cause but internal. It is possibly bowel or bladder linked. There is apparently no " mass" to be felt during a physical examination. Is this symptom familiar to anyone? It just adds to the misery at the moment and the anxiety.

[polkadotcom]

Does it ever let up? Would it be helpful to note the times when it is more intense/easier through a couple of days? Is it stopping you sleeping?

Paracetamol (Atenolol) I know is linked to gastric issues. Regarding the Tramadol, do you find this helps at all with PMR pain? It doesn't for me, which begs the question why are you reducing at all if you are still in pain with the PMR.

[Cemmein in reply to polkadotcom]

Hi SheffildJane,

Tramadol helps me enormously with PMR pain but I understand this is not true for everyone so glad it helps you too. I am one of the lucky ones. I have to get the balance between steroids & tramadol right. Very high prednisolone makes me feel really ill & ups my BP & cholesterol so better to take tramadol.

I should get the abdominal pain more thoroughly investigated.

All the best!

[Celtic PMRGCAuk volunteer]

Jane, I think this is something that you ought to get checked out further with your doctor. There are quite a few conditions that can cause pain in this area. As far as the different medication you are taking are concerned, can you pin the pain down to any one of those, ie did it start after commencing on one of the pills? For me, Tramadol was a complete no-no after just one pill which put me into more of a zombie-like state than normal! And I know others who were similarly affected. As far as Atenolol is concerned, that is a beta blocker and I assume it has been prescribed for your raised blood pressure? I took it for several years some time ago and the only discernible side effect for me was slowing of my heart rate and reduced energy levels. Do get it checked out by the experts.

[shella in reply to Celtic]

Hiya - I have the same and always wonder if it is PMR connected - had a few really hectic tiring days .... doc cdnt see anything / going to check today if it's a nerve pain via osteoporosis in spine ... it's quite painful when I walk too ..., as you say on top of GCA and everything else! On 10 mg might up it s bit in case it's inflammation. Trying to rest to see if that helps. Good luck.

[SheffieldJane]

Thanks for all your thoughts on this. I am particularly interested in the fact that you also have this pain shella. Please let me know what the doc says about your pain. It feels connected with the whole sicky unwell feeling of PMR. I seem to be the only person on this site that gets some benefit from Tramadol. As my doc says it is only one step down from morphine, I'd better stop floating above the pain, which I imagine I'm doing . I have cut down Pred from 20 mgs, stopping and starting over a 5 month period to 15 mg and I can feel myself sliding back to square one, wanting to sleep all the time and feeling like I've been hit on the back of my skull/neck with a cricket bat and generally being bad company. I was managing at 16 mg just!

[DavidMF]

My PMR started with an excruciating pain in my left groin. It lasted for about two weeks. In the first week I read an article from Alvin Stardust's wife, who's husband had just died of Prostrate Cancer. "He wanted to warn men, of not doing anything" so this is why she wrote. Monday morning I was at the Doctors, a whole series of tests were carried out over the next two months. Everything was O.K. The pain had left my groin, but shoulder & hip muscles pain, started to develop. My symptoms were picked up by a care home manager, who suggested PMR, ESR & CRP were tested and came in at 69/71 Straight onto 15mgs of Preds. Most of the pain gone, had to go to 30mgs to clear. 22 months later on 15mgs and now taking a Very Slow reduction. (Have been down to 9mgs)

My left side seems to be the first to get any reaction, currently the left heel is numb, now for two months. Awaiting to see Nuemy, requested April, might hear within 18 weeks.

With all the info and helpful comments I've grown more confident on what needs to be done. It does all seem to be very personal and each has different experiences. I try and document every change and action. At present my balance seems to be compromised and a fall with a possible fractured rib isn't helping.

Keep working with your Doctor list out how you are feeling in very simple terms and reactions to medicine. Don't try and remember, you will fail and this frustrates most Doctors if you are not precise and clear. Keep questioning, talk to interested friends, it's amazing what might crop up.

Try not to think of the worst, until it's been diagnosed, it's not that, become a Sherlock Holmes gathering the facts, keep a clear head and stay focussed.

Hope this of some help.

[shella]

Well - urine infection ruled out and have made appointment with gyny consultant this evening also checked not connected with spine so that's ruled out - yes it is a bit like Sherlock Holmes..... havent had pain in this groin/pelvic area before normally shoulders and top of legs so this one is a new one. Definitely feeling a lot more tired than usual - will keep you posted on result and hoping result not too disastrous! We all seem to have slightly different symptoms but anything new is a bit worrying....

[SheffieldJane]

Good advice DavidMF. I hope you haven't cracked a rib! It sounds like you have quite enough to contend with already. It is good to be able to share our weird and wonderful and often frightening symptoms. Doctors simply don't have the time or the interest. They only have a tiny handful of prescribing options anyway.

[PMRpro Ambassador]

I can't emphasise enough that you cannot blame everything on PMR or pred - or at least the PMR we discuss on this forum.

PMR (many painful muscles) is ONLY the name given to the symptoms of an underlying disease process, it isn't the disease itself. In the case of the one we talk about it is most probably an unidentified autoimmune disorder but there are several other things that can cause such symptoms. Some of them are other rarer and more complex forms of vasculitis (Keyes on this forum will tell you more about that aspect) but there are also a few cancers. The diagnosis of PMR as we mean it should only be made after ruling out the other options - and even then, some of the options remain unclear, such as LORA (late onset RA) which can present almost identically to PMR.

Any patient who doesn't respond typically to pred - such as needing a higher dose or not being able to reduce without major problems needs to be investigated thoroughly. And any symptom you have that is "different" must be treated the same as if you didn't have pre-existing PMR. You mustn't just assume it is PMR or pred - even if someone else says, oh yes, I have that. If lots of people say it then there is a better chance it is a subset of PMR - but not necessarily.

In this case it may be a pulled muscle - but it might not be. I'm sorry if I've dragged a few elephants into the room - but one suspicion too many is better than one too few.

[SheffieldJane]

That sounds like common sense PMRpro. I am aware that I ration what I tell the GP about. It has taken years of going along with vague seemingly unrelated symptoms to finally being told about and diagnosed with PMR. I was only diagnosed because the symptoms got much worse and more clearly defined following a bad flu type virus. With Prednisolone I seemed to get so much better and so quickly for a number of weeks, on 20 mgs. I was then told that my blood pressure was high and given Atenolol. I was also urged to reduce Pred. Which I am trying to do in small increments, hovering around 16 mgs. I have not felt well since those changes and wondered if the sharp pain in my lower right abdomen was a side effect of Atenolol or even Pred. Shoulder, neck and leg pain is returning as well. Apart from the almost constant abdominal pain, I have cystitis symptoms and bowel symptoms. Exhaustion is overwhelming and I need to sleep a couple of times during the day. This is unwelcome and confusing. A few days ago I was convinced that I was in remission as I felt so well. I am seeing my GP tomorrow and I think they will do my inflammation bloods again and refer me to a Rheumatologist . I feel as if I somehow spoiled things by starting to reduce Pred. And by adding Atenolol to the mix. I stopped Tramadol but that has made no difference to the low abdominal pain or the " sleeping sickness".

I hate going to the GP when I've lost the plot, I just seem to get nowhere. Sorry to go on, it's been a bad day.

[Chihuahua1]

When a cousin of mine had right lower abdominal pain after being diagnosed with PMR it turned out to be appendicitis. Advise getting yours checked just in case

[SheffieldJane]

Thanks Chihuahua, Saw the doctor today and it's a urine infection, probably worse because of a suppressed immune system due to Prednisolone. Of all the nasty options, I was content to take this one. The doctor was so kind and understanding, I suspect she'd had first hand experience of PMR.

[Draco77]

I had a similar pain (more a naggy ache) for months before being diagnosed with PMR. It has almost disappeared since taking Prednisolone, and only reappears if I've overtired myself.

[naturagirl]

Prednisolone has effected every organ in my body plus given me cataract. I would say your sharp pain might also be a side effect of pred. Perhaps a bladder infection. If you are still suffering under the same symptoms off and on try Cranberry capsules and drink chamomile tea a few times a day.

Good luck. Naturagirl