Advice for a friend

[Brixhamhampster]

A friend of mine who also has Polymyalgia has asked me to pose the question why he should be fine all day but then gets a lot of pain at night. He is on 5mg. Has anyone ideas as I do not experience of this and can’t offer him any advice. He is no good with computers so can’t ask for himself.

[PMRpro Ambassador]

When at night is the pain? Is it in the early morning, say 4am or a bit later, or is it significantly earlier than that, 2am or so? And if he is OK during the day - does getting up and getting going make a big difference to the pain?

[Brixhamhampster]

Thank you PMRpro for getting back to me and I have asked him the questions you raised. The pain starts about 2am and goes on all night but when he gets out of bed in the morning after putting the kettle on and drawing the curtains etc it all clears and he is fine for the rest of the day. Then at night it starts again.

[PMRpro Ambassador in reply to Brixhamhampster]

Then I think he should ask his doctor to consider whether he may not have PMR at all but something called ankylosing spondylits, because that pattern of pain is quite typical.

They are easily confused in the early stages and I know a few people who were told it was PMR when it was actually AS. For some people the question turns up quite late because they struggle to reduce their pred dose. Naproxen is often effective - and as you know PMR doesn't usually respond to NSAIDs so he could try that to see if it helps. That would add to the suspicion. Was his PMR diagnosis made by a GP or did he see a rheumy? My rheumy was determined to make my PMR AS and was quite put out when he could find no evidence!

There is a choice of 5 TNF factor blockers as well as another biologic I think.

mayoclinic.org/diseases-con...

arthritis-health.com/types/...

Do let me know what your friend thinks of this.

[Brixhamhampster]

Thank you PMRpro I will pass this on to him. You are such a help.

[yogabonnie]

interested in this post.. let us know what he says...

[Brixhamhampster in reply to yogabonnie]

Certainly will yogabonnie. I am hoping to have a chat with him today.