PMR - MORPHING TO RHEUMATOI ARTHRITus: Good morning... - PMRGCAuk

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PMR - MORPHING TO RHEUMATOI ARTHRITus

Sue_n profile image
4 Replies

Good morning,

I wonder if polymyalga can morph into Rheumatoid Arthritus, and if that would also affect the joints in the ankle and shin. I am on 5 mg predisnole, just been reduced. Have seen a rheumatologist, who says it is my back. My ankles have both got bumps on the main ankle bone. Nobody seems to be listeneing, and I can hardly walk.

Has anyone had experience of this please.

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Sue_n profile image
Sue_n
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4 Replies
SheffieldJane profile image
SheffieldJane

Good morning Sue. I am sorry that you are surrounded by people who are not listening. I am not sure about PMR morphing into RA, but I do believe everything is connected. PMR does not give you immunity from other conditions alas. As we reduce the Pred there is often the return of old arthritic pains. Did you experience a period of relatively pain free mobility in the early days of Pred ? If so you may have reduced too far and PMR is making itself felt with a vengeance.

Where are you? Is it possible to see a Rheumatologist who actually gives a d*mn?

HeronNS profile image
HeronNS

Hi Sue, so sorry to hear you are having such difficulty. Sometimes the original PMR is rediagnosed as something called late onset rheumatoid arthritis, or it has developed separately. I don't think polymyalgia leads to RA. Your rheumatologist should be taking you more seriously, has s/he run any tests? I also was wondering when these symptoms started? As Sheffieldjane said, the pred reduction may have something to do with it. How fast, or slowly, have you been tapering the pred?

I don't see how back problems could cause joint swelling, although compressed nerves in the spine can cause some surprising referred pain.

PMRpro profile image
PMRproAmbassador

It isn't known if PMR "morphs" into RA but it isn't uncommon for someone to first be given a diagnosis of PMR and later have it changed to RA, especially Late Onset RA. They are different though - RA is a disease of the joints while PMR is a vasculitis, due to inflammation of blood vessels.

If the rheumy thought you have PMR, a moderate dose of pred helped and he now says your problems are due to your back then he could well be right. A condition called myofascial pain syndrome causes back muscle problems which in some cases then cause referred pain to your arms and legs. It is more common in patients with PMR, often responds well to higher doses of pred and then returns as the dose falls.

As SJ says - as the dose falls we also tend to develop other pains because, let's face it, we aren't any younger! I doubt that bumps on your ankle bones are signs of RA - though, never say never. Did you have any tests for RA?

Admiral06 profile image
Admiral06

Hi Sue_n, While my ankles and shins have been OK (so far), I began to experience pain in my shoulders, hands, and wrists (at a slow taper) when my dose fell below 3.5 mg. I first thought these were PMR symptoms returning, but now believe they are from steroid withdrawal. It is well known that tapering too fast can bring on such problems, but according to the Hospital for Specialized Surgery in NYC, some patients can get joint pain even at a slow taper. And apparently this pain can last up to 3 months after the steroid is discontinued. I have also seen this condition referred to as "steroid rebound" which is explained as the body's exaggerated response to removal of the drug. I suspect this is just a fancier name for steroid withdrawal, but whatever the name, it can sometimes be a challenge for the patient or physician to differentiate between withdrawal symptoms and a flare of the disease itself. While several others have reported stabbing ankle pain while tapering, your shin pain seems unique. Good luck to you; PMR and steroids are a real adventure!

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