PMR and rib pan

[David_H]

Hi all, My PMR started getting on for 3 years now and my main symptoms for the past year have been pain in my rib cage, collar bone and neck; rib cage pain in particular (feels like you've been hugged by a bear!) I've only been on a low dose (1 or 2 mg pred) for this time but when I saw my GP he said it was pain caused by poor posture not PMR. I've stopped the pred now but still got the pain which is there all the time day and night. I saw a physio who gave me some exercises but I'm not confident. Is this likely to be the PMR as GPs seem to only associate PMR with muscle pain?

On another note has anyone suffered with irritable bladder symptoms when taking Adcal? I stopped drink alcohol which improved matters but if I do have a pint I'm up 2 or 3 times a night and not sleeping inbetween. Urologist said may be prostatitis but I'm not convinced.

Thanks

[markbenjamin57]

Greetings David

Funny you should mention the rib cage pain, I've had something similar for a few weeks following a bout of the Flu - a feeling of 'soreness' in the sternum and radiating out to the ribs. As you say, it's there constantly - I find the pain sharper if I cough or sneeze. A recent Chest x-ray was 'Normal - no action' so that's eliminated anything nasty going on in the lungs or cardiac department (the usual worry with chest pain).

I'm not a medic but it might be something called Costochondritis - 'inflammation of the junctions where the upper ribs join the costal cartilage that attaches them to the breastbone (sternum)'. Although it usually disappears within 6 - 8 weeks, in our case it might have a link to residual PMR disease activity and / or an infection. It doesn't appear to be dangerous, only uncomfortable...

Hope this helps - no doubt the 'Aunties' and others will be along soon with their thoughts too.

MB

[David_H in reply to markbenjamin57]

Thanks Mark, I don't think I will be getting a definite answer to this. It may be suggested going back on pred to see if it works but not keen on that idea

[markbenjamin57 in reply to David_H]

No worry David - only my (amateur) guess but PMRpro is the expert on these things. Good luck with your GP and keep us posted..!

[PMRpro Ambassador in reply to markbenjamin57]

No - personal experience!!!!!!!!

[PMRpro Ambassador]

If I take my AcCal and then do not drink enough I get irritable bladder symptoms - never mind what, it is the volume of fluid that counts! It often happens if I am travelling where I end up not drinking the normal 6 cups of tea I usually get through!

The rib pain MIGHT be costochondrits but I'm not convinced - that tends to be a very sharp pain and around the sternum area. Another possibility might be myofascial pain syndrome. This is caused by the same inflammatory substances as PMR but they are concentrated in areas called trigger points, usually in pairs on either side of the sine, in the shoulders, about rib level and in the lower back wher the baby's dimples are. This can lead to tight muscles and irritation of nearby nerves which then cause referred pain in arms (from the shoulders), around the ribs and upper legs and low back. So you get a double whammy - muscle spasm in the back and sciatic-type pain in arms and legs. I also get pain into my collar bones.

Mine is best dealt with by manual mobilisation of the trigger points by a therapeutic massage therapist. They also respond well to steroid shots in the area of the trigger points. I also had a lot of relief from Bowen therapy although it doesn't work for everyone.

[David_H]

Thanks very much. Informative as ever! I will mention this to GP but I expect a blank look in return!

[PMRpro Ambassador in reply to David_H]

Now why doesn't that surprise me...

[camerashy]

Hi David_H

I too have had intercostal rib pain not nice..I remember having a liver scan and the nurse pressed so hard over my rib area I wanted to scream...I didn't though

[SheffieldJane]

Have you had further investigations for that rib pain, like an x Ray or a bone scan? I had what I called the PMR hug for long enough to find it deeply unpleasant but then concluded that I had strained something during a coughing fit. It went like so many inexplicable symptoms. Neck pain I put down to Cervical Spondylitis. The collar bone pain I thought was part of my PMR picture, it only twinges now. Yes I think the Adcal irritates the bladder, I think it is the chalky, gritty consistency of it. I don't really drink, it doesn't help me with anything anymore sadly, but I drink a lot of tea which has a similar bladder effect. But this is something you need to have proper tests for being a chap.

[David_H in reply to SheffieldJane]

Hiya, I do think it is related to the PMR as discomfort is worse first thing and on both sides of rib cage and neck.I tried not taking Adcal for a day but made no difference. Funny I hardly pee at all all day and have to get up 2 or 3 times at night even though I have nothing to drink a couple of hours before going to bed!

[PMRpro Ambassador in reply to David_H]

That may be age-related and might be worth a mention to your GP. Pred does tend to cause nocturia for some people unfortunately.

[David_H in reply to PMRpro]

Yes, prob age related. I stopped pred a few weeks ago with no change to my symptoms

[bunnymom]

After a year of investigation my rib pain turned out to be due to spinal issues and not pmr. One sided shoulder pain was a bulging disc. Two steriod shots in the spine and pain is gone. Greatly helped me sort out my pmr pain