Flare? Advice : Hi all have had PMR for just over... - PMRGCAuk

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Flare? Advice

kate1978 profile image
17 Replies

Hi all have had PMR for just over 5 years and was doing well, but seem to be stuck at 3 mg trying gradually to get down to 2 and a half

I've been really busy in the garden for the last 3 weeks or so, digging out old shrubs, dividing perennial plants, taking stuff to the tip etc, I started with painful wrists, something I have never experienced before with PMR. Then the neck shoulders and arms, I was reluctant to up my dose of pred, but pain relievers didn't touch it, so took 4 mg on Wednesday, then 5 yesterday and this morning, still no relief .

Do you think I should increase the dose by more? I had forgotten just how painful this Is and it's making me utterly miserable. Thanks for reading and would welcome any advice

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kate1978
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17 Replies
DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Hi,

PMRpro is really the expert in this - I had GCA and fortunately no flares, but I would suggest a short sharp increase to maybe 7.5mg for a few days to get a grip of things - then drop back down to 5mg staying there a bit longer (a week to 10days) and depending on how things go, a staggered drop back down to 3mg may be on the cards.

The garden and the good weather has a lot to answer for!

kate1978 profile image
kate1978 in reply toDorsetLady

yes it's looking like I may have to do just that, thank you

PMRpro profile image
PMRproAmbassador

Your muscles remain intolerant of certain activities despite the pred - it is just managing the inflammation that the underlying autoimmune disorder causes and that continues attacking your body in the background despite the pred. So - if you do too much, you will suffer what is called delayed onset muscle soreness (DOMS) and it will probably be worse than you would expect and also last longer. Unfortunately - pred isn't likely to help. This is the equivalent of running a marathon without having done the training I'm afraid.

You could try a couple of days at 10mg and see if it helps relieve the pain but to be honest I doubt it somehow. Just time and rest. And in the future: pacing and resting as much as you work...

kate1978 profile image
kate1978 in reply toPMRpro

Hate to admit defeat but I will try that thank you for your reply

PMRpro profile image
PMRproAmbassador in reply tokate1978

Not defeat - realism. A learning experience.

PMRCanada profile image
PMRCanada in reply toPMRpro

I learned the hard way to. I think that is what is happening with my current physio strengthening exercises as I try to build up strength in my quads as recommended my my Ortho surgeon. He suggested it (along with continued weight loss) to help with my knee issues. Alas, I have had sore quads and hamstrings this last week I believe due to increasing the repetition of the assigned exercises. I will discuss further with physiotherapist next week, and in the meantime cut back the exercises. (sigh)

PMRpro profile image
PMRproAmbassador in reply toPMRCanada

Squats for thigh muscles always make my quads sore if I do more than about 5 at a time. Long gone the days of a 100 before breakfast...

Telian profile image
Telian in reply tokate1978

Exactly as PMRpro has said, I've experienced the same recently and increasing the pred wasn't that helpful but resting from the activity that caused it has. Take a higher dose if you wish then you can come straight back down after a few days even one - it's just another learning curve of getting to know your body, try not to be too disheartened, I had to give up aquarobics for the same reasons and it's been quite a few weeks and I'm still getting there.

SnazzyD profile image
SnazzyD

Hello, I only have GCA but have really noticed after 18 months of Pred that although the muscle wasting has greatly improved, they really complain if I do anything extra like a gardening frenzy. During the hot spell I was lugging can after can of water up the garden every evening. After about 4 weeks I thought I had PMR. Nope, it was my muscles just not being up to the job. I stopped and the pain went away after a couple of weeks total rest. Have done it again now that the ground doesn’t need explosives to make a hole in it and I can get at the weeds, though it wasn’t as bad this time. Anyway, just a thought.

kate1978 profile image
kate1978 in reply toSnazzyD

Resting isn't something I'm good at, but I will have to accept defeat, the weather isn't good for gardening now anyway, all the inside jobs which have piled up will have to wait!

PMRpro profile image
PMRproAmbassador in reply tokate1978

Resting doesn;t have to be doing nothing - you just have to use different muscles, letting the others recuperate.

Grants148 profile image
Grants148

Hi Kate,l have done the same as you,quite happy on 3 mgs.,then overdid jobs in the garden and had bad PMR flare up.l have increased my dose of Pred., to 5 mgs.,it has taken about three weeks to feel much better.l am not sure now when to go down 1/2 mlg.lf your pain is not responding on the 5 mlg., dose ,Dorset Lady has posted to increase to 7.5;mlg.,and l,would go to that dose first and then down to 5 mlg as she has advised.l,hope you will feel better soon.

kate1978 profile image
kate1978

You live and learn! It's good that we can have advice from each other on this site, I think I had got too complacent

David-42 profile image
David-42

Hi Kate. I am on exactly the same dose of pred as you, currently on a DSNS reduction to 2.5 and, like you, with lots to do in the garden. Nearly all my jobs in the garden involve the shoulders one way and another, so I have had plenty of time, over the last three years of PMR, to try to solve the problems this raises. Early on in this journey I realised that, for me, there is a world of difference between the aches and pains due to DOMS and the debilitating pain radiating through my body when the inflammation takes over. So, although I try not to push myself too hard, I have become used to living with the temporary DOMS aches etc, which ease and disappear after a spell on light duties. This last week, with the approach of storm Callum, I had three full on days in the garden followed by the inevitable aches and pains, but which have now resolved after three days of weather induced indoor activities. I have never increased pred in an effort to resolve DOMS. I suspect no two people with PMR react in exactly the same way in all circumstances, but this approach works for me. Keep enjoying your garden and maybe, when you and I reach zero pred, we can look back and see that the post garden ache was worthwhile.

kate1978 profile image
kate1978 in reply toDavid-42

Hi David because the spring was very wet and the summer was very dry I had a lot of catching up to do in the garden, as well as digging and separating, I planted 3 new roses and 3 new shrubs and lugged bags of compost from the garden centre. Have put lots of new bulbs in and still have some more to plant

I expect I have been very lucky until now as I've only had little niggles when trying to reduce to 2 and a half

This time it has really hit me!

Thanks to the advice on here I have taken 7and a half for the last 2 mornings and it feels a touch better today, but I'm taking it easy

David-42 profile image
David-42

Glad to hear that the pred worked and hope you are back on track before too long.

kate1978 profile image
kate1978 in reply toDavid-42

Thank you

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