Good morning ,
After reducing from 10 to 9 last week , got a pain in my hip on one side , went back up to 10 the next day, but the pain is still there. Could this be something else, or am I having a flare.
I have been doing a lot more with grandchildren, so maybe I've just done too much.
Would be vey grateful for any advice.
Thank you .
Hi there. Pain on one side is unlikely to be caused by polymyalgia. I know it is all too easy for us to blame pmr for all our aches and pains. As you had only just reduced your pred I personally wouldn't have increased it straight away. In the past I have done similar things but have come to realise that without asking for a blood test to see the inflammatory markers it is best left alone.
Hi Manchesterlady
Like polymy said it's all to easy to blame PMR for every pain. Are you still back at 10mg if so come back down more slowly or even to 9.5mg. As you say you may have done something to it, did you try a simple painkiller to see if it eased the pain? If it still persists see your GP
I hope it improves & good luck with your reduction.
Mrs N 💅🏼
Hi, I have also suffered hip pain when reducing steroids. It is only the right hip, but it is more stiff than the left, and then it can interfere with walking in that you feel as if your leg is going to give way. On my last rheumy visit I mentioned this and he immediately said "oh bursitis" I'll give you a steroid injection which will then enable you to continue to reduce. Although i was not too sure about having this, it was done and the pain and stiffness have eased. I'm not holding my breath though, as I know this steroid reduction mullarky is a long and tortuous road!!
I agree with the bursitis comment as I had been diagnosed years ago for hip pain on one side. This went quiescent for years then reappeared after GCA and pred intake. Even 2 years after reaching Club zero it. Is still evident until my prescribed painkiller kicks in. Now it is more joint pain in general so I think it is just a legacy we must live with as payment for saving sight in the remaining eye! Hope you are luckier and avoid the worst scenario as we are all different in our reactions to coming off pred. Good luck and keep on reducing!
Could it be trochanteric bursitis? That was part of my PMR originally and took months to fade with oral pred. I have had flares of it since - usually from standing "wrong" to trigger it but then from using the joint. It is after all a bit difficult to not use your leg!
As the others have said - a targeted injection will work wonders usually if that is what it is. In the meantime - icing may help. There are also physio exercises to do that supposedly help. I'm sceptical however.
Usually in my experience flares are Bi-lateral , but i guess everyone is different to a certain degree, I get pain in both hips and back when reducing , I keep being told it's osteoarthritis , but i don't think they really know. Good luck
Thank you for your prompt replies.
I am still taking 10mg , but will do 9 1/2 tomorrow as suggested by MsNails .Will try to see my doctor before my six week blood test , won't hold my breath though.
Had to go for a c t scan today for my repeated urinay infections , and to check for kidney stones .
Absolutely exhausted today , feel as if I'm loosing the plot with all this lot .
I was never ill before I started with p m r , now it's one thing after another.
Sorry to moan , just feel very down at the moment
My hip pain, which I originally treated by upping the preds again as advised by my GP, turned out to be trochanteric bursitis when I went back and saw a different GP in the same practice and was sorted with a steroid injection. Looking back it was a specific pain and I could almost point to the location, and it was unlike the general stiffness I had before going on steroids. I wonder if there is a link between bursitis and PMR as I also have it in one of my shoulders and many people mention it on here, or could be just coincidence?
Bursitis is part of PMR - many studies using MRI have shown it to be present.
Shoulder and hip bursitis are particular typical. If PMR is identified fairly quickly then the oral pred dose is generally enough to calm it down - I had trochanteric bursitis in the 5 years the PMR wasn't recognised and it got very painful, I couldn't walk far at all and was quite convinced it meant a hip replacement! After about 6 months on pred, albeit the entire time at not much less than 15mg, it did go away. It returned after a major flare a few years later but was immediately dealt with using steroid injections (they don't mess about here in Italy!). I've had one slight relapse - again a steroid injection stopped it in its tracks.
Tendons don't have a good blood supply which is why it takes a long time for oral pred to work when they are inflamed and why raising the dose is a very inefficient way to deal with it. A local injection floods the area with pred and works better and faster. The trouble often is that GPs are scared of pred and even more so of injections!
To show how much it has been looked at in studies, a review paper on imaging techniques in PMR in 2011 said:
"Objectives. Imaging is one of the most appealing techniques to explore PMR, a disease whose causes, development mechanisms and anatomical targets of inflammatory damage are still scarcely known. This review is concerned with an appraisal of PMR with different imaging modalities with a view to highlighting possible clues to its pathogenesis, diagnosis and prognosis.
Methods. A systematic literature research was performed searching PubMed until July 2010. The Cochrane Library was searched for the relevant reviews, and the abstracts of the ACR and European League Against Rheumatism congresses of the period 2005–10 were reviewed.
Results. A total of 1059 papers were retrieved, 46 of which were selected at the end of the review process; 6 of them were concerned with two different imaging techniques. Of these papers, 6 (11.5%) were concerned with conventional radiology; 8 (15.4%) with scintigraphy; 17 (32.7%) with ultrasonography (US); 15 (28.8%) with MRI; and 6 (11.5%) with PET. MRI, US and PET appeared to be the most promising imaging techniques. Bilateral subacromial bursitis, biceps long head tenosynovitis and trochanteric bursitis were particularly consistent findings. In addition, MRI and PET showed interspinous bursitis and PET frequently showed large-vessel vasculitis. Few papers have addressed the role of imaging for diagnosis, differential diagnosis and prognosis of PMR.
Conclusions. Imaging plays an important role in the comprehensive evaluation of PMR, including its pathogenesis, diagnosis and prognosis. Most of its potential is still unexplored, which fact should stimulate further research."
However - the imaging is rarely indulged in during diagnosis. It's a shame it isn't because I suspect if it were they would find a few things, particularly the amount of pain-causing inflammation would surprise them and so would the amount of large vessel vasculitis in patients with "just" PMR.
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