First Rheumatologist Appt

Sept of 2016 I went to a orthopedic surgeon thinking I would need surgery on my left shoulder MRIs were done X-rays were done only to find nothing when tests were done such a sedimentation rate at cetra they were slightly elevated I was put on 45 mg of prednisone to date I am taking 22 mg of prednisone saw the rheumatologist today she thinks it's not PMR because they were only slightly elevated she has put me on gabapentin and wants me to stop Ambien and once the Gabapentin is increased begin reducing the prednisone even further I'm in so much pain right now I am taking Tramadol 4 times a day since this was my first appointment I didn't want to be too assertive aggressive but I think she may be on the wrong track however I'm not a physician any feedback would be great thanks everyone

4 Replies

I am so sorry that you are suffering so much. That's a really high dose of Prednisalone to be put on for PMR and if you experience no relief from your pain it's unlikely to be PMR. If Tramadol is relieving your pain that is another contraindication for PMR. What a depressing puzzle your shoulder pain is. I hope someone comes along with some knowledge or experience that helps you. The more drugs they give us, the more confusing the symptom picture is too.

I agree that your physician seems on the wrong, or no clear track. Any chance of your getting a second opinion.

I hope this resolves soon, in a good way.


If you have that much pain while still on 22mg of pred and Tramadol helps - the chances are it isn't PMR. As I think we said to you somewhere else - ordinary painkillers very very rarely do anything for PMR as they cannot combat the inflammation enough to get a result. The trouble with starting patients on such a high dose as 45mg is that that will help a LOT of things, PMR is quite characteristic in responding at least partially to a moderate dose of pred (15-20mg). However, she is wrong about her conclusion that it isn't PMR because the markers are only slightly elevated - about a fifth of patients with PMR and almost as many with GCA don't have even slightly raised markers.

If it is just your left shoulder that is so bad and nothing shows on MRI or x-ray it could well be muscular. Myofascial pain syndrome can really hurt quite locally. If you have a muscle problem it won't show up on an MRI or an x-ray so the doctor may not suspect that.


I am so tired of doctors. They are not so good at diagnostics. I have many symptoms which should fit together like a puzzle. I have throbbing under my shoulder blade. My left arm is useless and it feels like I am laying on a sharp rock on my back. I wake up with my left side and face tingly and numb feeling. Pain is unbearable with or withou pain meds. I am miserable most of the time certainly no way to live.


Has anyone checked your BP in both arms? If your left arm is useless - that could suggest something called subclavian steal syndrome, The BP in your left arm would be much lower than in the right. It may not be - but it should be checked by someone.


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