Pulled muscles or PMR pain?

Hello everyone,

A quick question if I may.

I'm 7 months post PMR diagnosis and reducing prednisolone ( now down to 8mg ) and in general feeling ok. However I've noticed recurring pains across the top of my shoulders ( above the collar bones ) that feels like a "pulled muscle" yet I have no recollection of actually pulling a muscle. Is this a PMR symptom/pain or completely unrelated?

Thank you

15 Replies

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  • Could be either! However if it's both sides then more likely to be PMR. You don't say what dose you started on, but I guess 15mg.

    You say you haven't had any problems so far, that's good, but you may have now reached the level of Pred that is only just controlling your inflammation, and if so then you need to be careful that you don't drop below it.

    You are also reaching the level when your own adrenal glands need to start working again, up until now they have been suppressed because the Pred has produced the chemical equivalent to adrenaline. It's acknowledged that your own body produces an amount that is equivalent to about 7mg, so your body is getting to that transitional period.

    If it's a pulled muscle then taking an OTC painkiller may help, if they have no effect then more likely to be PMR.

    Whatever, suggest you stay at 8mg for a while to see what happens. If pain remains you may need to speak to doctor about increasing dose.

    If everything okay, then suggest you reduce by only 0.5mg and use a slow plan in future.

  • Thank you so much. What a detailed answer thank you for taking the time to reply. First diagnosis of the suspected PMR got me 30mg pred but only for one week. Confirmation of the PMR from rheumatologist saw me start on the 15mg dose as you correctly stated. You've taught me somethings I didn't know (nor was really made clear by the rheumatologist) so thank you so much for that it is really helpful.

  • Difficult to say - but in the meantime, treat it as a PMR problem, stick where you are and be a Precious Princess for a few days and see if it improves!

    I had some strange pains just above my collarbones but they eventually went away.

    And otherwise - I echo DL ;-)

  • Thank you PMRPro. I did have a bit of a hectic weekend and laid off the pain killers as I was having a little drink so maybe that's all part of it too - as well as what DorsetLady has kindly replied. I'm back on the Tramadol now so hopefully this shoulder pain will kindly do one now!!! Thank you.

  • Hi, why are you taking painkillers such as Tramadol? If it is for the PMR it will not touch it, if it is for something else fair enough! If the Tramadol helps the shoulder pain it is unlikely it is caused by the PMR.

  • Hi piglette and thank you for taking the time to reply. Interested in your comment that tramadol will not touch PMR..is that a medical assessment? I find taking a low dose at bedtime stops me from waking up stiff as a board the next morning! ( especially in my shoulders ) Is that my PMR or simply old age lol? Anyhow...it works for me. Thank you again

  • Medical? Probably experience. It is very rare for anyone to get any benefit for PMR using pain killers of any sort and the most recent recommendations advise against using NSAIDs at all for PMR. Tramadol of course isn't an NSAID - but a narcotic drug with the associated risk of dependence. And it is very likely to cause constipation amongst its side effects.

    But as piglette says - if tramadol helps, I'd be suspicious the pain wasn't PMR-related but possibly mechanical.

  • I had/have pain just below the collarbone, particularly when I sneezed. The physical therapist said the muscles were tight due to how I was holding my shoulders pre diagnosis. I went about 6 months without one and lost a lot of range of motion. I was given some stretches and life is better when I do them on a regular basis. If the pain doesn't sort itself out, I would talk to the doctor about them, before it becomes an issue.

  • Thank you. The pain is quite random and can be in either shoulder and apparently unrelated to anything I've done hence my question if it was the PMR. I'm suspicious it is more likely to do with my reduced pred dosage and what DorsetLady clearly explained. Ho-hum.......onwards and upwards (?....)

    Thank you again.

  • Hi MrsMac03

    Sorry to hear about your shoulder/s; if you've had PMR for a long time you instinctively 'know' if it's PMR or something else, or at least l do. As I said earlier in the week it's all too easy to blame PMR for every ache or pain we get. I have a shoulder issue at the moment & l know it's not PMR I'm having a scan on 14th to check if my shoulder is impinged, as I can make certain movements but not others, I had the same issue on the other shoulder pre PMR

    If your shoulder/s don't improve & its 'random' pain, l suggest you get your GP to check it out for you.

    Best Wishes

    Mrs N

  • Thank you MrsNails - I'm only 7 months in to PMR since formal diagnosis so still learning about it all and how my body is reacting/adjusting/coping. Some trial and error and I think I've been too quick sometimes to shrug off new random pains as general aches rather than attributing them to PMR.

  • Thank you MrsMac03 for raising this question because I'm aching around my hip area which is where my PMR was really bad on diagnosis 10months ago. I'm down to 8mg and should be reducing but decided to stay put for now as I am away next week. My blood test last week was in the normal bracket so I'm surprised at the pain!!

    THank you for all the comments from Dorset Lady and PMRPro all most helpful as usual. I do follow this site but don't comment very much.

  • Thank you RDy72 for taking the time to comment - I'm a relative "PMR newby" too ( just 7 months since diagnosis ) so still learning too. I hope you feel better for your time away next week.

  • This is my worst area of pain and has been since I was diagnosed the second time with PMR in 2015. It affects my neck as well. I massage my shoulders every night before going to bed with some relaxing oil. It helps. Massage in general helps.

    Janll

  • I'd suspect the possibility of myofascial pain syndrome affecting your shoulder muscles in particular. A good massage therapist should be able to identify the trigger points in the muscle - they are felt as hard knots of inflamed muscle fibres - and should be able to use manual techniques to disperse them. I've had steroid injections into the area too - they are concentrations of the same inflammatory substances that cause PMR - and that is faster but you need a compliant doctor to do that.

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