Struggling

[birthday1]

Hi guys, I'm really struggling with joint pain at the moment. Had my bloods done just over a week ago and my esr and crp had risen again so after having been put back up to 15mg 4 weeks ago I got a message from the GP surgery to up to 20mg and re test in 2 weeks, but I'm still struggling with joint pain and it's starting to get me down. I thought I was doing really well until my headache and A&E visit but it all seems to have gone wrong since then. Is this something that is common in PMR? or am I just unfortunate right now. Any advice would be appreciated.

[PMRpro Ambassador]

Which joints are the problem? If your problem now is specifically joint pain then I have to say, the question of PMR as the diagnosis should be questioned.

There are a few forms of inflammatory arthritis that can present in the same way but one of the characteristics of PMR is that joint pain tends to be restricted to the hips and shoulders in the form of bursitis and other joint pain isn't typical. If you have otherwise typical PMR symptoms and are now showing joint pain I think your GP needs to refer you to a rheumatologist in case the PMR isn't the right answer. And in view of your query GCA episode - that must also be borne in mind. There are some tests a GP can do and interpret well - but they are notoriously poor at rheumatology because the tests are not positive or negative in the sense they rule something in or out but in the sense they are part of a much bigger picture in the form of a jigsaw. Often it takes an expert to recognise the pattern.

[birthday1 in reply to PMRpro]

Hi thanks for the response PMRpro,

I have bilateral hip, knee, shoulder, elbow and back pain (the back pain is as a result of failed spinal surgery but was being helped immensely by the prednisolone.) I also have bilateral wrist pain and swollen hands. I was seen by a Rhuemy in 2015 who excluded rheumatoid arthritis but did say I had osteoarthritis in my thumb joints and knees. I have an underactive thyroid, which is now well controlled but I did have increased joint pain when I was getting that diagnosis but settled once my TSH levels were brought down. I'm just at my wits end to be honest. I have now been in chronic pain of some sort or another (in this episode) for just over 3 years (spinal surgery uppermost and the catalyst it appears for the PMR and thyroid problems). My mobility is affected, my depression is not helped with the on going chronic pain and I feel I just get passed from one thing to another with no resolution. Sorry for the moan, just feeling rather sorry for myself today.

[PMRpro Ambassador in reply to birthday1]

If you can't have a moan here - where can you have one? We all have grotty days and having a moan does make you feel better - perversely. Apparently having a really good swear helps with pain - scientific study published recently identified THAT!

The rheumy may have excluded RA last year - presumably on the grounds of no erosion being visible in your joints? - but things may have progressed and there are other forms of arthritis that don't always present with early erosion. And other autoimmune disorders that cause joint pain.

At the very least you should be referred to a pain specialist but I'd have thought another rheumy attempt might be worth it. Where are you?

[birthday1 in reply to PMRpro]

Hahaha, the swearing might come later 😀

Ironically I am under a pain specialist at the pain clinic who also thought going on to the Prednisolone would be my saviour! I have my re-test on Monday so I will see what they come back at this time and speak with my GP about where we go from there.

Thanks again

[birthday1 in reply to PMRpro]

Sorry, I'm in Nottingamshire

[PMRpro Ambassador in reply to birthday1]

Leeds too far????????