Wear and Tear

[rosie41]

I saw my rheumy yesterday and he said my pains might be due to wear and tear and not polymyalga . I have had it for 3 years now and down to 4m )g of pred and on methertrexate . I am not a happy bunnie as that is no help to me. Does that mean that excercize e is not good for and causes it. (please excuse spelling )

[HeronNS]

Wear and tear? Does he mean osteoarthritis? If so, then you must continue to exercise and maintain your range of motion and strength as much as you can. Osteoarthritis will respond to ordinary nsaids although it is not a good idea to take them as they actually inhibit cartilage regeneration. If you find you have much less pain if you take something like aspirin or Aleve, then your doctor may well be right about the cause. But don't use them regularly if you can help it. I've had OA for over thirty years and very early on learned about what aspirin (and later the other nsaids) would do, so went against my doctor's suggestion to take coated aspirin to relieve the pain. In the ensuing decades OA has progressed, but very slowly. Now that I'm at a low dose of pred I feel the OA much more. I had a migraine the last couple of days and took aspirin for that, and I'm virtually painfree today!

[PMRpro Ambassador]

They have a fixation with "wear and tear" - they offered that as an option to me when PMR started 14 years ago. I'm better now than I was then! Some was PMR. other stuff was muscle spasm in my back. Not sure what he's complaining about if 4mg pred keeps you OK.

But as Heron has explained - exercise is good and you should perhaps ask for a physio appointment to see if there is any muscle involvement as well as suggestions for suitable exercises that will help rather than harm.

[DorsetLady PMRGCAuk volunteer]

“Wear and tear” is a cop out! Bandied about when either they don’t know, or you’ve passed a certain age!

Gentle exercise is good. Look at the new arthritis web - got some good info

arthritisresearchuk.org

[PMRpro Ambassador in reply to DorsetLady]

The certain age isn't very high! It was bandied about when I was 51!!

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

I didn’t specify what age! Probably depends on the age of the medical bod!

[Hidden in reply to PMRpro]

As a message my GP left for me in the Results Book ~ “Nothing you wouldn’t expect for someone of my age!”

Oh Boy, did l give him both barrels when l saw him!........

And l asked for a copy of the X-RAY Report as it’s my back!

Funny, he never mentioned ‘age’ again!........

[Roy46 in reply to DorsetLady]

Good advice from Dorset Lady and PMRpro, as usual.

Rheumatologist says there's no sign of rheumatism, so cop out diagnosis seems to rule supreme, so may have to opt for private physio to get a genuine answer.

[Grants148]

I think that we are all bound to get a few aches and pains as we reach our seventies,but PMR is far worse and the pain can be really severe,and if prednisolone relieves that then l think it must be PMR.lt is important to ‘ keep moving’ with arthritis,and gentle excercise is something that we should all do if possible.l am surprised how many people l come across who have never heard of polymyalgia,and l think that a lot of doctors do not understand it either.

[Margaret1951 in reply to Grants148]

When I have been hospital and explained about PMR and GCA they look at me with a blank look !! Surely the amount of people with this they should know by now. I had to go doctors last night as been quietly in serious pain in hips for about 6 weeks now and got worse. Because of how I explained to him and that I upped my preds from 10 to 15mg with no effect he is 99% sure the osteoporosis I have - well - may have to have both hips done 😭😭 but I have to have X-rays next month to confirm this, my God I don't need anything else !!!!

[PMRpro Ambassador in reply to Margaret1951]

I know a couple of people who had hip replacements and subsequently were able to get off pred - it was as if the pain of the OA "fed" the PMR.

[Margaret1951 in reply to PMRpro]

Wow, that's sure given me some hope PMRpro ! do you know how long in hospital they were as I don't like hospitals and were they a success . I took my 2 chihuahuas out not long ago in the field behind me and honest to God I don't know how I got home with the pain and struggled to walk home !! Why is God punishing us good people and not the killers !

[PMRpro Ambassador in reply to Margaret1951]

Is the doctor sure it isn't trochanteric bursitis? That is commonly part of PMR and does respond well to steroid injections (done properly). Oral pred takes months to work unfortunately.

But osteoporosis doesn't usually have that sort of effect. OA maybe...

[Margaret1951 in reply to PMRpro]

I actually did mention that to him 😱 But he wants to be 100% sure with the hips first as my Densa scan did confirm early in year I think it was that my left hip was bad now it's both. Yet my muscles from knee up are so sore inside but upping to 15 mg did nothing. I can hardly get upstairs on my right hip, feel like a 100 year old ! 😂😂 if I don't laugh I will cry again so trying to stay on top of all this.

[piglette in reply to Margaret1951]

You sound like I was. I had just one hip replaced though. My orthopaedic surgeon wanted me to get off pred, we negotiated 5mg in the end. I think they want to minimise risk as much as possible so go for gold.

[Margaret1951 in reply to piglette]

Wow ! That means only low dose of preds then ?? How long were you in hospital for ???

[piglette in reply to Margaret1951]

I think most orthopaedic surgeons will go up to 7mg some higher, I think if they have not had problems in the last, it is just they are worried about infection and slow healing. I think they try the zero pred as starters to see your reaction!

[Margaret1951 in reply to piglette]

Does the body not react though without preds ??

[piglette in reply to Margaret1951]

They are worried silly about infection which can be pretty nasty if bones are exposed it seems, and pred can cause this to be more likely. I think the higher the dose the more chances of problems.

[Grants148]

Dear Margaret,l am sorry you are having such a bad time and in so much pain.l hope that you will be given the treatment you need and that you will then feel much better,it is obviously going to take time but l hope that there will be a great improvement for you ,please keep posting to let us know how you are getting on xx.

[Margaret1951 in reply to Grants148]

This is very strange now, I have rested all afternoon because of the pain, decided to take dogs out as I was fed up. I got up off sofa and and and the pain in right hip had almost gone !!! ?????????????? Why ! So I actually walked round the football field without limping or pain ! Can't believe it, but will wait to later 😱😱 first time in about 6 weeks, think I am jumping the gun, yes ??

[Grants148]

Margaret l find that resting can improve the pain and stiffness in my legs,we just have to pace ourselves and not do too much for too long.The trouble is when there are things that need doing it is hard to stop and rest,l do not like wasting time and just sitting around but it is the only way of hopefully relieving the aches and pains.l find that checking out the posts on this site gives me a chance to have a rest,and the time is not wasted ,and of course there is always knitting or a book to read.lhope that things continue to improve for you ,l find that some days are worse than others.