Just started with a new physical therapist. Tells me that my arm and shoulder issues are coming from my upper spine which is not as mobile as it should be. He does massage and I do flexibility exercises when I am there and at home twice a day. Yesterday was second visit. Going once a week. By evening my ribcage was feeling all flared up and my thinking was getting very negative just like when a flare starts. I am better this am. My question is..... I am currently on day 4 of 18 mgs on the slow reduction plan. Once I have finished and am on 18 everyday should I just stay there till this physio is over and not rock the boat? I am liking this physio guy. Talks and explains things well and has some PMR experience,
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bunnymom
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I think I'd wait to reduce further until the physio is done with. I'd also ask him to slow down just a bit for the moment - he's probably releasing cytokines from trigger spots in muscles that are making you feel as if you are flaring. Remember to drink plenty of water after the session - that may help. It does when you feel strange after a Bowen session which can also release the cytokines.
If he's got PMR experience then he should be treating you quite gently, but probably wise to drop it to one appt per week, that gives the muscles time to recover.
So sorry to hear about your sore shoulders and arm. I have had shoulder pain and hip pain..but mostly hip has been worse. I too have spine issues, and it can be hard to sort out what is PMR and what is the spine. In general, if pain killers touch it, then it is more spine than PMR.
Just recently completed 10-12 weeks of physio for a spine and hip issue. In my experience, physio did not really understand the the connection between PMR and pain in those major joints, even tho they claimed to be familiar with PMR. And, did not really understand the impact of a 'regular' massage/physio treatment in terms of pain the following day(s). I am lucky to have a chiro that is also trained in ART (active release therapy) and adjusts the level of his treatment to what I can tolerate.
I have recently come across an interesting article entitled " Inflammatory changes of hip
synovial structures in polymyalgia rheumatica". It showed a very strong link between trochanteric bursitis and the hip girdle pain most of us are so familiar with (90%).
Extrapolate to shoulders, and the high incidence of frozen shoulder....
I guess the points I am trying to make are: physio/chiro/massage, if they are not to leave you in more pain than you started with, need to adjust the level of their treatment to your particular tolerance, or intolerance, as the case may be, due to the disease PMR. Second, it is very important to keep up with an exercise program to keep core strong and joints limber,
but it too must be adjusted to level that you can tolerate...., and not just assign exercises/treatment for spine that do not respect the impact of PMR.
My doctor (GP) will not permit me to reduce pred while the spine/hip issues are being sorted out...perhaps you can discuss with your doctor.
I share your pain, and send wishes for healing and a speedy recovery....
Thanks Dorothy. Isn't it strange in this disease that when I feel I know so little I am teaching the medical community how to treat me! I appreciate you taking the time to share your experience and I will keep it in mind.
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Reducing Prednisolone
PMR and keeping physically active
reducing 
Pred - physical symptoms on lowering
Symptoms reduced but ESR/CRP unchanged 
