PMR

[KathleenJohnson107]

Just wondering if you kind people on this forum could give me some advice. Having been quite steady on 10mg for 3 months , when I tried to reduce I had my first flare up 6 weeks ago .Didn't connect it to PMR as it felt a different kind of pain to what ive been used to .I felt certain that I had cracked a rib or pulled a muscle opening a heavy sash window .So I waited a couple of weeks thinking it would get better . When it didn't I went to the doctors and had a blood test and results were that my ESR and CRP were elevated .I was advised to increase my preds but he didn't say what to . I increased from 10mg to 13mg and after a week it seemed to stabilize .3 weeks on another flare up and nit seems more painful than the last one .The pain and stiffness is unreal and seems to centre around what I believe is called my grufalo hump and also around my rib cage . My question is has anyone else had a similar experience and what dosage of preds would I need to go up to to relieve me of this pain .On sunday I increase from 13mg to 15mg but hasn't made any difference . Also my back seems very tender and sore . Would be so grateful for any advise as I feel like I am never going to get rid of this . Thank you very much . Kath x

[jinasc]

Look at the right hand side of this page Steroid Taper web application, if you find it not to your liking, email [e-mail], subject heading reduction plans. Two will be sent to you free of charge.

[DorsetLady PMRGCAuk volunteer]

Hi Kathy

Sorry to hear about your recent pain. Doesn't sound entirely PMR, and if increasing Pred hasn't helped at all, that sort of rules it out. Not entirely,ones never sure with PMR it does seem to manifest itself differently in people.

Were your original pains bilateral, or just one-sided. If one side are you sure you didn't do anything to cause, could have been something quite innocuous!

The fact that your CRP and ESR readings rise doesn't automatically mean it's the PMR, they rise through other things and the pains you describe would do that.

Have your tried painkillers, if they prove effective then it's probably not PMR.

You could try another increase, but if it's not PMR then that won't make any difference either.

I think your doctor needs to re-consider and think outside the box maybe. I'm sorry I can't answer what it is, but hopefully PMRpro may have an insight into what it might be.

[PMRpro Ambassador]

I think this sounds like myofascial pain syndrome - trigger points are formed in pairs in the should muscles, about rib level and in the lower back. They can irritate nearby nerve and lead to referred pain in the areas you describe. It is caused by the same inflammatory substances as PMR, just they are concentrated in these trigger points.

Mine is managed with local injections of steroids or lignocaine, depending on what my GP feels like using but also with physical therapy by physiotherapists or a masseur mobilising the spasmed muscles and fascia (the transparent skin you see around muscles in joints or meat and poultry). Bowen therapy also helped me a lot - as it has done for several others on the forum.

[Gaycreasey in reply to PMRpro]

Hi Kathy

The areas of your pain are very similar to my own. I am currently trying to manage on 6mgs and had been taking 3 after breakfast and 3 before bed. I am coming to the conclusion that this is too low because I have pain in my upper back, between my shoulder blades and around my ribs. I am also very fatigued, although this generally improves during the day. It is very disheartening having to increase the dosage but if it is necessary to live your life, then so be it. I was quite worried about my daughter's wedding a few weeks ago but managed on 10mgs and a large cup of strong tea to carry on until 1 in the morning! I hope you manage to find your requisite dose to alleviate the pain, or to find out if this is, in fact, something else. As someone else has suggest, Bowen therapy is an enormous help.