Dizzy? Not breathless but..

[Peggles]

Hello all. I'm also new and hoping my PMR diagnosis is incorrect....

I'm 51 and had the terrible shoulder pain and inability to raise my arms above shoulder height before Christmas. I also had flu like symptoms, and had self diagnosed Costochondritis because of pain in my sternum.

I went into a bit of a physical breakdown and finally visited my GP who has given me this diagnosis as well as hypothyroidism, and very low vit D. I've had a chest X-ray for the sternum pain, and because I can't take a deep breath and get breathless and dizzy after relatively little effort. I've also had a CT scan which has not shown anything.

I'm on 15mg of pred, down from 20, and this instantly removed the shoulder pain, but my chest is still uncomfortable and I am so horribly dizzy and fatigued. Previously to this I was a fit, active woman so it's all a horrible shock.

Anyone else dizzy? Unable to take a deep breath or even sigh comfortably?

[Celtic PMRGCAuk volunteer]

Peggles, has GCA (a linked condition to PMR) been ruled out? If not, perhaps it would be wise to ask your GP to refer you to a rheumatologist for further investigation. The inflammation of PMR can cause pain in the muscles of the chest area - I know that from experience. But GCA can affect the arteries in that area also, and a higher dose of steroid would be needed to tackle the problem if that were to be the case. If you experience any sudden change in vision or head pain, then get checked by your GP or ophthalmologist immediately - at A&E if that's the fastest route.

[PMRpro Ambassador]

Yes - I agree with Celtic, GCA could be a possibility and a CT alone wouldn't have shown it. I had a flare last January where i was suddenly breathless and dizzy if I tried to do more than a slow walk on the flat. They couldn't find anything to account for it so it was decided it was almost certainly due to some inflammation in the chest arteries. 15mg did the trick for me though - and here I don't think I entirely agree with Celtic, you don't necessarily need a much higher dose for GCA except for the case where vision is affected because small arteries in the head are involved. Then they use the high doses to try to avoid the threat of loss of vision. The large vessels in the chest are big enough for that not to be a problem, it will just take a bit longer perhaps. The local specialists here when I live are of the opinion that 15-20mg will deal with most things.

Were you any better on the 20mg dose? Did it make any difference to breathlessness and how long were you on it?

[Peggles in reply to PMRpro]

Many thanks. Yes I have been on 20mgs for a few weeks and it didn't help the breathlessness or sternum pain which is why I was put on 2 week pathway and had X-ray and CT.

[TooSore]

Just a thought - I lost shoulder mobility when I began this journey and after a few weeks of steroids I was approved to do some gentle PT, stretching and massage, not strengthening and exercising. The doctor was very particular about who I saw as not all physical therapists are ready to deal with PMR. The reason I mention this is I complained to the therapist that my chest hurt terribly when I sneezed. She said it was due to tightened muscles going into a spasm, I had held my shoulders in a position for so long due to the pain/stiffness that I now have to stretch the muscles across the front, below the collarbone.

[PMRpro Ambassador in reply to TooSore]

Yes - sounds about right. What a good doctor you have!

[TooSore in reply to PMRpro]

I've had my share of both kinds. This was a physiatrist (functional medicine) who diagnosed me and sent me on to a rheumatologist. I did not have a good experience with the first one but like my "new" one.