PMR or Something Else?

[Ronswife]

I'm seeing a new RA for a second opinion. He took X-rays and attributes much of my pain to osteoarthritis and said many types of arthritis are improved by steroids like Prednisone so how do we know the difference? I can tell something inflammatory is happening so it's not only osteoarthritis. I have been sick over two years now and have been back up to 12 mg Prednisone for months with bad pain.As I normalized I am trying to reduce a 1/4 mg at a time rather than 1% as I seem adrenal challenged. Can anyone share this experience?

[DorsetLady PMRGCAuk volunteer]

Hi,

I didn’t find my OA was helped by steroids - apart from when I was on very high doses. Once I got down to PMR type doses the pains returned, so I would suggest that many of your pains could be OA rather than PMR. I had no problem telling the difference, but maybe that’s because I had GCA only and no PMR.

Not sure what dose you are on a present, but anything above 8mg or so your adrenals are not going to think about working anyway. Plus if you’ve only been on Pred for 2 years your PMR still has some way to go, so your thoughts on very small reductions is the way forward.

[HeronNS]

I have osteoarthritis and I found ALL my aches and pains disappeared with 15 mg pred. The OA returned as the dose tapered and is quite troublesome now, possibly the worst it has been in my life. I was first diagnosed with OA over thirty years ago at age 40 but think I had some already before that. The pain of undiagnosed PMR was of an entirely different order although for the longest time I thought it was just worsening of the OA because I didn't know any better.

[yogabonnie in reply to HeronNS]

that is exactly my experience. although I am 7.5 and the OA is not nearly so bad as it was but I can feel it returning. Now if only my HAIR would return!

[peace_lover]

I too have Osteoarthritis and found that at 15mg of Pred and above ( I was on 30 mg at one point) virtually all my pain and stiffness went away, just like HeronNS. I am now just tapering to 10mg and the stiffness in my hips first thing has returned, although not as bad as it was before Pred took the PMR inflammation down.

However, my knees seem to have taken a real hammering with PMR. So - is it the PMR causing it, or is it just that they have gotten worse since I first developed PMR, which is about 15 months now? I think it’s quite complicated and varies between individuals, and it’s taken me a while to decipher which pain and stiffness is which. I’m still learning.

So, you are not the only one. Listen to your body, you know it better than anyone, even though it’s sometimes difficult to describe what you think is going on. Good luck with the new RA.

[PMRpro Ambassador in reply to peace_lover]

In some people steroids can cause increased wear of the cartilage. On the other hand - 15 years ago I was told I had OA in my knee by a lazy (and rude) rheumy. A recent x-ray found no evidence at all of OA. The x-ray cured the pain though...

[yogabonnie in reply to PMRpro]

Oh no ! I did no know about increased wear on the cartilage... I had a hip replaced before PMR and so dread a second one. I hope "some" people is a tiny tiny tiny percent? hoping hoping hoping!

[PMRpro Ambassador in reply to yogabonnie]

When I say increased - it probably makes something deteriorate a bit faster rather than anything else. Everyone is different...

[piglette in reply to peace_lover]

I was told by my orthopaedic surgeon that the steroids were causing wear of the cartilage and I needed a new hip which I now have had.

[polymy]

Hi There,

Pred made no difference to my OA. The PMR pain was very different.

Liz.

[Ronswife]

I feel the difference on OA pain and PMR pain so I hope the new RA knows what he's talking about. When my OA hurts he wants me to try an NSAID to see if it goes away

More like an experiment. All pain killers before Prednisone did not take away my PMR pain so it still sounds like PMR